NEW DELHI: Vietnam, as the chair of the Association of South East Asian Nations (ASEAN) in 2020, convened a special ASEAN Summit online on Tuesday (Apr 14) to discuss the situation of health and COVID-19 across the member nations.
The original ASEAN Summit, scheduled for Apr 6 to Apr 9, had to be postponed until end-June due to the COVID-19 pandemic in the region.
SPECIAL VIRTUAL SUMMIT
As expected, healthcare issues dominated the online meeting since it has assumed primacy in the current pandemic scenario, and will likely be a key agenda item when the summit is held in June.
Since COVID-19 broke out in the region in January, ASEAN members’ response to the virus has been scattered.
Some, like Singapore, have been lauded for their pro-active and calibrated approach whereas others, like Indonesia, have been slow to react resulting in fatalities numbering in the hundreds.
The capabilities and capacities of each ASEAN country to deal with the virus also differs. Developing states like Laos and Cambodia have less healthcare infrastructure and expertise than others like Malaysia for instance.
That explains why Tuesday’s meeting stressed on deeper collaboration and a joint response to the coronavirus.
While there was a tendency among countries to look inward and close borders until now, the leaders urged that coordinated movement across the region would actually be of greater help in sustaining the economy, ensuring proper functioning of the essential and health services, and delivery of food and medical supplies among the member nations.
“It is critical for ASEAN to mount a united response, because of how connected and interdependent we are,” Singapore’s Prime Minister Lee Hsien Loong said at the meeting. “Therefore, none of us in ASEAN can be truly safe unless the entire region is safe.”
UNEVEN HEALTHCARE LANDSCAPE
While the need for regional collaboration is important, the coronavirus has exposed the weak and uneven healthcare systems within ASEAN.
This disparity will make any regional cooperation on health difficult and these challenges will appear from now until the June summit.
On average, according to the World Bank, there are 0.8 doctors per 1,000 people within ASEAN. But the picture is different in each country with there being 2.3 and 1.8 doctors per 1,000 people in Singapore and Brunei respectively. At the other end of the spectrum, Laos and Cambodia have each less than 0.5 doctors per 1,000 people.
Clearly, the capacity gap means that some sharing of resources and expertise in the short-term during the pandemic will be helpful to lower the risks across the region.
But the gulf in capacity also means that any meaningful sharing will be limited. How would the likes of Singapore and Brunei increase the number of doctors in other parts of ASEAN for instance when their resources are fully utilized in fighting their own COVID-19 battles?
A structural transformation is needed in some member countries to be able to adopt similar combat mechanisms against the coronavirus. Otherwise the varying health facilities and people-to-doctor ratio among the ASEAN members makes it difficult to devise uniform functional health approach, particularly for COVID-19.
Even if capabilities and infrastructure are upgraded, there is however the issue of affordability of healthcare in many countries.
The out-of-pocket healthcare expenditure in the region is at 44 per cent, but in some countries like Cambodia and Myanmar, this is as much as 60 per cent and 76 per cent respectively, according to World Bank’s data for 2017.
No wonder, health security firm Metabiota points out that there is “systematic underfinancing” of healthcare in the region.
There is a need for ASEAN governments to allocate greater amounts to healthcare budgets and share expertise with each other, as countries like Singapore have near universal health coverage. Specifically, the World Health Organization (WHO) suggests building up disease surveillance, diagnostics and response capacities.
Health tech firms could ease the inequalities as much of the diagnostic services can be improved drastically through advancement in technology and digitisation.
Vietnam, as the chair this year, can pitch the idea of Southeast Asia as a major venture for investments by health tech firms but this will be a longer-term proposition to prepare for future pandemics or health crises
ADDITIONAL COOPERATION IN A PANDEMIC
During the virtual summit, there was additional attention given to the movement of agricultural supplies during the crisis.
The chair of successive summits must recommend that the scope of regional cooperation in a pandemic include the processing and distribution of food, the acquisition and storage of agricultural produce, meat and food grains.
As Singapore's PM Lee explained during the meeting, this is pertinent since ASEAN countries are not self-sufficient in essential goods, such as medical supplies and food.
“Closing our borders completely would therefore only deprive us all of goods and products that we can produce together, hurting our economies and worsening unemployment.”
He went on to highlight the Singapore-Malaysia Special Working Committee on COVID-19 as an example of cooperation as it has kept goods flowing between the two countries, despite current restrictions on the movement of people.
But such continuation of the movement of essential good is challenging. Many countries in the region are themselves short of supplies and therefore may be eager to hold on to their goods so that they have enough for their populations.
Rice is one item where ASEAN states have agreed to a common stockpile. Through the ASEAN Integrated Food Security Framework and Strategic Plan of Action on Food Security the ASEAN countries have established an emergency rice reserve.
This needs to be done for other essential supplies as well for future crises.
Further, cooperation on issues of intellectual property rights, production and distribution of essential pharmaceutical drugs across the region, is vital.
Injection of more funds into research and development are crucial for the healthcare industry in the region, considering greater privatisation in the recent years.
But here is where standards come into play. ASEAN countries must have a fast-track mechanism to ensure that, in health crises such as this, capabilities, information and research can be quickly shared to develop and distribute any vaccination or relevant drugs used in treating illnesses.
ECONOMICS AND TRADE
Besides the health implications of COVID-19, the region will also take a big economic hit since lockdowns and travel restrictions in most parts of the world has impacted their tourism sectors and supply-chain disruptions have affected their manufacturing and export revenues.
Thitinan Pongsudhirak, an associate professor at Chulalongkorn University, believes that the COVID-19 crisis maybe worse than the 1997 Asian financial crisis for Southeast Asia; warning that unlike the last time, the global markets and institutions may not have the ability to bail out ASEAN countries.
Thus, ASEAN governments should not lose sight of the deliberations on existing frameworks and arrangements to boost trade and economic growth, including the Regional Comprehensive Economic Partnership (RCEP) - which will be the world’s largest free trade bloc.
Vietnam will need to ensure that concrete economic solutions to address the crisis are put on the table at the summit in June, including discussing trade as a prominent theme, where member states should push for the signing of the RCEP this year as previously agreed.
The ASEAN plus three summit has also looked at financing sources to steer through the pandemic; and an ASEAN Response Fund (ARF) has been constituted. Vietnam will need to nudge ASEAN to ensure these schemes are accessible and implemented.
There are challenges though for ASEAN governments to ensure that these economic and trade measures are initiated and seen through. Not least is to spend political capital back home to convince their domestic bases that this would be the right thing to do.
Already before COVID-19 there was a global wave against globalization and increased protectionism. Critics and political opponents will use COVID-19 to hasten and deepen this trend with their countries.
As Lee said, the pandemic will “fundamentally change globalisation”; and governments, across the world, will reduce over-dependency on other nations, more so for essential products.
Doing so will be detrimental to ASEAN economies and more importantly undermine the spirit of ASEAN and its economic community.
The author is a Research Intern with Centre for Southeast Asia and Oceania in Manohar Parrikar- Institute for Defence Studies and Analyses (MP-IDSA) and Research Assistant at Centre for Southeast Asian Studies (CSEAS), Jindal Global University.