ASEAN COOPERATION ON HEALTH

Health and Communicable Diseases Division

ASEAN Secretariat

DAY 1 – SESSION 2: ASEAN SECRETARIAT PRESENTATION

PRESENTATION CONTENT

What is the basis of the regional cooperation on Health? What are the regional priorities in Health? What are the implementing mechanisms? What are the regional priorities of AEGCD and AWGPD?

AECBlueprint (November

2007)

ASCC Blueprint

(March 2009)

APSC Blueprint(March 2009)

2nd IAI Work Plan

(March 2009)

AEC Council ASCC Council APSC CouncilASEAN

Coordinating Council

implementation / monitoring:

ASCC: ASEAN STRATEGIC FRAMEWORK ON HEALTH DEVELOPMENT

Operationalizes the 55 health action lines of the ASCC Blueprint

Regional activities in health involve: B3. Enhancing Food Security and Safety B4. Access to healthcare and promotion of healthy lifestyle (PD

component included) B5. Improving capability to control communicable diseases (CD

component included) B7. Building disaster-resilient nations and safer communities

Xii. Promote multi-sectoral coordination and planning on PPR at the regional level including development of a regional multi-sectoral PPR plan

GUIDING PRINCIPLES - IMPLEMENTATION

Institutionalization on ASEAN Health Development

Health and Communicable Diseases Division, ASEAN Secretariat, Jakarta

FLOW OF HEALTH PROGRAMME CYCLE

IMPLEMENTATION MECHANISMS

Lead Countries Host Countries Resources from Development Partners Funds from Dialogue Partners with MOU Support from SOMHD and other working groups Collaborative, Coordinative and Facilitative Role of

ASEAN Secretariat

ASEAN EXPERT GROUP ON COMMUNICABLE DISEASES (AEGCD)_1 Initiatives started with the ASEAN Plus Three EID Program

supported by AUSAid (program concluded last June 2010) 6th AEGCD Meeting, Yangon, Myanmar: Outputs

Updated the Medium Term Plan on Emerging Infectious Diseases (MTP EID - Work Plan 2011-2015)

Endorsed the 9 components of the MTP EID for 2012-2015

Approved the Work Plans & Prioritized activities for 2012

ASEAN EXPERT GROUP ON COMMUNICABLE DISEASES (AEGCD) 6th AEGCD Meeting, Yangon, Myanmar: Outputs

Strengthened collaboration with WHO and other Development Partners

Malaria Initiatives with WHO approved; Myanmar volunteered to be lead country; Thailand to be confirmed by senior officials

Identified Regional Advocacy Initiatives

AEGCD: 9 COMPONENTS OF MTP EID ASEAN EID Mechanism (AEM), (Thailand); EID website,

(Indonesia); ASEAN Partnership Laboratories, (Malaysia) Risk Communication, (Malaysia) Human and Animal Health Collaboration, (Thailand and Lao

PDR); Operationalisation of Minimum Standards of Joint Multi-

sectoral Outbreak Investigation and Response, (Cambodia); Stockpiling of antivirals and PPE (ASEAN Secretariat), Field Epidemiology Training Network, (Thailand) WHO-EC Project on HPED particularly on cross-border

collaboration, (Thailand and Lao PDR) Specific diseases including Rabies (Viet Nam), Dengue (Viet

Nam and identified lead country for ASEAN Dengue Day), and Malaria (Myanmar, Thailand ?)

ENDORSED WORK PLANS (2012-2015) ASEAN Plus Three Partnership laboratories (APL); Risk Communication; Animal Health and Public Health Collaboration; ASEAN Emerging Infectious Diseases Mechanism (AEM)

and ASEAN EID Plus Three Website; Operationalization of Minimum Standards on Joint

Outbreak Investigation and Response; ASEAN Plus Three Field Epidemiology Training Network

(FETN); and Specific diseases including rabies and dengue with some

revisions from lead country, Viet Nam

ASEAN WORKING GROUP ON PHARMACEUTICAL DEVELOPMENT (AWGPD)

27th AWGPD Meeting, Hanoi, Viet Nam Outputs:

Finalized the Work Plan for 2012-2015Prioritized Activities for 2012Worked with AEGCD on Malaria Initiatives with focus

on Drug ResistanceStrengthened Collaborative Activities with WHOFinalized ASCC Scorecard Indicators Identified Regional Advocacy Initiatives

ASEAN Bodies related to PD

Proposed components & activities

Regional Strategies

Lead country

1) The 3rd Standard of ASEAN Herbal Medicine

Area 1 & 3 Indonesia & Thailand Proposal 2011

2) Development Programme to strengthen QA and Non-Pharmacopial Analytical Methods

Area 1 & 3 Malaysia

3) Building up & strengthening of PV

Area 1 & 2 Singapore & Thailand2012

Proposed components Regional strategies

Lead country

4) Rational Use of Drug

ASEAN – WHO Consultative Meeting on RUM, 12 July 2011

Area 2 & 3 Brunei, Singapore,

Indonesia

4.1 Workshop on Rational Use of Anti-Microbial Agents

Brunei, Singapore

4.2 ASEAN – WHO Collaborative Study on RUM in ASEAN

Singapore WHO

4.3 To conduct an ASEAN Forum on Pharmaceutical Care and its Effective Implementation in ASEAN (2013)

IndonesiaWHO

Proposed components/activities

Regional strategies

Lead countries/ $

5) Proficiency Testing Area 1 & 3 ThailandOngoing activity, donor - 2011

6) Production of ARS

• Certified Reference Material

Area I & 3 ThailandOngoing activity, donor - 2011

7) Technical cooperation with USP

Area I & 3 Thailand/USP2011

REMARKS: Activity 6 and 7 were combined: Thailand

Proposed components/activities

Regional Strategies

Lead countries/ $

8. Building up and strengthening ASEAN ‘s capacity in GCP and Clinical trial

Area 1 & 3 Thailand & Indonesia, Philippines

9) ASEAN Collaboration in combating counterfeit drug

Area 1& 2 & 3 Indonesia & LaosWHO collaboration

10) Drug resistance in malaria

Area 1 (policy advocacy)

Laos & WHO, 2011

11)Regional advocacy Area 2 ASEC, 2011

DAY 1: FEEDBACK SESSION ON THE ‘JOINT ASSESSMENT’ & ‘REGIONAL FRAMEWORK’

RELEVANT MESSAGES TO BE CONSIDERED BY ASEAN GROUPS BASED FROM THE JOINT ASSESSMENT OF THE RESPONSE TO ARTEMISININ RESISTANCE_1

Engage with the pharmaceutical sector; Enforcement of policies on counterfeit drugs

Information Sharing: Information on Drug Resistance should be shared to higher bodies in health of the region

Funding from External Sources are available but complementary support from dialogue partners can be encouraged

Cross border issues on infectious diseases should also include the concern on artemisinin-resistance

Identify main technical issues and gaps to be covered concerning artemisinin resistance and seek appropriate support from concerned partners

ASEAN Community by 2015: ASEAN has a critical role in raising political commitment and economic implications in addressing concerns relevant to issues on artemisinin resistance

RELEVANT MESSAGES TO BE CONSIDERED BY ASEAN GROUPS BASED FROM THE JOINT ASSESSMENT OF THE RESPONSE TO ARTEMISININ RESISTANCE_1

FEEDBACK: REGIONAL FRAMEWORK_1 Consider the framework to be inclusive of the ASEAN region

rather than the GMS Flexibility in the use of the funds beyond GMS to address issues

on artemisinin resistance and malarial initiatives in the region Elevate to appropriate and higher bodies the issues on malaria

initiatives and the challenge faced with artemisinin resistance with leadership from ASEAN Member States

Consider the economic impact: Elevating the issue of malaria to be one of the point of interest of the national agenda can be a concern if it is not a priority by the national government. But if we link this health issue to economic implications, then we can make this one of the priorities.

FEEDBACK: REGIONAL FRAMEWORK_2Objective 1: ASEAN has a comparative advantage in coordinating efforts on malaria initiatives Drug resistance can be placed in the context of ‘Elimination of Malaria’ Objective 2: Awareness and information sharing enhanced at the level of technical working groups initially and then to other higher bodiesObjective 3: System of monitoring can be done for malaria initiatives that is similar to MS JMOIRSupport mapping and strengthen surveillance Classify ASEAN Member States according to appropriate tiers

FEEDBACK: REGIONAL FRAMEWORK_3

Objective 5: Vector control in the context of promotion of integrated vector management (IVM) Add a narrative that this objective will complement prevention of transmission of resistant strains

FEEDBACK: REGIONAL FRAMEWORK_4Objective 6: Elevate issue of malaria concerns to the focus area of Migrants Health and Increase Access to Health Care during the workshop led by Indonesia SOMHDExplore involvement of private sector in the open sessions of the AWGPD and AEGCD meeting on matters concerning malaria

Objective 7: 7.1 consider ‘regional level’ rather the ‘GMS’ Include Economic Analysis of the impact of artemisinin resistance in the GMS and beyond

DAY 2: FOLLOW-UP/NEXT STEPS

RECOMMENDATIONS/AGREEMENTS General Comments/Agreement: Consider the following inputs

in coming up with a set of recommendations/agreements: “Facts” on Malaria by WHO is needed to level standard of

information among participants Consider the issues below that were discussed in Day 1:

Contextualized in the elimination of malaria Migration issues Cross-border issues Economic implications

Workshop Document should contain the following: I. Background

Facts WHA Resolution 2007

II. Challenges III. Key Recommendation IV. Way Forward

RECOMMENDATIONS/AGREEMENTS I. Background

Facts WHA Resolution 2007

II. Challenges (NOTE: for ranking) Awareness (community, border to decision level) Lack of cross sectoral interaction Access and quality of medicines/ Stock outs Migrants Health and Cross-border concerns Illegal trade across countries/ smuggling Economic implications Resource gap Limited alternative medicines Implications of rapid economic development to health situation

including the issue of re-emerging diseases (malaria in particular) Global Warming (?)

III. Key Recommendation IV. Way Forward

WHA: ASEAN sideline meetings (exchange) leaflets

RECOMMENDATIONS/AGREEMENTS III. Key Recommendation (NOTE: for ranking)

Ensure effectiveness of ACTs Every member state to monitor therapeutic efficacy of medicines Removal of artermisinin monotherapy (import, ban of production

and export) Standardization of quality of ACT Private sector involvement

Strengthen regional cooperation on regulations and monitoring of cross-border concerns such as trade of pharmaceuticals, migrants issues Assessment of impact of the disease burden as it relates to

economic implications Involvement also of the private sector and research Focus on migrants health and mobile populations Common regional regulatory framework on medicines Ensure bilateral cooperation will take into account regional

cooperation/agreements

RECOMMENDATIONS/AGREEMENTS III. Key Recommendation (NOTE: for ranking)

Ensure initiatives on elimination of malaria be included in the regional priorities of ASEAN subsidiary bodies Lead countries of concerned subsidiary bodies on AWGPD and

AEGCD to proposed work plan activities relevant to malaria initiatives

Relevant subsidiary bodies within ASEAN will also be involved in cross-sectoral collaborative activities

Strategy to strengthen prevention and control to reduce transmission

Strategy to maintain free malaria status Ensure adequate resources for the elimination of malaria

including artemisinin resistance Involvement also of the private sector

NEXT STEPS

WHO to finalize the workshop document – 2 weeks Circulate the workshop document to participants of the

workshop – 2 weeks Seek concurrence from the appropriate ASEAN health

subsidiary bodies (ie. AEGCD, AWGPD) – within May/June 2012

Elevate recommendations of AEGCD and AWGPD to SOMHD – within May/June 2012

SOMHD recommendations to be elevated to AHMM – within June 2012