THE INSIDE VIEW the ASEAN Regional COVID-19 Response

The

SPECIAL EDITION A SEAN NOVEMBER - DECEMBER 2020

ISSN 2721-8058 THE INSIDE VIEW CONVERSATIONS VIEWPOINT The ASEAN Regional Living Through WHO DIRECTOR-GENERAL COVID-19 Response The Pandemic Tedros Adhanom Ghebreyesus, PhD “Canada’s Weapons Threat Reduction Program deeply values its impactful collaboration with the ASEAN Health Sector through the Mitigation of Biological Threats Program. This collaboration has meaningfully enhanced the capacity of ASEAN partners to prevent, detect, and respond to all manner of biological threats, whether natural, accidental, or deliberate in origin.”

Diedrah Kelly Ambassador, Mission of Canada to ASEAN

Read the full article on page 30 Contents 3

Secretary-General of ASEAN Dato Lim Jock Hoi IN THIS ISSUE Deputy Secretary-General of ASEAN for ASEAN Socio-Cultural Community (ASCC) Special Edition: Kung Phoak

Stronger Health EDITORIAL BOARD Directors of ASCC Directorates Systems, Our Rodora T. Babaran, Lifeline in Ky-Anh Nguyen A Pandemic Assistant Directors of ASCC Divisions Ferdinal Fernando, Containment Measures Jonathan Tan, Across ASEAN 9 Mary Anne Therese Manuson, Mega Irena, Riyanti Djalante, ASEAN COVID-19 Sita Sumrit, Vong Sok Response: An Overview 11 ASEAN Center for Public EDITORIAL TEAM Editor-in-Chief Health Emergencies and Viewpoint Conversations Mary Kathleen Quiano-Castro Emerging Diseases 14 Associate Editor National Vaccine Security and Ltg. (Ret) Terawan Disa Edralyn, MD Joanne B. Agbisit Self-Reliance on the Pandemic Agus Putranto, MD, PhD Doctor, COVID-19 Survivor 40 Staff Writer Influenza Preparedness in Novia D. Rulistia Former Minister of Health, Indonesia Jonas Elmer Balneg Thailand 23 Senior Officer, Analysis Division and Chair of the ASEAN Health Registered Nurse 41 Ministers Meeting 6 Kiran Sagoo Regional Collaborative Strategy Paul Nyan Myint Soe for ASEAN Drug Security and Chiba Akira COVID-19 Survivor, Business EDITORIAL ADDRESS Self-Reliance 26 Ambassador, Mission of Japan Director 43 The ASEAN Secretariat ASEAN Socio-Cultural Regional Health Chart 28 to ASEAN 16 Kara Magsanoc-Alikpala Community Department Digital Technologies to Tedros Adhanom Advocate for Breast Cancer Literacy Jalan Sisingamangaraja 70A Strengthen Health Systems 33 Ghebreyesus, PhD and Early Detection, Journalist 44 Jakarta 12110, Indonesia Director-General, WHO 18 Tel: 62-21-7262991 Dy Sophorn Mental Health in a Post- E-mail: [email protected] Ngozi Okonjo-Iweala, PhD pandemic ASEAN 36 Primary School Teacher 49 Board Chair, Gavi, The Vaccine Peter Thipommajan ISSN 2721-8058 Building Back Better: Towards Alliance 21 Non-profit Founder and a Community-wide Recovery 46 Diedrah Kelly Coordinator 50 Understanding the COVID-19 Ambassador, Mission of Canada Melvin Chew Effects on ASEAN Livelihood 48 to ASEAN Hawker Stall Owner 51 Universal and Gender- ASEAN Plans to Boost Travel Issue 6 Responsive Health Care: Samak Kosem Amid a Pandemic. Here’s How. 58 https://bit.ly/ Artist and Researcher 52 Lessons from Canada 30 TheASEAN_V6 A Landmark Summit to Mark Ain Bandial an Extraordinary Year 61 Culture and Identity The ASEAN’s past issues Peter Schoof, PhD Digital Media Company are available at asean.org Amidst the Pandemic, ASEAN German Ambassador to Indonesia, Co-Founder, Journalist 53 Continues to Strengthen ASEAN and Timor-Leste Nguyen Qui Duc External Engagements 63 The Power of Storytelling Business Owner, Arts Advocate, ASEAN Leads the Way: The and Implementing the ASEAN Writer 54 Regional Comprehensive Communication Master Plan 70 Nadira Ramli and Economic Partnership 65 Bringing ASEAN to the People, Syed Abdul Rahman ASCC Meetings 68 One Story At A Time 73 Pilots, Entrepreneurs 56

Cover Illustration by Jojo Limpo 4 Message from the Deputy Secretary-General of ASEAN

Message from the Deputy Secretary-General

weaknesses in our nations’ health sharpened focus on post-pandemic systems. This Special Edition looks recovery, with initiatives that include into the initiatives that will enhance the COVID-19 Recovery Framework health systems and enable countries and the ASEAN COVID-19 Response to respond better to future outbreaks Fund. The establishment of the ASEAN and pandemics while providing Centre on Public Health Emergencies quality healthcare. and Emerging Diseases, which is supported by Japan, was also The ASEAN produced this edition announced at the sidelines of with valuable support from Canada’s the Summit. This initiative will government, ASEAN’s partner in the build the region’s capacity to health sector. prevent and respond to another public health emergency. Our distinguished contributors and experts weigh in on various ASEAN caps 2020 with the signing of aspects of healthcare—the universal the Regional Comprehensive Economic and timely delivery of health services, Partnership Agreement, a landmark the availability of safe and affordable trade pact that will be the world’s The world started 2020 with the drugs and vaccines, training and largest once it takes effect. alarming news of an unidentified development of health workers, disease. COVID-19 turned into upgrading infrastructure, and The pandemic is a defining moment a global pandemic that would adopting digital technologies. in history, a collective experience that exact a devastating toll on lives has altered the lives of ASEAN people, and livelihoods. The impact of the pandemic and will shape the policy landscape of goes beyond the health sector, ASEAN and its individual members for The year concludes with promising and it has spared no one. In our years to come. It is imperative to tell reports of vaccines that may soon region, thousands have lost their and record this story from multiple be available to help slow down the lives; millions are out of jobs; lenses, not only from the perspective spread of the disease. The collective businesses are forced to close of our leaders and policymakers, but effort to find successful vaccine down. This year’s uncertainties have also from people from all walks of life. candidates in such a short time put a toll on people’s well-being, and Narratives serve home truths, provoke is unprecedented. It speaks of the it underscores the need to address reflections and insights, inspire solutions, power of collaboration when the goal mental health as an integral part of and create hope and optimism. is for the common good. The difficult primary healthcare. The conversations task of ensuring the affordable and with people across the region reflect The magazine is grateful to the equitable distribution of vaccines, their struggles and hopes as they Government of India’s support that however, still lies ahead. cope with this year’s tremendous has allowed us to continue sharing and unforeseen changes. these ASEAN narratives. In January, ASEAN quickly activated regional health mechanisms that Inevitably, the pandemic’s socio- I share everyone’s hopes that the start of would support the Member States’ economic impact dominated the 2021 will write a better and kinder story. COVID-19 response measures. discussion during the 37th ASEAN There have been successes in the Summit and Related Summits. With Kung Phoak containment, but the pandemic’s Viet Nam as Chair, ASEAN navigated Deputy Secretary-General of ASEAN for impact has exposed the gaps and through this challenging year with a the ASEAN Socio-Cultural Community

The ASEAN November–December 2020 ASEAN’s COVID-19 response and the need to build stronger health systems

Ensuring national health systems are well prepared and resilient all starts by recognising health as a fundamental human right, which means a commitment to health for all. –Tedros Adhanom Ghebreyesus, WHO Director-General

COVAX is a model for international cooperation that shows governments can put aside national interests in the pursuit of a goal greater than any one of them could achieve on their own. –Ngozi Okonjo-Iweala, Board Chair, Gavi, The Vaccine Alliance

The lessons learned from this pandemic include the need to stimulate health system reform and build resilient health systems in anticipation of future outbreaks and pandemics. –Ltg. (Ret) Terawan Agus Putranto, MD, PhD, Former Minister of Health, Indonesia Photo Credit: © People Image Studio/Shutterstock 6 Special Edition

Viewpoint: Ltg. (Ret) Terawan Agus Putranto, MD, PhD Former Minister of Health, Indonesia and Chair of the ASEAN Health Ministers Meeting (AHMM)

In early December, Former Health Minister Putranto addressed The ASEAN's questions on the lessons learned from the COVID-19 pandemic, the importance of strengthening health systems and the AHMM's initiatives to help Member States respond to future outbreaks and pandemics. Indonesia chairs the

AHMM from 2020 to 2022. The COVID-19 pandemic underscored made the burden even harder. Due to the importance of a strong health system the rapid increase of infections, the ASEAN that is accessible to all. In what ways has Member States also encountered massive Within the framework of the ASEAN the pandemic affected thehealth strain in health financing which led to Post-2015 Health Development systems of Member States? prioritising their national budget Agenda, what are the plans and Minister Putranto: I believe that at the for the handling of COVID-19. priorities of Indonesia as Chair outset of the crisis, there was no country, of AHMM for 2020-2021? including the ASEAN Member States, Eventually, we realised that the pandemic Minister Putranto: As the deadline for that was well prepared for this COVID-19 has affected every country irrespective the ASEAN Post-2015 Health Development pandemic, even though every country of the state of development and the need Agenda is approaching by the end of 2020, has its core capacities to implement the for stronger national health systems and one of the priority goals for Indonesia’s International Health Regulations 2005. regional approach. Accordingly, we have AHMM Chairmanship for 2020-2021 is to identified the weaknesses and are working accelerate the implementation of the current The unprecedented scale of COVID-19 and on addressing them systematically. It has ASEAN Health Cluster Work Programme and its impact on the health systems of ASEAN made all realise the critical importance of develop the Work Programmes 2021-2024 Member States come in different stages robust primary health care comprised of in which promoting effective Governance for each country; particularly it adversely disease prevention, health education, and and Implementing Mechanism, including impacts health services delivery, the community empowerment in practicing a digital health figure prominently. health workforce, and financing. healthy lifestyle. All these aspects are part Furthermore, we are also targeting to of a whole health system, each supporting establish a Health Sector Knowledge With regard to the health service delivery, one another to achieve more resilience Management System. some countries are facing difficulties related and sustainable ASEAN health systems. to the inadequate number of referral hospitals In response to the current challenges, as with its bed capacity and other required This experience also taught us the the chair of AHMM, Indonesia is working equipment, laboratories, and essential medical need to ensure the sustainability of to synergise and scale-up ASEAN health supplies. The limited availability of test kits for health financing by establishing national mechanisms and platforms in preparedness the COVID-19 is also a challenge as the number health insurance programs and working and response to the COVID-19 pandemic of patients might be more than the numbers towards Universal Health Coverage (UHC) future public health emergencies in a more indicated. As for the health workforce, short for our people, particularly disadvantaged

coherent ASEAN way. supply of health personnel and front-liners and vulnerable groups. Photo Credit: © Ministry of Health, Republic Indonesia

The ASEAN November-December 2020 Special Edition 7

What are the ongoing regional initiatives What are the lessons learned and insights briefings, cross-ministries collaboration, the led by the ASEAN Health Sector specifically you can share about Indonesia’s COVID-19 establishment of a COVID-19 laboratories designed to address gaps in and improve response and national initiatives? network across Indonesia, setting up referral Member States’ health systems? Minister Putranto: Indonesia’s COVID-19 hospitals, emergency temporary hospitals Minister Putranto: Each country has responses are reflected in the steps taken such as Wisma Atlet in Jakarta and Galang a different policy approach based on by the government to flatten the curve of Island, the deployment of additional human its specific problems. Aside from the COVID-19 transmission. Our first principal resources for health, and forging public- different national responses, ASEAN approach is in the public health sector, private partnerships, among others. managed to activate its existing regional where we control the spread of COVID-19 mechanisms and platforms in responding by testing, tracing, isolating, and treating Since the beginning of the outbreak, we to the COVID-19 pandemic. the patients. The next step taken is in the realised that it would not be easy.Through socio-economic sector in which we the IAR, we learned our lessons identified These mechanisms are ongoing: ASEAN prepare a social safety net for the poor challenges and put more efforts into Emergency Operations Centre (ASEAN EOC), household to meet their basic needs and addressing them: Network for Public Health Emergencies, protect the vulnerable group from falling • Capacity enhancement for contact ASEAN Plus Three Field Epidemiology Training into poverty. Further, we are committed to tracing and surveillance in which Network (ASEAN+3), ASEAN BioDiaspora supporting the business sectors, especially we are now collaborating with local Virtual Centre (ABVC) for Big Data micro-, small, and medium enterprises, government to apply decentralisation Analytics, ASEAN Risk Assessment and so that they could continue to operate and recruit volunteer; Risk Communication (ARARC), the Regional during this difficult time. • In terms of testing kits enhancement, Public Health Laboratories Network (RPHL), we are establishing government Human and Animal Health Collaboration, Prior to the first case of COVID-19 detected to government, government to ASEAN Vaccine Security and Self-Reliance in Indonesia on 2 March 2020, Indonesia’s person, and government to non- (AVSSR), Regional Collaborative Strategy government had preparedness measures government collaboration; on ASEAN Drug Security and Self-reliance in multiple points of entry, considered to • To address the gaps in lab capacity, (ADSSR), Biosafety and Biosecurity training have high mobility. Several days after we are doing some capacity building and networks. WHO declared COVID-19 as a pandemic, in which we are partnering with cross- President Joko Widodo established a task sector lab, the development partner, These mechanisms and platforms force to accelerate all prevention measures. and utilising the digital platform; enable the ASEAN health sector The government officially declared COVID-19 • We realised that our infrastructure is still to address gaps and improve the as a national public health emergency, considered inadequate considering that ASEAN Member States’ health system by followed by the issuance of a Presidential Indonesia is a big country, therefore conducting rapid information sharing and Decree that directed large-scale social as of now, we have expanded 422 technical exchanges, risk assessment, risk distancing measures. The subsequent laboratories and 920 referral hospitals; communication, contact tracing, exchange declaration of COVID-19 as a national • We are also still experiencing logistics of laboratory readiness and response disaster enabled the government to challenges, and as such, we are working action, and capacity strengthening. reallocate all resources and activate the to simplify the medicines and medical emergency fund for COVID-19 handling. supplies importation mechanism. We As the ASEAN Health Sector continues are also undertaking government to to respond according to the evolution Since early June 2020, Indonesia has adapted government and business to business and trajectory of the outbreaks in Member the “new normal” concept by applying strict collaboration, and partnering with States, the ASEAN Health Ministers convened health protocols in people’s daily lives. It was other non-government bodies such a special video conference on 7 April 2020 then followed by the issuance of a presidential as the UN and Non-UN. among ASEAN Health Ministers and with decree creating the COVID-19 Handling and Plus Three, and also on 31 April 2020 National Economic Recovery Committee The COVID-19 pandemic needs robust health with the United States, to review the to support the revival of businesses and systems to respond adequately, both in current situation and response, outline prevent further economic downturns. mobilising resources for handling COVID-19 priority policy and strategic directions pandemic and handling the decline of for the ASEAN Health Sector, and enhance On 11-14 August 2020, Indonesia conducted essential public health services. The lessons cooperation with partners. The mandates the Intra Action Review (IAR) as a follow up learned from this pandemic include the need are, among others, to sustain and to the 4th Meeting of the WHO Emergency to stimulate health system reform and build institutionalise the existing regional Committee, which is a comprehensive multi- resilient health systems in anticipation of mechanism, mobilising timely technical, sectoral qualitative review of the ongoing future outbreaks and pandemics. The areas material and financial resources critical COVID-19 response to identify gaps and of health system reform are education and to sustaining national health system opportunities to learn and improve deployment of human resources in line with response including drug and vaccine Indonesia’s COVID-19 response. There are future health problems; strengthening of security and self-reliance, and ensuring many other measures taken such as the primary health care; upgrading health facilities access to essential health care services. establishment of hotline services, daily media in isolated, border and geographically remote 8 Special Edition

areas; building self-reliance of pharmaceuticals ASEAN preparedness, response and ASEAN’s connectivity, business and and medical devices; reinforcing health security; resilience to public health emergencies, prevent further economic downturns. improving communicable diseases prevention particularly on emerging and re-emerging The TCA will facilitate essential and control, including immunisation; boosting infectious diseases; partnering with Japan business travel among ASEAN Member health financing and the use of information in carrying out the feasibility study and States under strict health protocols and technology; and raising community preparing for its establishment. We also public health regulations; empowerment to practice healthier lifestyles. welcome future collaborations with other • The development of the ASEAN Strategic partners once the Centre is established; Framework for Public Health Emergencies Most importantly, we will ensure the • ASEAN Portal for Public Health and upcoming Standard Operating availability of vaccines and medicines for Emergencies, in collaboration with Procedure on Public Health Emergencies the prevention and treatment of COVID-19 Canada and Germany. This portal will as core documents that guide ASEAN by participating in solidarity trials, research later serve as the platform for public cooperation in enhancing regional and development, and vaccine provision, information to step up knowledge and preparedness, detection, response, and once these are available. experience sharing within the region; resilience to public health emergencies. • ASEAN-Canada has developed the We have seen the importance of collaboration Mitigation of Biological Threats Apart from these new initiatives, we are to overcome the challenges in combating Programme, which prepares and also taking on these activities that were COVID-19 among government bodies, the responds to outbreaks and emerging supported by Partners: private sector, civil society organisations, dangerous pathogens, and now focuses • Enhancing the Detection Capacity for other countries in the region, as well as on the COVID-19 outbreak; COVID-19 in the ASEAN Member States our international development partners. • ASEAN Public Health Emergency with the Republic of Korea (ROK); Coordination System, in collaboration • Technical assistance and exchanges, Can you share with us the new initiatives of with the USA. This initiative will also and provision of medical supplies and the ASEAN Health Sector and its partners provide support for ACPHEED once equipment at bilateral and regional levels not only to eliminate COVID-19 but also to the ASEAN Centre is established. with China, ROK, Canada, and Germany; prevent another pandemic or be prepared • Expert Panel on COVID-19, as supported for a similar health emergency in the region? Since public health emergencies and by GIZ through European Union funding, Minister Putranto: We are aware that global pandemics can recur many times in the will be implemented soon once the crises require global cooperation. In light future, ASEAN needs to fortify the region’s project team has been put in place; of this, we enhanced our engagement with security against future public health • Developing the ASEAN Health Protocol external and development partners, threats. We also realise the importance of as a preventive measure; which delivered several initiatives that collaboration, not only within the ASEAN • Noting that ASEAN has a good and aim to enhance the current response Health Sector, but also with other non-health close working relationship with the and ensure future preparedness. sectors and partners. In view of this, we are WHO WRPO and WHO SEARO, they at the helm of some projects and activities are now proposing cooperation In view of these considerations, we are initiated by the non-health sectors and that includes activities in the ASEAN currently establishing new initiatives that supported by external partners. These include: Member States and a component of intend to have ASEAN’s comprehensive • COVID-19 ASEAN Response Fund and support to regional coordination in the approach in responding to public health ASEAN Regional Reserve of Medical region for better response to COVID-19; emergencies and other future emerging Supplies for Public Health Emergencies • A series of discussions with multilateral and re-emerging infectious diseases (RRMS), initiated by the non-health sector key actors, such as officials from the Gavi, threats, namely: to step up our response to COVID-19, the Vaccine Alliance on the Global • The establishment of ASEAN Centre for particularly in filling health system gaps COVID-19 Vaccine Access Facility to Public Health Emergencies and Emerging faced by ASEAN Member States; ensure COVID-19 vaccine supplies Diseases (ACPHEED) which is intended • ASEAN Travel Corridor Arrangements (TCA), and distribution for the region. to enhance integrated and sustained a post-pandemic recovery plan to restore ASEAN is working at different levels to augment each Member State’s national capacity to handle the challenges posed by the pandemic. We are enhancing regional Since public health emergencies and cooperation and adopting approaches designed to adapt to the cross-border and pandemics can recur many times in the future, cross-sectoral nature of the pandemic. We ASEAN needs to fortify the region’s security are also strengthening cooperation with our international partners and external against future public health threats. organisations, dialogue, and development partners to support ASEAN’s current efforts to build capacity in handling future threats.

The ASEAN November-December 2020 Special Edition 9

In Brief ASEAN MEMBER STATES'

COVID-19 Response and BRUNEI DARUSSALAM Containment Measures First confirmed case: 10 March First confirmed death: 27 March

MYANMAR Requirement for all passengers arriving from countries with COVID-19 cases to First confirmed case: 23 March Relaxation of restrictions in five townships in Yangon: 28 May-31 July undergo 14-day self-isolation: February First confirmed death: 31 March Opening of high schools after Ban on outbound travel: 16 March a two-month delay: 21 July Ban on entry and transit of all foreign nationals Requirement for all travellers to Nationwide school closure due to through land, sea, and air: 24 March undergo a 14-day government facility rising COVID-19 cases: 27 August Closure of schools, places of worship, and quarantine upon arrival in Myanmar: Domestic travel ban: 11 September restaurants and other businesses: 31 March 25 March Lockdown and stay-at-home rules Easing of social distancing measures, Ban on all incoming international in Yangon region: 21 September 1st phase (e.g. reopening of markets, passenger flights: 30 March Resumption of domestic flights: food stalls, sports facilities): 16 May Lockdown and stay-at-home notice 16 December Reopening of schools for in-person in seven townships in Yangon: 18 April instruction: 2 June Compulsory wearing of face masks in Sources: Ministry of Health and Sports Easing of social distancing measures, 2nd 44 townships of Yangon: 13 May Myanmar, ABVC Risk Assessment Report phase (e.g. reopening of museums, senior citizen centres; higher volume of people in mosques and commercial establishments): 15 June CAMBODIA Easing of social distancing measures, First confirmed case: 27 January Lifting of international travel ban: 22 May 3rd phase (e.g. reopening of cinemas, No confirmed deaths Reopening of public kindergarten and swimming pools): 6 July primary schools for in-person instruction Easing of social distancing measures, 4th in low-risk areas: 7 September phase (e.g. mosques, markets, restaurants, Ban on entry of foreigners Requirement for all travellers arriving in other establishments can operate at full coming from countries with Cambodia to quarantine in government- capacity): 27 July COVID-19 cases: 17 March designated centres: 18 November Entry of foreigners for essential travel; Closure of educational institutions: New ban on mass gatherings in areas mandatory testing upon arrival; quarantine 16 March with clusters of cases, such as Phnom period depending on the level of risk: Requirement for foreign nationals Penh: November 15 September to present COVID-19 -free health certificate within 72 hours before Sources: CDC Department of Cambodia’s Sources: Brunei Darussalam’s Ministry date of travel: 31 March Ministry of Health, ABVC Risk Assessment of Health, ASEAN BioDiaspora Virtual Center Domestic travel ban: 9-16 April Report, WHO (ABVC) Risk Assessment Report

LAO PDR MALAYSIA First confirmed case: 24 March First confirmed case: 25 January Relaxation of restrictions, known as No confirmed deaths First confirmed death: 18 March Conditional Movement Control Order, which permits the movement of people Closing of international, interprovincial, Ban on entry and transit of all foreign within the territory of each state and and traditional borders: 30 March-19 April nationals, with very limited exception; opening of most sectors of the Nationwide restrictions on internal mandatory 14-day quarantine upon economy: 4 May movement: 1 April-3 May arrival: 16 March Compulsory wearing of face masks Reopening of schools, business Implementation of nationwide in public places: 1 August and entertainment places: 2 June lockdown or Movement Control Order Entry ban on citizens of countries that Requirement for all travellers entering Laos to (Perintah Kawalan Pergerakan Kerajaan have recorded more than 150,000 cases: present COVID-19 -free health certificate Malaysia), i.e. prohibition of mass 7 September within 72 hours of arrival: 18 October movements and gatherings, closure Reopening of higher education Suspension of visa issuance to visitors of schools, closure of all government institutions: 2 October from countries that remain affected and private premises except those Shorter quarantine period for incoming by the COVID-19 outbreak: 2 December involved in essential services: travellers: 14 December Lockdown and restriction of movement in 18 March areas with new cases: 4 and 7 December Ban on entry of all tourists and Sources: Ministry of Health Malaysia, foreign nationals: 18 March ABVC Risk Assessment Report, WHO Sources: ABVC Risk Assessment Report; WHO 10 Special Edition

PHILIPPINES SINGAPORE First confirmed case: 30 January First confirmed case: 23 January First confirmed death: 2 February Compulsory wearing of face masks First confirmed death: 21 March and other protective equipment in public areas: 9 April Ban of visitors arriving from areas with Ban on entry of foreigners Transition of various areas COVID-19 cases: 1 February (China), from areas with COVID-19 to General Community Quarantine, 26 February (other areas) cases: 31 January (Hubei, China), i.e. operation of public transportation Mandatory 14-day stay-home notice for 2 February (other areas in East Asia) and select businesses at reduced Singapore citizens, permanent residents, Placement of the entire Luzon capacity: May-July and long-term pass holders returning from island including Metro Manila Imposition of modified ECQ in Metro COVID-19-affected areas: 18 February under Enhanced Community Manila and select provinces due to Ban on entry and transit of all short- Quarantine or ECQ, i.e. closure rising cases: 4-18 August term visitors from anywhere in the of schools, offices, non-essential Lifting of the ban on non-essential world: 23 March businesses; ban on mass travel of Filipino citizens: 21 October Implementation of safe distancing gatherings; suspension Mandatory use of face masks and face measures called Circuit Breaker, which of public transport: 17 March shields outside of people's homes: entails closure of schools, work Ban on entry of foreign nationals, 15 December with some exception; mandatory place premises, and non-essential testing and quarantine upon Sources: Department of Health of businesses: 7 April entry: 17 March the Philippines, Philippines COVID-19 Compulsory wearing of face masks Ban on outbound travel: Inter-agency Task Force, ABVC Risk outdoors: 14 April 17 March Assessment Report, WHO End of Circuit Breaker, gradual resumption of activities: June Loosening of travel restrictions and negotiations to create special lanes for THAILAND INDONESIA visitors coming from identified low-risk countries; mandatory testing upon First confirmed case: 13 January First confirmed case: 2 March entry: beginning August First confirmed death: 1 March First confirmed death: 11 March Pilot programme to reopen a limited number of nightlife establishments: Temporary closure of nine border Ban on entry of foreigners coming from 9 December checkpoints (land and sea): 22 March areas with COVID-19 cases: 5 February Requirement for all foreigners on (China), 8 March (other areas) Sources: Ministry of Health Singapore, international flights to present COVID-19- Compulsory wearing of face mask ABVC Risk Assessment Report, WHO free health certificate within 72 hours in public spaces: 5 April prior to the date of travel: 22 March Implementation of nationwide large- Declaration of a state of emergency, scale social restrictions (Pembatasan requiring closure of public places, ban Sosial Berskala Besar or PSBB), including VIET NAM on mass gatherings, and shutdown of closure of schools, offices, places First confirmed case: 23 January land, sea, or air borders: 26 March of worship; suspension of social First confirmed death: 31 July National implementation of curfew: and cultural activities; and limited 3 April movement of people: 10 April Resumption of domestic flights: 1 May Ban on entry and transit of all foreign Requirement for travellers from China Gradual reopening of several businesses: nationals through land, sea, and air: to submit health declaration and undergo May-June 24 April 14-day quarantine in government- Resumption of in-person instruction Requirement for domestic and controlled facilities: January in all schools: 13 August international travellers to present Compulsory wearing of face masks Gradual reopening of the country to COVID-19 -free health certificate: 4 June in public places: 16 March tourism under a special tourist visa scheme; Easing of PSBB in Jakarta in preparation International travel restriction: 22 March mandatory testing and quarantine upon for transition to new normal: June Nationwide lockdown: 1 April-23 April arrival: October-December Reopening of schools for in-person Sub-national/localised lockdown: Easing of travel restrictions for citizens instruction in low-risk areas: July 27 July-14 September rom 56 countries; mandatory 2-week Reinstatement of PSBB in Jakarta due Resumption of international commercial hotel quarantine: 17 December to rising cases: 14 September flights with select countries; mandatory Return to transitional phase of PSBB testing and quarantine of arriving Sources: in Jakarta: 11 October passengers: September ABVC Risk Reciprocal green lane arrangement Temporary suspension of all inbound Assessment with Singapore: 26 October international commercial flights Report, WHO Extension of transitional phase of following new local community PSBB: 7 December transmission cases: 2 December

Sources: ABBVC Risk Assessment Report, Sources: ABVC Risk Assessment Report, Indonesia’s National COVID-19 Task Force WHO, World Bank

The ASEAN November-December 2020 Special Edition 11

ASEAN HEALTH SECTOR’S Collective Response to COVID-19

FERDINAL M. FERNANDO, MD HEAD, HEALTH DIVISION ASEAN SOCIO-CULTURAL COMMUNITY DEPARTMENT

The ASEAN Health Sector has been engaged in the prevention, detection, and response to COVID-19 since the first week of January 2020 when information about the cluster of pneumonia cases in Wuhan City was shared with the ASEAN Secretariat.

Figure 1

Latest New Deaths Reported First Total New Cases Case Reported Report On Total (7-day Test Last RT Region Country Confirmed Confirmed (7-day Rolling Fatality Case/ Confirmed Deaths Rolling 14 Days/ Mean** Case (S) Cases Average) Rate 100,000 Case(S) Average) 100,000

ASEAN Brunei 10 Mar 20 08-Dec-20 152 - 3 - 1.97 39 REGION Cambodia 27 Jan 20 21-Dec-20 363 - - - - 2

Indonesia 02 Mar 20 22-Dec-20 678,125 6,347 (6,957) 20,257 172 (164) 2.99 285 265 1.1

Lao DPR 24 Mar 20 07-Dec-20 41 - - - - 1

Malaysia 25 Jan 20 22-Dec-20 97,389 2,062 (1,539) 439 1 (2) 0.45 341 961 1.0

Myanmar 23 Mar 20 22-Dec-20 117,946 964 (1,040) 2,484 19 (24) 2.11 229 517 0.9

Philippines 30 Jan 20 22-Dec-20 462,815 1,310 (1,586) 9,021 64 (30) 1.95 501 411 1.1

Singapore 23 Jan 20 22-Dec-20 58,461 29 (17) 29 - 0.05 1,510 5,082 1.5

Thailand 13 Jan 20 22-Dec-20 5,716 427 (218) 60 - 1.05 8 25 4.9

Viet Nam 23 Jan 20 22-Dec-20 1,420 6 (2) 35 - 2.46 2 -

1,422,428 11,145 32,328 256

*The calculated CFR is based on reported deaths and reported case counts, and does not account for recovered cases over time or rate of testing in a particular region **Rt Transmission Rate: the average number of secondary cases caused by each infectious individual, based on the daily incidence of new cases over the previous seven days

ince then, the ASEAN Health Sector’s collective response to on the region has made its health systems and socio-economic COVID-19 was synergised and scaled-up to ensure harmonised conditions more fragile. Sregional efforts in sustaining and further enhancing regional health cooperation and efforts in responding to the impact of COVID-19. The epidemic curve from the latest risk assessment report indicates that there are a few ASEAN Member States that are still experiencing As of 23 December 2020, based on the Risk Assessment for International increased COVID-19 transmission. The majority are reporting slower Dissemination of COVID-19 to the ASEAN Region consolidated by the rates of transmission with a cluster of cases in local communities ASEAN Biodiaspora Virtual Centre (ABVC), the ASEAN region has over being reported. 1,422,400 confirmed cases of COVID-19 and at least 32,300 deaths. The table above indicates that all ASEAN Member States have With this development, some Member States are transitioning from reported cases either through local or imported transmission lockdown measures to gradually opening up their communities within the month of December. and economic activities while sustaining public health and social measures applicable for local and international movements As of this writing, globally, there are more than 78,400,000 confirmed of population. However, there is still a need to strike a balance cases, including more than 1,722,000 deaths, and the case fatality between continued efforts to suppress and stop the transmission rate (CFR) is 2.20. The ASEAN region’s total confirmed cases make of the virus, and mitigation of the pandemic’s economic and up just two per cent of the global figures, the impact of COVID-19 social impacts. 12 Special Edition

678,125 600000 Figure 2 Covid-19 Epi curve among ASEAN countries 500000

400000 462,815

300000 117,946 5,716

200000 97,389 1,420 Confirmed COVID-19 cases reported in ASEAN region by date of report through December 22, 2020 58,461 363 100000 152 0

17 21 25 29 06 10 14 18 22 26 05 09 13 17 21 25 29 06 10 14 18 22 26 30 08 12 16 20 24 28 05 09 13 17 21 25 29 07 11 15 19 23 27 31 08 12 16 20 24 28 05 09 13 17 21 25 29 07 11 15 19 23 27 31 08 12 16 20 24 28 06 10 14 18 22 41 1-Nov 03-Jul 13-Jan 03-Oct 01-Jun 02-Apr 02-Feb 01-Sep 02-Dec 01-Mar 04-Aug 04-May Thailand Singapore Viet Nam Malaysia Cambodia Philippines Indonesia Brunei Myanmar Lao DPR Source: https://asean.org/?static_post=updates-asean-health-sector-efforts-combat-novel-coronavirus-covid-19

The ASEAN Health Sector, through existing mechanisms and platforms, cooperation of the international community. The cooperation has sustained the interventions launched since the first week of with Dialogue and Development Partners has been harnessed January 2020 through cooperation within ASEAN and with other and enhanced through the ASEAN Health Sector cooperation. external partners. The ASEAN Health Sector continues to have These resulted in ongoing and new initiatives that aim to enhance technical updates and information exchanges, sharing of good the current response and ensure future preparedness. These practices, production of risk assessment reports, and enhanced initiatives include as follows: cooperation and coordination in preparedness, prevention, detection The Enhancing the Detection Capacity for COVID-19 in ASEAN and response among health and non-health stakeholders. Member States with the Republic of Korea, which was launched in June, has progressed to procurement of kits and equipment, and The sustained implementation of these activities is leveraged soon to delivery and conduct of in-country trainings. with the strength of the: The Development of an ASEAN Portal for Public Health Emergencies ASEAN Emergency Operation Centre Network for Public with Canada has moved forward with the production of a beta Health Emergencies; website; its further development will be supported through GIZ. ASEAN BioDiaspora Virtual Centre which manages the programme The Feasibility Study on the Establishment of the ASEAN Centre for for big data analytics and visualization; Public Health Emergencies and Emerging Diseases with Japan has ASEAN Risk Assessment and Risk Communication Centre training on also advanced substantially through the engagement of experts risk communication; and resource persons from ASEAN Member States, Japan, Existing ASEAN Health Plus one or Plus Three mechanisms Canada, United States and international institutions such as of cooperation with Dialogue Partners such as China, Japan, WHO, Asian Development Bank, among others. This feasibility Republic of Korea (ROK); study was concluded in October 2020 with the final report ASEAN Plus Three Field Epidemiology Training Network; and and its recommendations elevated to the ASEAN Summit. Regional Public Health Laboratory Network The Expert Panel on COVID-19, as supported by GIZ through EU funding, conducted its first webinar series in December 2020. These platforms enabled ASEAN Health Sector to continue to: The next webinars in the series are scheduled in January 2021. Share situational updates and response information; technical The outcome of these webinar series with expert panel members exchanges; real-time critical information and operational referrals will be the policy briefs for consideration by the ASEAN Health via mobile instant messaging; Sector in strengthening response to COVID-19 and moving Share preparedness and response strategies, good practices towards recovery. and lessons, as well as operational challenges, gaps and needs, The ASEAN WHO Cooperation on COVID-19 Response will likewise through video conferences and webinars. We have conducted be implemented with the support of EU funds to enhance existing these activities within ASEAN and with Plus Three, Italy, United mechanisms on public health emergencies and support capacity States, and during the period with health experts from building of Member States for sustaining COVID-19 response. Australia and from France; There will also be the continuation of relevant programmes for Produce thrice-weekly reports on the Risk Assessment for COVID-19 through the Mitigation of Biological Threats Programme International Dissemination of COVID-19 ASEAN Region; supported by Canada. Carry out exchanges on disease surveillance and laboratory Research and innovation initiatives on COVID-19 with the European readiness and response actions, including risk communications, Commission have been conducted among relevant research and and technical and material support. academic institutions of the ASEAN and EU regions. Technical assistance and exchanges, and provision of medical supplies Collaboration and solidarity are critical in this extraordinary, and equipment at bilateral and regional levels with China, ROK, unprecedented global health crisis, and it requires enhanced and Canada.

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Figure 3 Enhanced Engagement with External Partners MITIGATION OF BIOLOGICAL THREATS PROGRAMME (INCLUDES ENHANCING DETECTION CAPACITY EOC FOR PHE, DISEASE & FOR COVID-19 IN ASEAN MEMBER LABORATORY SURVEILLANCE, BIG STATES (JUNE 2020–JAN 2021/WITH ASEAN DATA ANALYTICS & VISUALIZATION; REPUBLIC OF KOREA) PLUS THREE 2014–2022/WITH CANADA) /OTHERS

ASEAN – ASEAN – FEASIBILITY STUDY ON THE GIZ ROK DEVELOPMENT OF ASEAN PORTAL ESTABLISHMENT OF THE ASEAN FOR PUBLIC HEALTH EMERGENCIES , CENTRE FOR PUBLIC HEALTH PHASE 1& 2 (JUNE–JULY 2020/WITH EMERGENCIES AND EMERGING CANADA & GIZ) DISEASES (JUNE–OCTOBER 2020/ WITH JAPAN)

ASEAN – ASEAN – RESEARCH AND INNOVATION FORMULATION OF THE ASEAN PUBLIC WHO ASEAN CHINA INITIATIVES ON COVID-19 (WITH HEALTH EMERGENCY COORDINATION HEALTH EUROPEAN UNION) SYSTEM; (WITH US/USAID PROSPECT) SECTOR

ASEAN–WHO COOPERATION EXPERT PANEL ON COVID-19 ON COVID-19 (WITH WHO AND (WITH GIZ WITH EU SUPPORT) CANADA ASEAN – EU SUPPORT) GPP JAPAN

ASEAN – ASEAN – TECHNICAL ASSISTANCE AND US EU EXCHANGES (AMS, PLUS THREE, FRANCE, ITALY, US, AUSTRALIA, AND PROVISION OF MEDICAL SUPPLIES AND EQUIPMENT (AT BILATERAL AND REGIONAL LEVELS WITH CHINA, ROK, AND CANADA)

Noteworthy in our sustained response is the enhanced GAVI COVAX Facility, IHR, SDG, and the ASEAN Health Development coordination and cooperation with external partners which Agenda for 2021-2025; have resulted in expanded or new initiatives. Closely collaborate and coordinate with ASEAN Sectoral Bodies and Development and Dialogue partners. Figure 3 provides a summary of these ongoing cooperation with external partners. Figure 4 maps out 27 health-related various interventions to address health and health system issues and support the regional In an effort to address the mounting challenges from this unprecedented prevention, detection and response measures. These include: crisis, the ASEAN Health Sector has been further engaged with 11 operationalised mechanisms and platforms within the ASEAN a number of proposed initiatives that emerged in response to Post-2015 Health Development Agenda including the implementation different aspects of the pandemic including fortifying the region’s of the ASEAN Vaccine and Drug Security and Self-reliance; security to future public health threats. These initiatives have been 8 new health initiatives including the Establishment of ASEAN proposed by the Health Sector, non-health sectors as well as partners. Centre for Public Health Emergencies and Emerging Diseases 5 non-health sector-initiated regional programmes endorsed For this reason, the senior health officials of the region collectively initially by the ASEAN Coordinating Council Working Group on engaged in synergising and scaling-up COVID-19 responses involving Public Health Emergencies (ACC WG PHE) that require SOMHD the ASEAN Health Sector. This was done to map existing and proposed contribution, which include the implementation of the ASEAN initiatives relevant to health; determine and avoid redundancies Regional Reserve of Medical Supplies, ASEAN Comprehensive Recovery or duplication of efforts; and synergise initiatives and enhance Framework and COVID-19 ASEAN Response Fund; and, the ASEAN complementarity of health-related response measures to COVID-19 Strategic Framework on PHE and future pandemics or outbreaks. They hope that greater cooperation 3 new areas of cooperation with Development Partners to support can be realised with ASEAN’s partners since there is still the need to: the ASEAN Health Sector’s efforts involving the initiatives on the Access regular and vital COVID -19 data and information; ASEAN-WHO Collaboration on Responding to COVID 19 funded by Access to resources for essential medical supplies, including vaccine; an EU grant; the ASEAN-GIZ Support COVID-19: Strengthening ASEAN ‘s Develop regional framework for cross sectoral coordination in Capacity on Crisis and Health-Related Communication, which will response and recovery; support the further enhancement of the ongoing project supported Further align with regional and global movements through the by Canada on the Development of the ASEAN Portal on Public 14 Special Edition

Health Emergencies; and the conduct of a series of sessions of Expert Panel on COVID-19 Response which will result in the development of relevant policy briefs on selected cross-cutting ASEAN Center themes/concerns; and, the first phase of the implementation of the ASEAN Vaccine Security and Self-Reliance (AVSSR), which will for Public Health focus on the timely and equitable access to affordable and quality-assured COVID-19 vaccine/s under the AVSSR Regional Strategic and Action Plan for 2021-2025. Emergencies and

With all of these ongoing and upcoming cooperation, greater engagement with other stakeholders are encouraged to further Emerging Diseases enhance the whole of society and the whole of government approach to responding to health threats. (ACPHEED)

Figure 4 FERDINAL M. FERNANDO, MD ASEAN Health Sector COVID-19 Response: HEAD, HEALTH DIVISION Continue to Synergise and Scale-up ASEAN SOCIO-CULTURAL COMMUNITY DEPARTMENT

New health initiatives including the 8 establishment of the ASEAN Centre for Public On 12 November 2020, the ASEAN Health Emergencies and Emerging Diseases Leaders during the 37th Summit under the Chairmanship of the Socialist 5 Non-health-sector-initiated efforts Republic of Viet Nam announced the 3 New cooperation with development partners establishment of the ASEAN Centre for Public Health Emergencies and Access to Coordination Emerging Diseases (ACPHEED). information with Partners

CPHEED will serve as a centre of excellence and regional Access to resources for Public Health prevention, detection Emergency hub to strengthen ASEAN’s regional capabilities to prepare and response coordination for, prevent, detect and respond to public health emergencies frameworks and A and emerging diseases. mechanisms

Aligned with Build capacity The Chairman’s Statement of the 37th ASEAN Summit also emphasised IHR, Sustainable and mechanism that the ACPHEED will complement the national health sector, Development Goals, ASEAN Post-2015 Health national centres for disease control (CDCs), and other regional Development Agenda platforms relevant to ensuring public health and safety.

The proposal to establish the ACPHEED resulted from the

11 ongoing measures within the ASEAN Health Cluster Feasibility Study on the Establishment of the ASEAN Centre for Public Health Emergencies and Emerging Diseases that was 1. ASEAN Emergency Operation Centre Network for Public supported by the Government of Japan. It was conducted by Health Emergencies the implementing agency, McKinsey and Company-Japan, 2. ASEAN Risk Assessment and Risk Communication Centre 3. ASEAN Plus Three Field Epidemiology Training Network; from June to October 2020. 4. Regional Public Health Laboratory Network (under GHSA through Thailand) Further support from the Government of Japan amounting to 50 5. ASEAN BioDiaspora Virtual Centre million US dollars will be committed to the operationalisation of 6. Development of ASEAN Portal for Public Health Emergencies 7. Joint Multi-sectoral Outbreak Investigation and Response ACPHEED in 2021 once a host country among the ASEAN Member 8. Guideline for All Hazards SOP States is chosen. Other Dialogue Partners have pledged similar 9. ARCH Project in Mobilising EMT assistance. Australia, for example, announced a commitment 10. ASEAN Vaccine Security and Self-Reliance of 21 million Australian dollars to support the ACPHEED. 11. Regional Collaborative Strategy on ASEAN Drug Security and Self-Reliance The ACPHEED has undergone numerous consultations among various key experts from Member States; regional and international

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Strategic focus pillars and overarchiving themes

MISSION FURTHER STRENGTHEN ASEAN’S REGIONAL CAPABILITIES TO PREPARE FOR, DETECT AND RESPOND TO PUBLIC HEALTH EMERGENCIES AND EMERGING DISEASES AS A CENTRE OF EXCELLENCE AND REGIONAL RESOURCE HUB

PREVENTION AND PREPAREDNESS DETECTION AND RISK ASSESSMENT RESPONSE INCLUDING • Regional-level incident For Laboratory Network: RISK COMMUNICATION management training • Operationalisation of regional • Rapid response mechanism • Network coordination of supply reference laboratory networks • Region-wide risk communication management • Laboratory training programme process • Expansion to sub-regional level • Biosafety and biosecurity • Accumulate best-practice risk incident management training capability building communication For Surveillance/Field Epidemiology: • Standardisation of risk assessment • Regional-level data infrastructure • Multi-database consolidation • Core analytics capability building • Data management and sub- national level field epidemiology

INFORMATION SHARING AND ANALYTICS • Unified information sharing platform • Standardisation of information shared

CAPABILITY BUILDING • Launching capability training programmes • Establishment of the sustainable scheme to enhance capability

INNOVATION COORDINATION/ • Network development SUPPORT (INCLUDING RESEARCH • Sharing and consolidation of R&D information AND DEVELOPMENT) • Facilitate training in R&D areas

organisations such as Centres for Disease Prevention and Control; noted the final report of the Feasibility Study; the agreed WHO regional offices; academia; and other subject matter experts. scope of work of the ACPHEED which includes the mission, The Feasibility Study and its results came from an objective strategic focus pillars, overarching themes, and priority consultative process as shown in this multi-stakeholder minimum and intermediate capabilities; and the agreed structure of the Feasibility Study. critical criteria of host country selection. The establishment of the ACPHEED and relevant recommendations have been Based on the results and recommendations of the final report of reported to the ASEAN Leaders as well as Japan’s Leader around the study, the ASEAN Health Sector through the ASEAN Health the time of the 37th ASEAN Summit and its Related Meetings on Ministers endorsed the establishment of the ACPHEED; 11-15 November 2020. 16 Special Edition

Viewpoint: CHIBA AKIRA AMBASSADOR, MISSION OF JAPAN TO ASEAN

First of all, I would like to congratulate the ASEAN infections, then expands it by mapping Secretariat upon the launching of The ASEAN and cross-referencing. magazine. It is my honour to join in this issue with “Three Cs” stand for closed spaces, this interview on a most pressing and important crowded places, and close-contact settings. This concept serves as a guideline subject of healthcare systems. for avoiding situations with high risks of infection. The cluster-based approach, in particular, the avoidance of “Three Cs” is an you share with us the Thus, viral infections can be controlled by employed as a core measure to suppress strengths of Japan’s health containing or preventing such a chain. Japan transmissions of the virus while enabling Csystem, which enabled your adopted two methods called “retrospective the resumption of social and economic country to effectively manage the tracing” and the avoidance of “Three Cs.” activities. Additionally, it works as a core COVID-19 pandemic? What lessons measure to cope with the low winter can ASEAN and other countries derive “Retrospective tracing” is a contact temperature and to prevent the rapid from Japan’s experiences in providing tracking technique which, unlike increase of re-infections. quality and affordable health care? standard methods of tracking the Ambassador Chiba: At the initial stage, behavior of those infected, identifies At the same time, the active cooperation Japan realised that COVID-19 is a disease the location of clusters and infection of Japanese citizens plays a pivotal role in that spreads along with a relatively small sources by identifying patients’ behavior preventing the spread of infections. The

number of expansive transmission chains. and their interactions with people before Government of Japan calls on citizens Secretariat/Kusuma Pandu Wijaya Photo Credit: © ASEAN

The ASEAN November-December 2020 Special Edition 17

infectious diseases easily sweep across national borders, and it is now clear once again that international cooperation is crucial to respond to such situations.

During the Special ASEAN Plus Three Summit on Coronavirus Disease in April 2020, Japan announced to fully support the establishment of the ASEAN Centre for Public Health Emergency and Emerging Diseases (ACPHEED). A Feasibility Study was carried out in June 2020, followed by the inauguration event held at the 23rd ASEAN-Japan Summit in November 2020. We would like to express our appreciation for ASEAN’s positive acceptance and our respect for the efforts made by all relevant parties in ASEAN Member States.

We understand that the Centre will be responsible for the dissemination and analyses of infectious disease- related data, human resources development, as well as research and development programmes. Through such efforts, ACPHEED will develop as a core centre to tackle infectious diseases and public health emergencies in to help reduce the risk of infections by than any other ASEAN country. Under the region, and will become an categorising “five cases” to be avoided, this programme, efforts have been made institute that contributes to the namely social gatherings consuming to share knowledge and experience on prevention of future outbreaks alcohol, lengthy feasts in large groups, the management and administration of of infectious diseases and the conversations without wearing masks, Japan’s medical insurance system with preparation of effective responses lodging together in a small limited ASEAN countries in order to respond in public health emergencies. space, and roaming about, as they increase to the increase in public expenditure infection risks. Citizen cooperation is so far on medical expenses as a challenge in Japan has contributed approximately achieved not through coercive measures realising UHC. In addition, the “Project 50 million US dollars to the Japan-ASEAN but through request and encouragement. for Strengthening the ASEAN Regional Integration Fund (JAIF), which has become Capacity on Disaster Health Management a major tool through which we support Globally, half of the world’s population still (ARCH Project)” is implemented in Thailand ASEAN Outlook on the Indo-Pacific for the do not have access to basic health services, in cooperation with the ASEAN Secretariat establishment of ACPHEED. Based upon and the situation is worsening due to the and emergency medical institutions in the results of the Feasibility Study, Japan COVID-19 pandemic, which poses a threat ASEAN countries. This project supports will support the construction of the to human security. Hence, in order to the creation of a mechanism for Centre, the maintenance of relevant respond to the global spread of COVID-19, information-sharing among ASEAN goods and equipment, as well as human it is crucial to focus on achieving universal countries in response to COVID-19. resources development, including health care (UHC) under the premise experts at the Centre. In addition of “no one is left behind.” Japan has been a staunch supporter to the contributions to JAIF, Japan of ASEAN’s initiative to establish the will prepare training and the From this perspective, Japan is advancing ASEAN Center for Public Health dispatch of experts through the efforts to promote UHC in Southeast Asia. Emergencies and Emerging Diseases Japan International Cooperation For example, under the Japan-Thailand (ACPHEED). Why do you think it is Agency (JICA). With such efforts, Partnership Programme (JTPP), South- important to set this up? And how Japan will continue to provide South cooperation is vigorously being can Japan support this center? maximum knowledge and expertise, pursued with Thailand, leading to the Ambassador Chiba: The global spread as well as to provide continuous and

Viewpoint: TEDROS ADHANOM GHEBREYESUS, PHD DIRECTOR-GENERAL, WORLD HEALTH ORGANIZATION

Director-General Tedros Adhanom Ghebreyesus shares t has been nine months since with The ASEAN, WHO's ongoing initiatives to ensure the WHO declared COVID- 19 Ia public health emergency the fair and equitable access of countries to safe of international concern. To what vaccines, and continuing cooperation with ASEAN to extent have initiatives, partnerships, or strategies changed to ensure that control COVID-19 and prevent future pandemics. He also WHO remains relevant to the Member discusses securing global health and better emergency States needing guidance and support? preparedness through sweeping institutional changes Dr. Ghebreyesus: After I took office in 2017, we embarked on the most extensive at WHO and stronger national health systems. transformation in WHO’s history, to make the organisation much more focused on delivering measurable impacts and outcomes in countries and supporting the strengthening of community-level health systems. We’ve already made major changes to the way we work, our structures, business processes, culture, and approach to partnerships.

As part of our transformation, we created a dedicated pillar of work focused on emergency preparedness and response. This has expanded and streamlined our systems for helping keep people safe from emergencies around the world. In addition, we established the independent Global Preparedness Monitoring Board to identify gaps in emergency preparedness globally.

WHO’s transformation has made important changes in many other areas. We have created our first department for digital health and innovation to ensure that WHO is on the cutting edge of technology when it comes to health. We appointed the first-ever chief scientist to drive research and development on emerging diseases and established the WHO Academy, which is now training five million medical personnel for emergencies.

The WHO Foundation is a new addition to mobilise additional resources—not a matter of money, but quality money. The foundation

will also help ensure independence for WHO Photo Credit: © WHO

The ASEAN November-December 2020 Special Edition 19

by increasing the potential to receive need, when and where they need them— response to the COVID-19 pandemic. We more flexible sources of funding to especially services to promote health and saw that countries that have experienced support the delivery of health services. prevent disease. large-scale outbreaks in the past, invested in emergency preparedness, strengthened And to build the evidence base for the Strong primary health care services are their health systems to cope, and adhered economic benefits of investing in health, the eyes and ears of the health system in to science-based measures perform better we are establishing a new Council on the communities. Primary health care can help than others. Economics of Health for All, which will detect and respond to an outbreak early, elucidate the links between health and which is vital for stopping it before it While we continue to receive encouraging sustainable, inclusive and innovation-led becomes widespread. news about COVID-19 vaccines and remain economic growth. cautiously optimistic about the potential for new tools to start to be All this has been done available for at-risk people with the aim to strengthen around the world in the WHO’s ability to meet the Health is a political choice. coming months, we are needs of our Member States extremely concerned by in achieving our shared goals But it’s a choice we see more and the surge in cases we see in of serving the vulnerable, more countries making. This must some countries. Particularly keeping the world safe in Europe and the Americas, from emergencies, and lead to action, especially in investment health workers and health promoting health. in systems to prevent disease and systems are being pushed to the breaking point. What do you think are promote health, equitably provide the core essentials in services, and prepare societies to In many countries during maintaining a resilient the first wave of the virus, health system? prevent and respond to emergencies. measures were taken to Dr. Ghebreyesus: Ensuring break transmission chains national health systems are and reduce cases. However, well prepared and resilient all some countries did not take starts by recognising health as a fundamental At last year’s United Nations General the opportunity to strengthen their human right, which means a commitment Assembly, world leaders agreed on public health systems enough. Even to health for all. This is achieved through a historic way forward for advancing before widespread transmission investment in and advancement, of universal universal health coverage. At the recent beyond China was recorded, WHO health coverage, with primary health care as G20 summit, heads of major developed advised countries to use the window the strong foundation. I am impressed nations again demonstrated their of opportunity to strengthen their with the commitment of many ASEAN commitment to promoting action public health capacities, including testing, Members in promoting universal on health, this time in response tracing, and isolating and treating cases, health coverage. to COVID-19 and ensuring as well as clearly advising their citizens not equitable access to vaccines. to lower their guard. Even when countries Political commitment for universal health experience increased numbers of cases, coverage at the highest level is essential Health is a political choice. But it’s a choice we need to keep strengthening our public for this to succeed, with the support of we see more and more countries making. health systems and increase public parliaments to translate that commitment This must lead to action, especially in engagement to respond. into law, backed by a whole of government investment in systems to prevent disease approach that addresses the commercial, and promote health, equitably provide But we saw how communities in many economic, environmental, and social services, and prepare societies to prevent parts of the world relaxed and returned determinants of health. and respond to emergencies. too quickly to normalcy after experiencing their first wave. The response to the Universal health coverage underpins all From your perspective and given pandemic is everyone’s business. This is a our work and is our top priority. Ensuring WHO’s pool of information about the dangerous virus, which can attack every everyone can access quality health services COVID-19 situation in countries around system in the body. Those countries that without facing financial hardship is essential the world, what would you say are the are letting the virus run unchecked are for building strong economies and global key elements to a successful response? playing with fire. health security. Why is there an upsurge of COVID-19 cases in countries that seemed to have As countries take extreme measures to Primary health care is fundamental for initially controlled the virus? curb the rapid spread of COVID-19, now achieving universal health coverage by Dr. Ghebreyesus: Emergency preparedness is the time to invest in the systems that delivering the health services people has been the critical ingredient for a successful will prevent further waves of the virus. 20 Special Edition

Can you tell us about the Access to COVID-19 Tools Accelerator (ACT- Accelerator) that was launched by the World Health Organization (WHO) together with partners with the vision of creating a global solution to end the COVID-19 pandemic? Dr. Ghebreyesus: Since the start of the emergency, WHO has been focused on harnessing scientific knowledge on the virus and how to treat COVID-19. As part of this, from the very beginning, we have been thinking about the end game—the provision of COVID-19 vaccines and to guarantee ASEAN Plus Three Special Summit on of safe vaccines equitably globally, fair and equitable access for every country COVID-19 in April, and the plenary of the starting with health workers, older in the world. Can you please share: 37th ASEAN Summit in November. I have people, and other at-risk groups. This been greatly inspired and informed by is why we launched in April the Access What are the key principles that their national experiences, and their to COVID-19 Tools (ACT) Accelerator underlie COVAX and the mechanisms in commitment to working together to with the Presidents of France and the place to ensure that all countries have secure a shared future. European Commission, and the Bill & access to quality and safe vaccines? Melinda Gates Foundation. This historic Dr. Ghebreyesus: COVAX is the world’s As a result of the experiences that ASEAN initiative is today supported by 189 countries, largest, most diverse portfolio of vaccines members had, for example, with SARS and plus the world’s leading scientists and health with 11 candidates under evaluation, nine avian influenza, these countries have put in partners. These include the Bill & Melinda in clinical trials. With countries spending place measures and systems that are now Gates Foundation, CEPI, FIND, Gavi, trillions to prop up economies, COVAX helping them to detect and respond to The Global Fund, Unitaid, Wellcome, represents the best possible deal as it will COVID-19. These serve as examples for the WHO, and the World Bank. mean a quicker recovery for all and an end the rest of the world to follow. to stimulus. The ACT Accelerator is a unique How can ASEAN as a regional entity global collaboration that supports the The central principle of COVAX is equity. become more prepared to address development and equitable distribution We must protect, with vaccines, the highest future outbreaks or pandemics? of the tests, treatments, and vaccines risk populations everywhere, rather than the Dr. Ghebreyesus: As a group, ASEAN the world needs to fight COVID-19. entire populations of just some countries. countries have performed very well in Sharing finite supplies strategically and response to the pandemic, and we expect Since April, the ACT Accelerator globally is actually in each country’s that the lessons they have learned during partnership has supported the fastest, national interest. No one is safe until this crisis will help them even further in most coordinated, and successful global everyone is safe. their preparations for future events. effort in history to develop tools to fight disease. With significant advances in If and when we have an effective COVID-19 All countries of the world must continuously research and development by academia, vaccine, we must use it effectively. Vaccine upgrade and strengthen their health and the private sector, and government nationalism will prolong the pandemic, emergency preparedness systems, with initiatives, the ACT Accelerator is on the not shorten it. the aim to promote and protect the health cusp of securing a way to end the acute and well-being of their citizens. phase of the pandemic. From your perspective, how can the robust cooperation between WHO ASEAN members have a long history of This historic initiative has created hope for and the ASEAN Health Sector make a doing just this, and I am confident, based us all, and today we see that 189 countries difference in the regional and global on the experiences they have had and the have signed up for it. The collaboration we response to COVID-19 and future outbreaks? systems and readiness they have built, had from the start with many leaders Dr. Ghebreyesus: WHO values highly the that they are well placed to respond encouraged me and made me feel confident close and effective collaboration we enjoy to the next threat that may emerge. of achieving something truly monumental with ASEAN countries on many health for the health and well-being of the world. fronts, from promoting healthy lifestyles Key ingredients are needed in this regard— to ensuring food safety, and COVID-19 national unity, willingness to support global The COVAX facility is one of the pillars has been no exception. solidarity, adherence to science, and investing of ACT- Accelerator and is led by Gavi, in health systems strengthening. ASEAN the Coalition for Epidemic Preparedness I have had the honour of working closely members have repeatedly demonstrated Innovations (CEPI), and WHO to accelerate with heads of state and government from their commitment and expertise

the development and manufacture the ASEAN region, participating in the on these fronts. Photo Credit: © CROCOTHERY/Shutterstock

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Viewpoint: NGOZI OKONJO-IWEALA, PHD BOARD CHAIR GAVI, THE VACCINE ALLIANCE

Dr. Ngozi Okonjo-Iweala talks to The ASEAN about COVAX, one of three pillars of the Access to COVID-19 Tools (ACT) Accelerator, which focuses on ensuring the equitable distribution of COVID-19 vaccines to both higher-income and lower-income countries. She also shares her insights on the ongoing competition and prospects for cooperation in vaccine development and distribution.

hat specific mechanisms are in place to ensure Wequitable access to the vaccines, particularly in less-developed or developing countries? What factors will determine which countries will get the approved vaccines first? Dr. Okonjo-Iweala: The Gavi COVAX Advance Market Commitment (AMC) is a unique funding mechanism aimed at providing vaccine doses for 92 lower- income countries. It operates on the principle of equitable distribution, meaning that doses of safe and effective vaccines, once prequalified, are allocated at the same time to all participants, including self-financing economies that also participate in the COVAX initiative.

Regarding lower-income countries, in particular, Gavi is currently fundraising to finance the costs of at least 1 billion COVID-19 vaccine doses through the Gavi COVAX AMC. These fully subsidised donor- funded doses will jumpstart new COVID-19 vaccine introductions in AMC-eligible economies. Whilst mindful of uncertainties on vaccine pricing, resource availability, and manufacturing supply, Gavi aspires to be able to cover 20 per cent of the population of AMC-eligible economies with these donor-funded doses. This roughly translates to health and social care workers, the elderly, and those with underlying health conditions—thereby making a very real impact towards ending the acute phase of the pandemic by the

world and evaluating whether these circulating strains may impact COVID-19 Diversity of vaccine candidates is absolutely vaccine development.

essential because we know that no single The pooling of resources and producer will be able to provide enough expertise from 189 countries doses to vaccinate the entire world, and through COVAX and the Access to COVID-19 Tools (ACT) different vaccines are better-adapted Accelerator is unprecedented. to different circumstances. How will this cooperation change the development and distribution of vaccines in the future and improve global preparedness for the next pandemic? Through a cost-sharing approach, that no single producer will be able to Dr. Okonjo-Iweala: Ultimately, COVAX countries will have an opportunity provide enough doses to vaccinate the is about providing equitable global access to complement and build on the essential entire world, and different vaccines are to COVID-19 vaccines, but it is also foundation built by these early, donor- better-adapted to different circumstances. more than that: it is a model for funded doses if they wish to achieve international cooperation that a higher population coverage. With accelerated testing and trials, shows governments can put aside how are scientists addressing possible national interests in the pursuit of With over 200 vaccines in development, research on other strains or mutations a goal greater than any one of them with a few reporting high success rates of the coronavirus? could achieve on their own. We believe in their trials, what are the advantages Dr. Okonjo-Iweala: Newly circulating strains that the spirit of COVAX, the lessons and disadvantages of the ongoing race of the virus are very closely monitored to we will learn, and the infrastructure in the COVID-19 vaccine development track the evolution of the SARS-CoV-2 and expertise we are building will and distribution? virus over time so that we have an early help us be better prepared to respond to Dr. Okonjo-Iweala: The world has now warning system of any emerging viral pandemics and other global emergencies seen three promising candidates that strains that could impact the effectiveness in the future. In this respect, we hope that target product profile for COVID-19 of medical countermeasures, including the framework we have now built with vaccines. The race to develop a vaccine vaccines. This includes a task force set the ACT Accelerator will be triggered that is safe and efficacious has led to up by the Coalition for Epidemic when the next pandemic appears, unprecedented innovation. At the same Preparedness Innovations or CEPI rather starting from scratch. It is vitally time, diversity of vaccine candidates is which is monitoring emerging viral important that we build resilience

absolutely essential because we know strains and mutations around the to future pandemics. Photo Credit: © MBLifestyle/Shutterstock

The ASEAN November-December 2020 Special Edition 23

National Vaccine Security and Self-Reliance on the Pandemic Influenza Preparedness in Thailand (PIP Action Plan) for regular use and improve the factory’s NAKORN PREMSRI, MD potential to be prepared by 2020 to DIRECTOR OF THE NATIONAL VACCINE INSTITUTE (NVI) produce Pandemic Influenza vaccines in MINISTRY OF PUBLIC HEALTH, THAILAND response to the next influenza pandemic. Therefore, access to and self-sufficient, sustainable supply of seasonal influenza Thailand has suffered severe economic losses and vaccine for the country would be ensured. social disturbance due to the global outbreak of diseases At present the imported seasonal influenza vaccines could cover only or pandemics. In January 2004, the highly pathogenic one-third of the total target groups, avian influenza (HPAI) virus of the H5N1 subtype was estimated at 3.1-3.5 million people. first confirmed in poultry and humans in Thailand. We could say that this project, aiming for an industrial-level influenza/avian n the following year, when the epidemic Thai government had already formed a multi- influenza vaccine factory, is just an was ongoing, more than 62 million birds ministerial, multi-sectoral committee to example among many other sustainable Iwere either killed by HPAI viruses or guide the comprehensive national Avian solutions to our need to strengthen the culled. H5N1 virus from poultry caused Influenza response based upon the “One preparedness, prevention, and response 17 human cases and 12 deaths in Thailand, Health” approach, which considers an to influenza pandemics in the country. while a number of domestic cats, captive integrative view of human, animal, and tigers, and leopards also died of the H5N1 environmental aspects of health. The Finally, in a broader national context, the virus (Thanawat Tiensin, 2005). At the global committee is composed of, to name a few, National Vaccine Institute, Thailand, under level, the World Health Organization (WHO) the Ministry of Public Health (MOPH), Ministry the guidance of the National Vaccine reported that there were at least 224 of Agriculture and Cooperatives, Ministry Committee, works together with units human cases with 127 deaths within of Interior, and Ministry of Foreign Affairs, under the MOPH such as the Department 10 countries, i.e., Viet Nam, Thailand, private and trade sector, etc. A national of Disease Control, the Department of Cambodia, Indonesia, China, Turkey, Iraq, strategic plan to prepare, prevent, and Medical Sciences, the Food and Drug Azerbaijan, Egypt, and Djibouti (Prasonk respond to influenza pandemic was first Administration, as well as other concerned Witayathawornwong, 2006). launched in 2005 by the committee and public organisations such as the National has been consecutively developed through Health Security Office and the GPO, in the In response to the H5N1 pandemic, the the years into the current Thailand’s National regular assessments of the country’s WHO established a Global Action Plan for Strategic Plan for Emerging Infectious readiness and sustainability of pandemic Influenza Vaccines in 2006 to strengthen Disease (2017-2021). Collaboration with response. As mentioned earlier, the global pandemic preparedness by increasing the WHO and other relevant development Pandemic Influenza Preparedness (PIP)’ access to influenza vaccines through three partners has been included in all Thailand’s Plans for Thailand have been prepared different mechanisms, namely, i) to increase national strategic plans. and developed by multi-stakeholders in seasonal influenza vaccine usage, ii) to increase the country. Development of such plans influenza vaccine production capacity, and In 2007, the cabinet approved a project to always has a few guiding principles, namely, iii) to support for research and development establish an industrial-level influenza/avian the “One Health” integrative concept, the of influenza/avian influenza vaccines. The WHO influenza vaccine factory in accordance emerging infectious diseases dynamic intended to support the transfer of influenza with the WHO standards (WHO-GMP), and potentials, and the health system approach, vaccine development technology to assigned the Government Pharmaceutical which includes service delivery, human countries that were willing to work with the Organization (GPO) to be in charge. resources, pharmaceutical products, WHO to assess the country’s readiness and Unfortunately, the project then suffered vaccine and technology, information, sustainability of pandemic response. Those a long delay due to the political and financing, leadership, and governance. countries were Indonesia, Mexico, South administration turbulence in Thailand. The vaccine key value chain and essential Africa, Vietnam, Brazil, Morocco, and Thailand. However, in 2017 after the long postponement, vaccine-preventable diseases in normal the project was revived by the Minister of times and emergencies are reviewed Thailand then moved on to collaborate Public Health, leading to the completion continuously and taken into consideration with the WHO and other partners to both of factory construction and installation in such PIP plan development to best address the country’s pandemic preparedness and of plant machinery. The project would the pandemic preparedness and effective self-reliance at the same time. In 2005, the produce a seasonal influenza vaccine response of our country. 24 Special Edition

ASEAN VACCINE BASELINE SURVEY KEY FINDINGS

The ASEAN Vaccine Baseline Survey (AVBS) was conducted (AVSSR). The survey describes “the most current capacity, gap by the National Vaccine Institute, Thailand (NVI) as part of and/or challenges in relation to the whole vaccine value chain, Thailand’s commitment to ASEAN as the assigned lead country i.e. research and development, production, regulation and and focal point for the ASEAN Vaccine Security and Self-Reliance immunisation, at regional and country levels within ASEAN.”

Type of Vaccines Currently In Use and in the Pipeline for National Immunisation Programme Introduction by Member State

Types of Routine Expanded Programme on Immunisation (EPI) Brunei Vaccines Darussalam Cambodia Indonesia Lao DPR Malaysia Myanmar Philippines Siangpore Thailand Viet Nam

WHO recommendations for all immunisation programmes

BCG √ √ √ √ √ √ √ √ √ √ Hepatitis B √ √ √ √ √ √ √ √ √ √ Polio (OPV/IPV) √ √ √ √ √ √ √ √ √ √ DTP containing vaccine √ √ √ √ √ √ √ √ √ √ Haemophilus influenzae √ √ √ √ √ √ √ √ a √ type B Pneumococcal • √ √ b √ √ √ √ (conjugate) Rotavirus √ b a Measles √ √ √ √ √ √ √ √ √ √ Rubella √ √ √ √ √ √ √ √ √ √ Human Papilloma √ √ b √ b √ √ √ √ √ Virus (HPV)

WHO recommendations for certain regions

Japanese encephalitis √ √ b √ √ b √ √ √

WHO recommendations for some high-risk populations

Typhoid √ √ Cholera √ √ Meningococcal √ Dengue a √

WHO recommendations for immunisation programmes with certain characteristics

Mumps √ √ √ √ √

Seasonal influenza (inactivated tri-and √ quadrivalent)

a: Demonstration project is underway b. National Immunisation Programme is planned

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Challenges and Gaps A. Vaccine research and development 6. Shortage of essential vaccines at national, regional, 1. Insufficient qualified staff, skilled personnel, experts and global levels and bioinformaticians for vaccine development 7. Discrepancy of immunisation coverage rate and how 2. Budget constraints to maintain a high coverage rate of immunisation 3. Lack of essential facilities, machineries, equipment, 9. Data quality related to high drop-out rate etc. for vaccine development 10. Discrepancy of vaccination schedule between public 4. Lack of know-how for vaccine development and private health sectors 5. Lack of clear political policy and commitment to support 11. Different geographical areas cause of difficulty to access vaccine research and development vaccination services 12. Complexity of mechanisms for new vaccine introduction B. Vaccine production which leads to delayed introduction of essential vaccines 1. Lack of infrastructure or facilities for manufacturing in the EPI of potential vaccines 13. High turn-over rate of qualified staff and need for 2. Lack of qualified staff, skilled personnel and experts continuing capacity building for vaccine production 3. Need to improve vaccine quality to meet high international standards i.e. WHO-PQ for exportation 4. High competitive market between vaccine produced locally Download the Report of the ASEAN Vaccine Baseline Survey: Current Situation and Gap Analysis from: and imported vaccines from multifunctional companies https://asean.org/storage/2017/02/AVBS_Final_23082019.pdf 5. Lack of promotion in usage of vaccine produced domestically in the NIP/EPI 6. Lack of clear political policy in support of vaccine production for national security and self-reliance 7. Lack of firm support on vaccine production from the government 8. Survival of local vaccine manufacturers under limited budget allocation from the government 9. High turn-over rate of qualified staff and appropriate measurements for retention

C. National immunisation programmes 1. Reliance on supplies from international manufacturers; hence the high price of vaccines (cost per dose), uncontrolled logistics and timeline 2. In the process of an accelerated transitioning phase to graduate from Gavi support to full self-financing on vaccine procurement 3. Vaccine refusal at selected areas and countering vaccine- hesitant groups (negative campaign, religion issues) 4. Limited budget for vaccine purchasing needed for timely fund disbursement and clearance process 5. Cold chain control during transportation and storage, including infrastructure for expanded new cold chain equipments 26 Special Edition

REGIONAL COLLABORATIVE STRATEGY FOR ASEAN DRUG SECURITY AND SELF-RELIANCE

project was proposed, and Malaysia was given the mandate as the lead country and focal point for the project. The overall objective of the ADSSR is for all Member States to work together and improve access Ho See Wan Chan Pui Lim Abdul Haniff to medicines by enhancing drug security Senior Principal Assistant Senior Principal Assistant Director, bin Mohamad Yahaya, PhD Director, Research & Development Research & Development Deputy Director, Research & Development and self-reliance in the region. The scope of the ADSSR includes all medicines for Pharmacy Policy and Strategic Planning Division, Pharmaceutical Services Programme, therapeutic use, including essential drugs, Ministry of Health, Malaysia orphan drugs, antidotes, high-cost medicines, biological products, and medicines for emerging infectious diseases, pandemics, and Access to Life-saving Medicines In the past decade, several emerging neglected tropical diseases (ASEAN Health Countries in the ASEAN region persistently infectious diseases were reported in the Cluster 3 Work Programme). A similar effort face crucial challenges to ensure continuous ASEAN region, such as avian influenza A to ensure vaccine security in the region, access to medicines for the population. H5N1, influenza A H1N1 (2009), severe acute known as ASEAN Vaccine Security and These include disruptions in the availability respiratory syndrome (SARS), Nipah virus, Self-Reliance (AVSSR), was assigned to of some essential medicines, including those leptospirosis, among others. During a public Thailand as the lead country. needed to treat infectious diseases. These health emergency or pandemic, the sudden medicines are often claimed to be “non- spike in demand for medicines such as From 2018 to 2020, four key activities were commercially viable”; hence, they are not antivirals could cause drug shortages in the conducted: the preparation of the concept manufactured and made available to the region. Member States also face significant note, conduct of the Baseline Pharmaceutical public readily. When there is a disrupted challenges in determining drug supplies Situational Analysis Survey, supplementary supply of these essential medicines, ASEAN and developing strategies to build an information search, and focus group discussion Member States will have to look for emergency drug stockpile effectively among the Member State-representatives. alternative sources. When this happens, (R.J.Coker, et. al, Emerging Infectious The survey and supplementary information states are compelled to pay higher prices Diseases in Southeast Asia: Regional search were carried out as situational analysis and risk purchasing products of low quality. Challenges to Control, Lancet, 2011). to examine the laws, regulations, and policies pertaining to production, regulatory, The cost of life-saving medicines and ASEAN’s Vision to Ensure Drug distribution, procurement, pricing, medicines orphan drugs can be extraordinarily high Security and Self-reliance use practices, and the gaps and challenges because they are so rare and unprofitable In line with the Sustainable Development in the 10 Member States. In November 2019, that manufacturing them would need Goals (SDGs), the ASEAN Post-2015 Health the Technical Meeting on Regional government assistance. The prices vary Development Agenda was initiated to achieve Collaborative Strategy for the ADSSR was widely among Member States due to the a healthy, caring, and sustainable ASEAN held in Putrajaya, Malaysia to examine the limited supply. The same could be said about community through four health clusters. feasibility of regional collaboration and to new life-saving patented medicines, such The health clusters highlight different health develop the collaborative strategies for the as targeted cancer therapies that most priority issues: promoting healthy lifestyles, project. The technical meeting produced health systems in ASEAN can ill-afford. responding to hazards and emerging threats, the proposed framework and draft action strengthening health systems, and access plans for the regional collaborative strategy. Fundamentally, ensuring access to to care and ensuring food safety. essential medicines is a key objective The proposed theoretical framework of all health systems and an integral The ASEAN Health Cluster III (AHC3) Work comprises four domains and five strategies. component of improving universal Programme for 2016-2020 on Strengthening The domains are: (i) research and health coverage (UHC). Despite global Health Systems and Access to Care focuses development (R&D) and manufacturing, and national efforts to improve access on strengthening the regional capabilities, (ii) medicine registration and other regulatory and affordability of medicines, millions capacities, and advocacy in health system issues, (iii) supply and distribution of medicines, of people, particularly those from low- development to increase access to safe, and (iv) medicine procurement and pricing. and middle-income countries, remain affordable, quality, and holistic health care. without full access to quality, safe, and Under the work plan, the ASEAN Drug Domain 1 addresses the growing demand efficacious medicines at affordable prices. Security and Self-Reliance (ADSSR) in ASEAN’s pharmaceutical markets.

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in the market and the most desirable Theoretical Framework for outcome is “value for money.” Although the Regional Collaborative Strategy for ADSSR the idea of regional pooled procurement Mission: To improve drug security and self-reliance in ASEAN is still at its embryonic stage, the proposed regional collaborative strategies will lay down Platform of Communication some important ground works towards it. Domain 1: Domain 2: Domain 3: Domain 4: For example, regulatory harmonisation, R&D and manufacturing Medicines registration Supply and distribution Medicines procurement sharing of supplier information, and and other regulatory of medicines and pricing medicine price sharing are essential Strategy 1: Enhancing issues regional collaboration in Strategy 3: Ensuring Strategy 4: Encouraging foundations to build pooled procurement manufacturing and R&D Strategy 2: Enhancing uninterrupted, timely price transparency in the region. Further engagements among regional collaboration in supply of medicines among ASEAN countries all Member States to find common grounds strengthening regulatory for day to day and and pursue political commitment are pathways during public during emergency Strategy 5: Strengthening health emergency for procurement necessary to establish a feasible unregistered medicines management and model of cooperation. accountability The baseline analysis identified many challenges faced by the Member States in the production, regulation, supply and distribution, procurement, and pricing It establishes regional collaboration procurement management and of pharmaceuticals. The ADSSR framework among Member States in manufacturing accountability. Price information sharing draws out some feasible mechanisms to and research and development. A good is believed to be able to improve Member improve ASEAN’s self-reliance to ensure communication platform among the States’ negotiating power to ensure more the availability of important medicines. As Member States is needed to share updates affordable medicine prices for the country. some ASEAN countries are pharmaceutical and promote the development of novel Under this domain, the feasibility of manufacturers and others are buyers, this drugs especially for tropical diseases and different levels of medicines pooled creates the opportunities for collaboration non-commercially available medicines. procurement will also be explored. in grouped-production or group-purchasing This strategy is important to make ASEAN of non-commercially viable products from self-sufficient in drug manufacturing to Across all domains and strategies, effective and for the ASEAN region, rather than fulfil the region’s own needs and demands. cross-country communication is most critical, sourcing from the other regions. It is also therefore sophisticated data exchange hoped that with ASEAN’s improved capacity Under domain 2, regional collaboration among the Member States will be instituted in the production and procurement of in strengthening regulatory pathways is in the ADSSR action plans. medicines and active pharmaceutical highlighted. The alignment of regulatory ingredients (API), the region can be self- pathways in all Member States is crucial Overall, the regional collaborative strategy sufficient, rather than continually relying to expedite the marketing authorisation for ADSSR aims to improve drug security on and sourcing from the other regions. approval without compromising the quality, and self-reliance within the region, as well safety and efficacy of medicines during a as to complement relevant pharmaceutical To date, the regional collaborative public health emergency. This will ensure systems in Member States. As most Member strategy for ADSSR is still undergoing the availability of medications during public States share similar issues with the access a consultation process. Once the health emergencies. The initiatives in to non-commercially viable medicines, regional collaborative strategy framework this domain are crucial in support of orphan medicines and expensive patented is endorsed, the lead country or institution theASEAN Public Health Emergency medicines, they are willing to participate in for each initiative or project under the Operation Centre. regional collaborations. They expect more strategy, the expected outputs, and competitive medicine pricing and the indicators, timelines, and resource The key strategy in the third domain of improved availability of more medicines needs will be further deliberated. the ADSSR is to ensure the uninterrupted in their countries. and timely supply of medicines. Enhancing This initiative is still at its beginning collaboration among the Member States and Several countries have also expressed stage. Malaysia, as the lead country, strengthening the procurement capability interest in collaboratively developing wishes to call for the continuous are needed to ensure that medicines are a regional pooled procurement commitment from all Member States available and in continuous supply in both mechanism. With economies of scale, to address all the challenges towards normal times and emergencies. pooled procurement may improve the achieving the objective of ADSSR. It is with affordability of drug prices significantly. great hope that the proposed strategies The fourth domain lays out strategies The main rationale for pooled procurement could help the ASEAN nations improve to encourage price transparency among is to increase the availability of affordable, access to medicines and achieve better the Member States and to strengthen quality essential pharmaceutical products health outcomes for the population. 28 Special Edition

Regional Health Chart National Health Systems In ASEAN

GDP

UHC Index of Essential Current Health Expenditure Service Coverage as a Percentage of GDP as of 2017 as of 2018 81 60 2.4% 6% Brunei Darussalam Cambodia Brunei Darussalam Cambodia 57 51 Indonesia Lao PDR 2.9% 2.2% Indonesia Lao PDR 73 61 Malaysia Myanmar 3.8% 4.8% 61 86 Malaysia Myanmar Philippines Singapore 80 75 4.4% 4.5% Thailand Viet Nam Philippines Singapore

Note: The index combines 14 indicators in four broad categories of health services that must be part of universal health coverage: 3.8% 5.9% reproductive, maternal, newborn and child health; infectious diseases; non-communicable diseases; and service capacity and access. A higher Thailand Viet Nam index value means better service coverage. The index was developed to monitor SDG 3.8.1. Source: WHO Global Health Expenditure Database Source: WHO Global Health Observatory

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Medical Doctors per 10,000 Population Latest Year Available

16 (2017) 1,93 (2014) Brunei Darussalam Cambodia

4,27(2018) 3,73 (2017) Indonesia Lao PDR

15,36(2015) 6,77 (2018) Malaysia Myanmar Hospital Beds per 10,000 Population 6 (2017) 25 (2019 ) Latest Year Available Philippines Singapore

8,05 (2018 ) 8,28 (2016 ) (2016) (2016) 28,5 9 Thailand Viet Nam Brunei Darussalam Cambodia Source: WHO Global Health Observatory, Singapore Department of Statistics, Brunei Ministry of Health 10,4 (2017) 15 (2012) Indonesia Lao PDR

18,77 (2017) 10,4 (2017) Life Expectancy at Birth (Years) Malaysia Myanmar as of 2019

9,9 (2014) 24,86 (2017 ) 74,3 70,1 Philippines Singapore Brunei Darussalam Cambodia

21(2010 ) 31,8 (2013 ) 71,3 68,5 Thailand Viet Nam Indonesia Lao PDR

Source: WHO Global Health Observatory, UN Data 74,7 69,1 Malaysia Myanmar 70,4 83,2 Philippines Singapore 77,7 73,7 Thailand Viet Nam

Source: WHO Global Health Observatory 30 Special Edition

Viewpoint: UNIVERSAL AND GENDER- RESPONSIVE HEALTH CARE: LESSONS FROM CANADA

DIEDRAH KELLY s our partners are aware, Canada AMBASSADOR, MISSION OF CANADA TO ASEAN continues to be a strong and vocal Aadvocate at home and around the world for gender equality, the empowerment It is with great pleasure that I welcome the opportunity of women and girls, and the realisation to contribute insights from a Canadian perspective. of their human rights. Despite global progress, gender inequalities persist This COVID-19 Special Issue on “Strengthening Health in all sectors of social and political life, Systems in ASEAN” is timely to reflect on the challenges in all countries, including in Canada posed during this unrelenting global pandemic. and here in the ASEAN region. Apart from its devastating economic impact, the pandemic has widened the gender and economic inequality in the world. Women across the ASEAN region have been disproportionately affected due to their overrepresentation in sectors hardest hit by the pandemic— manufacturing, textiles and garments, care services, hospitality, and tourism. Globally, women make up to 70 per cent of the health and social care workforce. Economic necessity forces many to continue working, despite the risk of infection for them and their families. The economic fallout and the health risk for women will intensify the gap, and without gender-responsive policies in place, the crisis can have regressive impacts and derail hard-won gains in gender equality and other inclusionary efforts.

The surge in COVID-19 cases is straining even the most advanced and best-resourced health systems. With resources diverted to fighting the pandemic and the cancellation of other essential health services, many women were left without adequate maternal and sexual and reproductive health services and rights. Despite the pandemic’s strain on health systems, governments must ensure that essential health services continue with initiatives integrating gender mainstreaming to safeguard gender equality in its policies and programming to protect the sexual and reproductive health and rights of

women and girls and their newborns. Photo Credit: © Mission of Canada to ASEAN

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Current health systems approaches do not adequately address the impact of COVID-19 on certain groups who are most severely Current health systems approaches impacted by the pandemic—in particular women. In Canada, while responding to do not adequately address the impact COVID-19, the first focus was on descriptive of COVID-19 on certain groups who are most statistics (number of cases), but there was no analysis on who was affected most. This severely impacted by the pandemic— kind of research should be done sooner to in particular women. help design interventions. Initiatives to assess gender impacts and differential impacts on the poor and marginalised are also needed in other countries to share with decision- health systems by strengthening the role the ASEAN response to the COVID-19 makers so that interventions are targeted of primary health care services to reach pandemic, including the ASEAN Emergency and not too diluted. vulnerable groups and provide gender- Operations Center Network (led by Malaysia) responsive services, including ensuring and the ASEAN BioDiaspora Virtual Centre Strengthening health information systems that concerns, needs, and priorities of the (led by the Philippines, with support to improve sex-disaggregated data, and data poor and the marginalised are included from Singapore). We are committed to disaggregated by other factors are extremely in the service provision. furthering these successful partnerships important to inform appropriate interventions. and working with ASEAN to engage other Closing the gender data and information gap But, there is also the question of preventing, partner nations and organisations with requires: 1) collection of real-time COVID-19 detecting, and responding to health threats. a shared commitment to strengthening data on incidence, hospitalisation, testing, Canada’s Weapons Threat Reduction Program health security. We see an opportunity and mortality; 2) greater support to national (WTRP) deeply values its impactful to better engage with other members of statistical systems, strengthening of gender collaboration with the ASEAN Health Sector the G7-led Global Partnership Against the data collection, and integration of a gender through the Mitigation of Biological Threats Spread of Weapons and Materials of Mass perspective in all statistical operations; (MBT) Program. This collaboration has Destruction (GP), in close cooperation with and 3) investments in dissemination meaningfully enhanced the capacity of the Philippines (the only ASEAN member and use of gender data. ASEAN partners to prevent, detect, and of the GP). Similarly, the new ASEAN Centre respond to all manner of biological threats, for Public Health Emergencies, if properly Improving access to gender-responsive whether natural, accidental, or deliberate structured, has the potential to serve as health services for all women and all gender in origin. Canada is particularly pleased an important base for projects supported

Photo Credit: © Ali Jabber/Shutterstock orientation requires initiatives that decentralise that the capacity built has supported by Canada and other donors. 32 Special Edition

from COVID-19 in Canada occurred in long-term care facilities, and the rate of death from COVID-19 among long- term care residents is higher than in many countries. These tragedies may be due, in part, to long-term care not being fully embedded in UHC in Canada and not benefitting from the same attention as other areas of health care, such as hospital safety and governance.

One fact is clear: to respond effectively to a global pandemic there needs to be a collective effort. The COVID-19 pandemic has underscored the need to reinforce and deliver on joint commitments by the international community to strengthen health-security systems and reinforce prevention, preparedness, detection, and response capabilities worldwide. The COVID-19 pandemic has shown Canada’s The UN Secretary-General has flagged that UHC strengths and weaknesses. Cost is not the pandemic may increase bioterrorism and other international security threats. a barrier to accessing medically necessary Canada is committed to working with hospital and physician services. partner countries and organizations to deliver concrete and impactful programming to mitigate all manner of biological threats, including in the ASEAN region. Access to health care underpins the coverage. Also, the system is flexible: while ability to respond. Universal and publicly provinces and territories manage health care One key lesson from the pandemic is funded health care is a core Canadian services tailored to the needs of the residents that international security partners (e.g., value. By ensuring reasonable access of each jurisdiction, the federal government Canada’s WTRP) have the ability to move to health care services, Universal Health ensures national standards for hospital and quickly and decisively to deliver assistance Coverage (UHC) enables a healthy and physician services are maintained through during a crisis, which underscores the productive labour force, and inclusive and the Canada Health Act. importance of further strengthening sustainable economic growth. Ensuring all collaboration at the health-security interface. people have access to health care services The COVID-19 pandemic has shown Canada’s In addition, it will be important to encourage can help reduce the impact of inequities, UHC strengths and weaknesses. Cost is not traditional partners to apply creative and including those based on gender, race, a barrier to accessing medically necessary innovative solutions for a range of pressing and disability status. Canada’s health-care hospital and physician services. COVID-19 challenges, including real-time disease system is designed to ensure that all eligible testing and virtual care services are available surveillance (using big data analytics, residents have reasonable access to medically free of charge. Inequities have been reduced machine learning, and artificial necessary hospital and physician services (e.g. testing is available for everybody, and intelligence, such as that offered on a prepaid basis, without charges related there is a commitment that vaccines will be free by the BioDiaspora Virtual Centre) to the provision of insured health services. for all). Provincial/territorial management of and the development of new types the health care system means that centralised of sustainable biological laboratories In terms of lessons learned from Canada’s management and reporting systems were and equipment. The pandemic has health system, we can underline a couple already in place to deal with the pandemic, revealed the fragility of supply chains of key points. The system offers a competitive e.g. testing, tracking, and contact tracing and the vulnerability that comes with advantage for Canada in a competitive world. of cases, supply and distribution of personal concentrating critical industries in a few It is a driver of a more inclusive and productive protective equipment, and supply of countries (whether vaccine production economy, as businesses are not burdened hospital intensive care resources. or PPE manufacturing)—key issues with financing health insurance premiums that will need to be considered if the for their employees. It enables employees However, COVID-19 exposed long-term international community is to be better to change jobs and move between regions care as a clear vulnerability in Canada— prepared to prevent, detect, and

without fear of losing their health care early data show two out of three deaths respond to the next pandemic. Photo Credit: © Mission of Canada to ASEAN

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Strengthening Health Systems in ASEAN Through Digital Technologies Photo Credit: © Milles Studio/Shutterstock 34 Special Edition

NGIAM KEE YUAN, MD ASSOCIATE PROFESSOR NATIONAL UNIVERSITY HEALTH SYSTEM, SINGAPORE

Healthcare is a significant cornerstone of every more services or “skills” may be made political system in the world. This is even more so in available to users. For example, chatbots with AI conversational capabilities may the post-pandemic world, where tectonic shifts in the replace most call centres and other way medicine is transacted have altered the dynamics service functions such as payments. between healthcare providers and patients. The messaging nature of chatbots is a familiar interface, given the popularity of he pandemic has exposed to prevent the onset of chronic diseases, messaging apps, and this facilitates access opportunities for the quality which is a major burden in both developing to multiple services without the need to Tof healthcare delivery to be and developed countries. The same strategy navigate through menus. A well-designed improved dramatically, propelled by digital is also employed to help patients who have AI conversational engine in a chatbot would innovations such as artificial intelligence been discharged from the hospital to allow healthcare institutions to scale-up (AI) and automation, and the acceptance manage their health at home, in the their scope of services beyond institutional of new modes of healthcare delivery. hope of bringing healthcare from services to wellness coaching, patient the hospital to the community. education, and even patient counselling. Due to movement and travel restrictions during the pandemic, telemedicine has Given the accessibility to these digital This level of service provision and integration become the primary means through which applications, there are now as many as requires healthcare institutions to invest people gain access to outpatient healthcare 325,000 health-related apps in the various in scalable IT architecture. For healthcare services. With the increasing penetration app stores. This presents a dilemma to the systems that have yet to migrate to electronic of smartphones to rural communities, consumer, as the reliability and ease of use health record systems or are in the initial isolated communities now have more of these apps are highly variable. stages of doing so, it is vitally important to teleconsultation services made available Furthermore, these apps are not consider hosting such services on a hybrid to them. This is only possible because of the typically integrated with public cloud architecture. This would allow for increased demand for such services, which healthcare systems due to high barriers both rapid scalability and cutting edge resulted in a corresponding improvement in of entry, internet separation, and complex capabilities at the lowest possible cost. the quality of such services and an increase health financing models. Healthcare apps in the number of such providers. would likely go through a period of The decision to adopt cloud-based consolidation before an integrated infrastructure is a revolutionary step, Teleconsultations open yet another avenue app that addresses these issues would especially for some countries in to automate healthcare delivery through emerge as the dominant solution. Southeast Asia, where the digital the use of apps and chatbots. Mobile apps infrastructure is more developed can provide services to users, much like A special class of mobile apps, termed than healthcare IT systems. It presents a online merchants but for healthcare services chatbots, is set to transform healthcare once-in-a-lifetime opportunity to leapfrog such as teleconsultations, medication refills, delivery using familiar messaging from expensive incremental generations and health products delivery. interfaces. Present chatbots have limited of technology by leveraging on ubiquitous functionality and are largely Q&A bots that cloud technologies that many can access. Apps also offer a portal through which are subsidiary to current websites or apps. As an illustration of such a technological future AI services such as teledermatology However, as this technology matures, leap, Mongolia never built extensive and teleophthalmology can be delivered. These novel technologies may completely disrupt the way high demand specialist screening services such as diabetic The pandemic has exposed opportunities eye screening is delivered, reducing the long wait-time and high costs for the quality of healthcare delivery to be associated with them. improved dramatically, propelled by digital Some apps now offer preventative health innovations such as artificial intelligence (AI) services with attractive incentives to encourage and automation, and the acceptance of new users to adopt a healthier lifestyle. Through a combination of gamification and rewards, modes of healthcare delivery. these apps encourage lifestyle modifications

The ASEAN November-December 2020 Special Edition 35

required by healthcare institutions, while the commercial cloud systems In the post-pandemic world, consumers offer flexibility and lower costs. would demand digital healthcare services Government leaders need to familiarise that are more accessible, of better quality, themselves with the benefits and risks of implementing hybrid cloud systems and at a lower cost. for healthcare and design policies that promote its use. More importantly, if these policies provide data privacy and personal data protection from the outset, it would go a long way to reducing the cost and telephone landlines throughout its vast Some barriers to adopting this infrastructure friction of transacting healthcare services. territory because they installed cell phone are the lack of appreciation of the capabilities It would also catalyse research and towers instead, which instantly provided of cloud-based systems and the lack of development of new AI technologies that widespread coverage to its largely confidence in the security of these platforms. require large amounts of data to achieve nomadic population. Commercial cloud platforms are inherently highly accurate models. more secure than most on-premise Similarly, when ASEAN countries contemplate datacentres as multiple sites throughout The future of medicine would be improving their healthcare IT systems, they the world monitor them. They are also dominated by digital technologies too can benefit immediately from adopting more reliable due to the large number that improve the delivery of healthcare cloud-based technologies from the outset. of datacentres they run, which achieves to patients. In the post-pandemic world, This would save millions of dollars in economies of scale and translates to lower consumers would demand digital the cost of implementing incremental costs compared to on-premise datacentres. healthcare services that are more IT technologies and open the door to AI Most healthcare IT systems are running accessible, of better quality, and at technologies that can be easily integrated on a “hybrid cloud” architecture, a lower cost. This could be achieved into cloud-based systems. It would also combining on-premise cloud servers through policy changes that promote empower engineers to actively build AI and commercial cloud systems. The the adoption of AI technologies on cloud tools that would improve medical services, on-premise cloud servers provide infrastructure to deliver better healthcare

Photo Credit: © Rido/Shutterstock benefit doctors, and patients. independence to run critical services services on mobile devices. 36 Special Edition

Mental health in a post-pandemic ASEAN Photo Credit: © Mary Long/Shutterstock

The ASEAN November-December 2020 Special Edition 37

HARRY MINAS, MBBS HEAD, GLOBAL AND CULTURAL MENTAL HEALTH UNIT, SCHOOL OF POPULATION AND GLOBAL HEALTH, THE UNIVERSITY OF MELBOURNE, AUSTRALIA

The COVID-19 pandemic has caused global change in the wider society.” (United Nations Policy most aspects of life, but the impact has been unevenly Brief: COVID-19 and the Need for Action on Mental Health, UN, 2020) distributed as with any major change. Across ASEAN Member States, the experience of the pandemic People with mental and substance use has varied considerably. disorders have historically been among the most disadvantaged and marginalised groups in all societies. Persons with severe ates of SARS-COV-2 infection per possibly long-lasting increase in the and persistent mental disorders, such as million population have ranged from social determinants that are known to schizophrenia and bipolar disorder, almost Rfive in Lao PDR to 70,624 in Indonesia, contribute to the increased risk of mental always have multiple vulnerabilities, and deaths attributed to COVID-19 from disorder. These include isolation from including undiagnosed and untreated 0 in Cambodia to 18,653 in Indonesia. family, friends, and co-workers; disrupted general health problems, unemployment, Community transmission continues in education; loss of employment; financial poverty, insecure housing or homelessness, Indonesia and the Philippines, while there hardship and apprehension about the social isolation, limited social supports, are currently no cases in Brunei and sporadic future; restricted movement; a sharp stigma, discrimination, and human rights cases or clusters of cases in all other ASEAN increase in family violence experienced abuses. The pandemic has exacerbated Member States (WHO COVID-19 Dashboard). by women and children; and restricted these vulnerabilities. access to health and other essential The elderly and health workers have services. The population mental health At the same time, as the need for mental suffered the most direct health effects, impact of the pandemic—including health services has increased, pandemic while the negative social and economic population-wide apprehension and response measures have resulted in the impacts that have resulted from measures distress, stress-related disorders, closure or reduction of mental health taken to control the spread of infection anxiety, and depression—has been services and psychosocial support programs have been disproportionately felt by severe and is likely to be prolonged. in 93 per cent of countries worldwide (Pulse already disadvantaged, marginalised, Survey on Continuity of Essential Health and vulnerable populations. Services during the In most societies, the COVID-19 Pandemic, pandemic has starkly World Health Organization, revealed substantial 2020). Interruption in drug pre-COVID social and The pandemic’s social and economic supplies, closure of in-person economic inequities disruption has resulted in a global and psychological treatment and the vulnerabilities possibly long-lasting increase in the services, and disruption associated with such of rehabilitation and inequities, including social determinants that are known psychosocial support increased risk of to contribute to the increased risk programs are likely to have mental disorder (Social resulted in increasing rates Determinants of Mental of mental disorder. of illness relapse, Health, World Health exacerbations of drug Organization and Calouste abuse and addiction, and Gulbenkian Foundation, an unknown number of 2014). Among the most vulnerable According to the UN: preventable suicides. Disruption of school- populations are the elderly, people with “As a result of the 2008 economic crisis, based and workplace mental health programs pre-existing physical illnesses, ethnic and a rise in ‘deaths of despair’ was recorded has meant that the vital work of mental cultural minorities, migrant workers, the among working-age Americans. Suicide and health promotion and illness prevention has poor, people with insecure employment, substance-use related mortality accounted been reduced just when it is most needed. those reliant on the informal economy, for most of these deaths, which were linked women experiencing family violence, to loss of hope due to the lack of employment Digital technologies have been important children, and young people. and rising inequality. As the economic burden in disseminating information about all of COVID-19 rises, a similar toll on people’s aspects of the pandemic, including issues The pandemic’s social and economic mental health may be anticipated, with a relevant to mental health. In the context of disruption has resulted in a global and major impact on individuals, families, and closure of or reduction in access to in-person 38 Special Edition

Enhancing Health Systems, Strengthening health, poorly developed mental health Human Security, and Accelerating Inclusive information systems, and little capacity to Digital Transformation. scale up mental health services quickly to respond to mental health emergencies. In the short term, three priorities are essential. The UN stated: The first is wide dissemination of information “Good mental health is critical to the about mental health and illness: how to functioning of society at the best of times. maintain mental health, recognise emerging It must be front and centre of every country’s mental health services, many countries mental health problems and get access to response to and recovery from the COVID-19 have turned to digital technologies for mental health support, treatment and care pandemic. The mental health and wellbeing service provision. when this is required. Accurate, accessible of whole societies have been severely public information about mental health impacted by this crisis and are a priority Many claims have been made concerning and illness is as important as information to be addressed urgently.” (United Nations the extent to which digital technologies can on hand hygiene, social distancing, mask Policy Brief: COVID-19 and the Need for enable increased mental health program wearing, and testing. Action on Mental Health, UN, 2020) reach and accessibility. However, very few have been adequately evaluated for safety The second is to ensure capacity for early In a constrained post-pandemic fiscal and efficacy. This is an important area for identification of mental health problems space, it is difficult to see how sustained research in ASEAN. An additional concern and rapid and effective response. COVID- and large-scale mental health system is that persons with mental and substance safe availability of mental health services development can happen if there is use disorders are more likely to be poor and expanded service capacity are urgent no focused and sustained leadership at and lack access to digital devices and priorities. Closed or restricted mental health the highest levels of government. While technologies. Effective implementation services should be reopened as soon as it substantial investment will be needed to of digital mental health services will is safe to do so. Where the mental health develop effective mental health systems, require programs that bridge the digital impact of the pandemic has been severe, it is important also to consider the social divide to ensure that inequities are it will be necessary to substantially increase and economic costs of failing to make not exacerbated. service provision capacity to meet the necessary investment. An indication increased population needs. of the economic costs may be gained Given the considerations outlined above from the recent report of the Australian how should countries respond to the mental The third is that information and services, Productivity Commission (2020): “In total, health challenges posed by the pandemic? whether in-person or digital, should initially mental illness, on a conservative basis, is be targeted to population sub-groups that costing Australia about $200-220 billion The first and, in the long term, the most are at increased risk of significant mental per year. To put that in context, this is just important response is to bring about an health problems. Among these groups very over one-tenth of the size of Australia’s attitudinal shift among leaders and the high priority should be accorded to women entire economic production in 2019.” broad community that recognises that and children experiencing family violence, mental health and physical health are women in the perinatal period, elderly people Attention to mental health must be of equal importance. Although such who are socially isolated, young people at understood as an essential component an attitude is encapsulated in the WHO risk of suicide, and people with severe mental of the ASEAN economic recovery. To ensure slogan, "there is no health without mental or substance use disorders who may have the necessary mental health leadership health," this has not been turned into had their treatment and care disrupted. and the extensive inter-ministerial and sufficient practical action. The post- inter-sectoral collaborations and pandemic period of recovery is an In the mid- to long-term, attention must partnerships that will be required opportunity to make this change, which turn to substantially strengthening mental to build comprehensive and effective will enable the attention and investment health systems. mental health systems, ASEAN Member required to adequately promote and States may wish to consider the whole-of- protect the mental health of individuals, Mental health services in many ASEAN society benefits of creating the position families, and populations. Member States were already inadequate of Minister for Mental Health. prior to the pandemic (ASEAN Mental The ASEAN Comprehensive Recovery Health Systems, ASEAN Mental Health Simply returning to pre-pandemic Framework and Implementation Plan, Taskforce, 2016; The Impact of COVID-19 levels of mental health system adopted at the 37th ASEAN Summit, sets out on Mental, Neurological and Substance capability would neglect what has the pathway to recovery, and the principles, Use Services - Results of A Rapid been learned from the pandemic about objectives, strategies and priorities, that will Assessment, World Health Organization, the importance, and the current relative guide the recovery. Three of the five broad 2020). They were beset with inadequate neglect, of population mental health strategies are particularly relevant to the investment, insufficient and inequitably and would constrain the post-pandemic task of mental health system development: distributed human resources for mental social and economic recovery.

The ASEAN November-December 2020 Special Edition 39 Conversations The impact of COVID-19 has spared no one across our region.

Healthcare workers, survivors and a patient advocate

A teacher, small business owners, grounded pilots and fake news fighters

These are quarantine conversations on how people are coping with the crisis. Photo Credit: © Tavarius/Shutterstock 40 Special Edition

Conversation Disa Edralyn, MD Doctor. COVID-19 Survivor.

Months into the “My mother got COVID-19 pandemic, Dr. Disa in April, and her symptoms Edralyn understood that were mild too. She’s a dentist at a community health the risk of contracting centre in Jakarta. She was the coronavirus is higher unwell, but her first rapid for medical workers test result was negative, so in Indonesia. I treated her by myself first at home. She didn’t get any better after a week, so she The 27-year-old doctor, who took a second rapid test, is currently inactive to focus and the result was reactive on her specialty study on and was tested positive anaesthesiology, was tested after taking a PCR test. positive with COVID-19 in July. Earlier, her 61-year-old dentist “At that time, there were only mother was also infected two COVID-19 referral hospitals by the virus. in Jakarta: Sulianti Saroso Infectious Diseases Hospital and Persahabatan “It’s one of the risks of being a Hospital. Considering her emotional doctor. When I was diagnosed factor and her mild symptoms, my with COVID-19, I was not surprised family and I decided to treat her at but felt guilty instead because I was home. I always wore complete afraid of spreading it to others. Dr. Disa encourages people to maintain personal protective equipment Fortunately, those who had close safety protocols as the pandemic in Indonesia every time I checked on my mother. contacts with me were fine. At that is far from over My relative is also a doctor so we time, I treated many patients with always had discussions about COVID-19 symptoms during my her treatment. shifts in an intensive care unit (ICU) at a private hospital in “The pandemic has been “She took another swab Jakarta. I felt unwell a few days test, but the result was still after meeting a patient with a difficult period for positive. We were so confused as COVID-19 symptoms, so I took medical workers; we are she no longer had the symptoms. a swab test, and it was positive. Her third test finally showed all tired physically that she no longer had the “My symptoms were mild; I had a and emotionally.” disease. It was very emotional headache, sore throat, and a little for me treating my mother, shortness of breath, but no fever. but I kept it to myself. I was put in isolation for a week in the hospital. I started to feel calmer during the isolation period, but then the “The pandemic has been a difficult period for medical loneliness and boredom crept in because this disease workers; we are all tired physically and emotionally. In the requires you to be all alone—no one could visit or early days of the pandemic, the visits to our hospital dropped accompany you. I filled my time with studying, calling significantly, maybe because people were afraid of going my friends, and exercising in my room. But I spent out. The number of patients coming to the hospital most of the time resting and eating. started to increase gradually, and many came with COVID-19 symptoms. “After being tested negative, my pulmonologist discharged me but told me to do a recovery isolation “The toughest period was I think in August or September at home for another week. I still maintained my distance when we had a lot of patients, but we didn’t have enough with my parents and did not meet them for a week. beds in the ICU. Similar conditions also happened in many

I don’t want my mom to get reinfected with COVID". other hospitals. We also met some challenging patients, Photo Credit: © Disa Edralyn

The ASEAN November-December 2020 Special Edition 41

like those who could not accept Conversation the fact that they or their family members got COVID-19, blaming Jonas Elmer Balneg the hospital and saying that we’re part of a conspiracy. Registered Nurse

“There was also a time when the pandemic broke me down so much; Jonas Elmer Balneg studied nursing because his mother when I needed to choose which one was a nurse too. The Philippines is one of the major sources to save, which one has a higher of nurses globally. survival rate, since we only have one bed left in our ICU and it was also difficult to find an Many like Jonas take up nursing available bed in other hospitals. with hopes of landing an overseas I kept asking myself, ‘Do I really job. His plan was to work in the need to choose?’. country for two to three years and move abroad but Jonas has chosen “I became extra cautious, and thoughts to stay for now. like ‘Do I carry the virus? Will it spread it to other people if I’m actually a carrier?’ kept He has worked for almost a decade at bothering my mind. With shorter days off, one of the Philippines’s largest public those times were emotionally draining for hospitals, where he says he is earning me. Sharing with friends and trying new a comfortable living. Jonas talks about hobbies have been helpful to get it off the health workers' fears when my mind. I tried baking and enjoy it so reports about a new coronavirus first much now. broke, the uncertainty of handling patients, and the important role “This pandemic is far from over, nurses play in a health emergency. but if the people don’t care about it anymore, I’m afraid we will go back “When we received the first suspected to the time when it’s difficult to find patient in our unit, as the nurse in charge available beds in hospitals. The front that day, I had to find a way to isolate the liners are not us, the medical workers, patient. I decided to be like a private nurse but it’s people themselves who can and stayed with the patient for the first control the pandemic. 24 hours. Back then swab tests results Jonas says the nursing profession took longer to process, so my colleague is now getting the respect it deserves “We still have a lot of work to do and I took turns watching over the to improve our health system. The patient for almost three straight days. policymakers down to the people When it later became a COVID-19 serious. Maybe I was crying too for the need to be more solid in responding referral hospital, I volunteered to whole of humanity. There were thoughts to health emergencies in the future. be part of the first team to handle like, ‘Is this it? What about our future? Is It’s also important to improve our the COVID-19 wards because I had COVID-19 the end for us?’ I also wondered information system, especially on some experience with taking care if it could have been prevented earlier and health, so people won’t be easily of a probable case. We took care people didn’t have to die. Those are the misled by fake news. We can also of patients who were suspected questions I ask every time I have a patient learn from the other ASEAN countries of having COVID-19. Many of them with COVID-19. What if this pandemic in responding to the health crises, and tested positive and the team was never ends? collaborate more to improve our health quite shocked at how quickly systems so that if we face another the numbers rose. “We had to limit our contact with the pandemic in the future, we all patients because we also had to think can have the same standards “I acted like an assistant to the head nurse of our own safety. in responding to it.” of a unit then. I had to establish protocols and guidelines to keep members of my We tried to reassure them as often as Interviewed by Novia D. Rulistia. The conversation team safe, while making sure the patient possible but we couldn’t spend too much has been edited and condensed for clarity. The didn’t infect others. On that week, I also time in the room with them. Sometimes, views and opinions expressed in the text belong experienced losing my first COVID-19 it was a real struggle. Before we had the solely to the interviewee and do not reflect the patient. I cried, maybe that was when it level four hazmat suits, of course there

Photo Credit: © Jonas Elmer Balneg official policy or position of ASEAN. sank in that this pandemic was getting was the fear of getting infected but 42 Special Edition

“Respect especially for nurses has increased. We have been called heroes in this pandemic. In our hospital, we have been given a voice, especially in determining the guidelines and protocols on staffing and how to handle patients.”

that. We used to work 7-day weeks and go on quarantine. That has changed so I guess now there is a semblance of normalcy. I think it has helped with our mental health.

“They say maybe the vaccines will be Jonas and his colleagues available in 2021. I think governments and lifted each other up through people are relying too much on vaccines. This extended hospital shifts and will not go away soon. I’ve accepted that this quarantine periods is the new normal. We Filipinos are quite good at adjusting to things and situations.

if we didn’t do it, who else will? “Respect especially for nurses has increased. We had to conquer that fear and We have been called heroes in this pandemic. my colleagues and I had to In our hospital, we have been given a voice, support each other. especially in determining the guidelines and protocols, staffing and on how to handle “During that time, we worked for patients. Now, it’s recognised that nurses one week and then went on a two- have a large contribution to the health week quarantine. We couldn’t go team, so we can enhance health policies. home. We were very thankful that hotels around the area offered “I can understand complaints from the general us temporary accommodation public about the long lockdown. Limit your while we were handling the gatherings, if you can, because there was a COVID-19 unit. Some government time when hospitals were overwhelmed by officials arranged for the hotel accommodation and there was also COVID-19 cases. When they eased quarantine measures, that’s free transportation to and from the hospital. It was a huge help. when the surge of cases happened. I know we miss our families and loved ones but let’s limit those visits and don’t risk infecting “I kept in touch with friends through social media and messaging apps others especially the elderly. but after a while it became depressing. It was an unending cycle. I would often wonder, when will this end? There was a point sometime “There are many lessons to be learned from this pandemic. I think in June when I didn’t want to go to work anymore. It felt endless and governments have to listen more to healthcare workers. When I read the number of cases just kept rising. There was a feeling of despair. the news, I get the impression that they are relying on vaccines to address the pandemic. That shouldn’t be the case. Let’s look “Everywhere, there have been many nurses, health workers who at other countries that have been more successful in containing have lost their lives. Whenever I read news about that, I really the disease. Let’s listen to the experts.” wonder if the epidemic could have been addressed before it became a pandemic. It’s just sad. Interviewed by Mary Kathleen Quiano-Castro. This conversation has been translated, edited, and condensed for clarity. The views and opinions “Our work and quarantine schedules have become more manageable. expressed in the text belong solely to the interviewee and do not reflect the

There was a point when there was outrage among the staff over official policy or position of ASEAN. Photo Credit: © Jonas Elmer Balneg

The ASEAN November-December 2020 Special Edition 43

Conversation wife, my father and the nanny were all negative so they could Paul Nyan Myint Soe go home, but I continued my treatment at another COVID-19 COVID-19 Survivor. Business Director. treatment center. “I also called my mother everyday For human resources since she arrived at Phaung Gyi on consultant Paul Nyan 4 October and my last contact with Myint Soe, the COVID-19 her was on 7 October. After that my mom was either asleep or pandemic means chaos unconscious each time I called. The and disaster. medical officers informed us that her oxygen level was low, and her sugar level was high. My mother The 43-year-old business passed away on 17 October. director was diagnosed with COVID-19 in October, and “My father and I drove as fast from his quarantine room, as we could to her quarantine he learned how the virus center to see her for the last time caused him and his family before the cremation. We couldn’t a great loss. see her actually, as she was all wrapped up, but we managed “When my mother fell ill in to pay our last rites together with late September, we took her the Chaplain from Phaung Gyi to a private hospital. The doctor COVID Treatment Centre and suggested for me to either take the pastors from our church. my mother to a government hospital for a COVID-19 test “Throughout this whole ordeal, or to return home and give Despite the chaos the pandemic creates, my family, relatives, the church her antibiotic injections every Paul believes that positive changes have community are my biggest 12 hours. Due to my mother’s also emerged in society sources of strength. My friends condition of needing fulltime checked in on me, while my assistance, we took the second physician and my father told option. With there being no improvement to her condition, me to focus on myself. I ate healthy foods, took vitamins, and did we decided to test her for COVID-19. She was found positive light exercises to stay fit so I could go back to my family and work. and taken to the Phaung Gyi COVID-19 Treatment Center, which is about 100 kilometres away from our home. “My company, Sagawa Development Company, was also affected by the pandemic. We started to work from home in February. We “As I was taking care of my mother day and night, I felt I may shifted the consulting arm of our business to online platforms, but have contracted COVID-19 too. Adhering to my responsibilities, the other areas of business had to close. We turned our small in-house I immediately contacted the township medical officer to get further catering services into food delivery service for my clients. Some clients guidance. My family was quarantined at a hotel, and each of us ordered the food and donated them to COVID-19 treatment stayed in different rooms. My 11-year-old daughter and 2-year-old centres in Yangon. son were able to stay with their nanny, which I was thankful for. We underwent testing and my household helper and I tested positive. “If I can express COVID-19 in a formula, it’s equal to chaos and disaster. We need to be careful, not only for ourselves but also “While I had no serious symptoms, I couldn’t sleep well because for our loved ones. there were many things running through my mind. I was concerned about my children. Should my kids be affected, who would take “But COVID-19 is not all negative, I can see some positive changes. care of them? Also if the kids were fine but all adults were positive, People are more aware of health and hygiene. With the increased who was going to be with them? I also thought about my mother rate of handwashing, there appears to be less regular coughs and who was all alone, and also my position as the family breadwinner. colds. We also see the rise of e-commerce, digital shopping, e-banking These caused considerable stress. and payment, which can be a positive trend for the future.”

“During the quarantine period, my family supported and encouraged Interviewed by Novia D. Rulistia. The conversation has been edited and condensed one another through video calls. At night before going to bed, we for clarity. The views and opinions expressed in the text belong solely to the

Photo Credit: © Paul Nyan Myint Soe usually had a video call to pray together. Thankfully, my kids, my interviewee and do not reflect the official policy or position of ASEAN. 44 Special Edition

Conversation “The Philippine Society of Medical Oncologists, in an internal informal survey done among some of its members, showed Kara Magsanoc-Alikpala that about 74 per cent of their cancer patients deteriorated due to delay in cancer Advocate for Breast Cancer Literacy treatments because of the pandemic. and Early Detection. Journalist. Most of them had to delay treatment by a week to a month because of all the barriers to care. For more than 20 years, the ICANSERVE Foundation “ICANSERVE Foundation provided our staff has been on a mission to save and volunteers, breast cancer patients, and the healthcare frontliners we work with in lives by advocating for early local governments with shields and masks. breast cancer detection, and Back in March, when we experienced a total by linking breast cancer lockdown, shields and masks were as rare patients and survivors to vital as pink and yellow diamonds. We had to information and resources scramble to find some. On top of the usual that can set them on the path surgical masks, we had to resort to small manufacturers and volunteers based at home to healing and wellness. who would create makeshift masks or shields. Some shields were so creative they came with ICANSERVE Foundation was founded messages of encouragement which made by four cancer survivors who all know Kara says one of ICANSERVE Foundation's the recipients happy. what it takes to overcome the disease. early interventions was to raise funds for Kara Magsanoc-Alikpala, an the manufacture of masks and shields for “Next, we had to make sure that those on accomplished Filipino broadcast distribution to cancer patients cancer treatments didn’t stop for too long. journalist and documentary filmmaker, There were many barriers. Besides financial, is one of the founders and served as the biggest obstacle for the poor was its president. She now sits as a member overwhelmed by the number of COVID-19 transportation. There were no public vehicles of the board of trustees and chairman patients. Later, some cancer patients were during the lockdown so we had to secure of the advocacy committee. allowed back in the health facilities or special passes for our volunteer drivers and hospitals, but everything was only by patients so they could be driven to the Since the onset of the COVID-19 appointment. When they rank in importance hospitals to resume their cancer treatments. pandemic, Kara and her team have the cancer patients that need to be seen first, The ICANSERVE Foundation had in place been working tirelessly to continue those in treatment, in need of immediate before the pandemic, a free car program ICANSERVE Foundation’s advocacy surgery, or radiation are the priority. Next for breast cancer patients on chemotherapy. work and at the same time, address would be cancer survivors who need regular We expanded this service by partnering with the urgent needs of breast cancer monitoring. Last priority goes to women the Cancer Coalition Philippines to provide patients, such as access to face masks, and men who never had cancer but need free car service to all cancer patients. transportation, and funding. to go through early detection protocols. “For now, our free clinics and in-person “Without a doubt, breast cancer screening “It was a little more complicated for the poor forums, trainings, in-person fund raising and treatment have been delayed because who don’t have dedicated doctors. For the events and other activities are on hold. But of the pandemic. Not only due to fear of poor who go to public hospitals, they are we continued basic breast cancer awareness getting COVID-19, but because many of the assigned a doctor, usually a resident. And forums online. We continued fund raising cancer patients went broke and can no longer residents rotate a lot. So they hardly form online plus our online ICANSERVE shop afford treatment or screening. Many of them a rapport with one doctor. This means they’re stayed open. We’ve hosted several webinars lost jobs. Or, a relative based abroad who not in contact with one particular doctor. to give our volunteers, patients, and the helps with expenses also lost their job. This means they don’t have a particular breast cancer community guidelines on One other big problem even for the middle doctor on their speed dial; or, a doctor who how to go about regular checkups for those class is the absence of public transportation could help them navigate through the new cancer patients in remission, and for those during the lockdown. Even private vehicles normal. A lot of poor cancer patients were currently on cancer treatments. needed special passes to ply the streets. also disconnected from the health system because all information shifted online. Most “We only started to actively promote “Cancer units and cancer centres were of the poor can’t afford smartphones, nor do resuming visits to the hospital for women closed during the lockdown beginning they have connectivity to access these kinds who can benefit from early detection about

in March, when the hospital system was of information or tele-consults. two to three months ago because most Foundation Photo Credit: © Kara Magsanoc-Alikpala and ICANSERVE

The ASEAN November-December 2020 Special Edition 45

ICANSERVE Foundation's breast cancer screening event in Pasay City, Philippines; photo taken before the pandemic

oncologists agreed hospitals and health facilities were safer. It’s not easy to convince them and we don’t force anyone.

“Since many women are afraid to go for a regular mammogram or breast ultrasound, we’re strengthening the power of women to take care of their breast health on their own, and giving them the courage to see a doctor, a nurse, a midwife, a community health worker, if the need arises. We created “The ICANSERVE foundation co-founded home or just getting together on Zoom for a Kamay Gabay (translated as “guiding hand”) the Cancer Coalition Philippines that lobbied someone’s birthday. That helps heaps for Kit. It contains mini-brochures that have for the passage of the National Integrated people’s mental and emotional health. information on breast self exam, breast Cancer Control Act. The Cancer Act was care, and breast cancer myths and facts. It signed into law in February 2019 but it hasn’t “I lost four friends to COVID-19 and six also comes with what looks like a charm been implemented or funded. If even just relatives and friends to non-COVID-19 bracelet or a bag charm. This bracelet has bits of it were implemented last year, it disease during the pandemic. And yet, it’s several beads, and the size of each bead would’ve helped the cancer community the same feeling, there is no closure because represents the size of breast lumps one during this pandemic. It contains all the you don’t get to mourn in person. You don’t can detect if one does a regular breast self assistance and safeguards for the cancer get to visit them in the hospital to say exam, and if one doesn’t. community. We’ve been knocking on the goodbye or to say thank you. You can’t doors of Congress and the Department of even leave your home to console the “Breast cancer patients need help to pay Health for this to happen. The law includes bereaved family. There must be a big effect for their medical bills and treatments and the creation of regional cancer centers, a on a society that doesn’t have collective for good nutrition. Funds have dried up at cancer assistance fund, the expansion of closure and a lot of pent-up grief. government agencies that help poor cancer cancer coverage of the national health patients. As a result, most patients have no insurance, mandatory cancer screening, etc. “There are many reasons to worry but I one to turn to. It’s alarming and saddening. Every delay in the implementation of the choose to be grateful, grateful that I and my Cancer groups have banded together Cancer Act can spell death and the break family are healthy and get to spend more to help wherever we can. Together up and heartbreak of a family. time together at home. The pandemic made with the Cancer Coalition Philippines, me rid myself of clutter and noise. It made me the ICANSERVE Foundation has appealed to “The feeling of anxiety and depression realise I didn’t need a lot of trappings. It made pharmaceuticals to donate whatever they is not unique to cancer patients. As a me rediscover things that were essential. can to our patients—cancer medicines, foundation, we check on our members supportive care like pain medicines, and volunteers and stay connected “Our neighborhood grew closer. We were and nutritional products. online. The human connection can doing something old fashion which helped never be under estimated. It’s best to us survive as a community. We sent each “We need COVID-19-safe facilities and admit when one is feeling anxious and for other food and plants, offered to do chores standalone cancer facilities so cancer patients the other party to listen and acknowledge for each other like buy food and medical don’t share the same entrances, the same the other person’s feelings. An honest supplies. We were each other’s repairman. CT scan, the same operating room as conversation has healing powers. Doctors in the village would do home visits. COVID-19 patients. In the Philippines, it takes a long time to convert standalone facilities “Families can do the same, to really be “I think the world will be a better place if we into, say, a dedicated chemotherapy infusion present to other family members. Many all took time to pause for introspection and center. I wish the government would of those feeling stressed by loss of loved gratitude. We will think before we leap and consider this urgent and find a way to ones, long periods of isolation, financial hopefully that means we can be kinder cut the red tape. The virus will be with us insecurity, or fear of COVID-19 and the future, and smarter.” for some time so we need to create safe don’t show it. Family members must be spaces. We need to quickly restore patient observant of the actions of their members Interviewed by Joanne Agbisit. This conversation confidence in the health system. It’s also and not simply rely on what they say. I find has been edited and condensed for clarity. The good to prepare for future pandemics or that it helps to create “special occasions” at views and opinions expressed in the text belong outbreaks and simply good practice to home or online for people to look forward solely to the interviewee and do not reflect the

© Kara Magsanoc-Alikpala and ICANSERVE Foundation Photo Credit: © Kara Magsanoc-Alikpala and ICANSERVE have multiple cancer-focused centers. to—whether it’s a special Sunday dinner at official policy or position of ASEAN. 46 Special Edition Building Back Better: Towards a Community-wide Recovery

JULIA TIJAJA, PHD RUTH KARLINA MAHYASSARI DIRECTOR, ASEAN INTEGRATION OFFICER, ANALYSIS AND MONITORING ON TRADE, MONITORING DIRECTORATE INDUSTRY AND EMERGING ISSUES DIVISION ASEAN ECONOMIC COMMUNITY DEPARTMENT ASEAN ECONOMIC COMMUNITY DEPARTMENT

The ASEAN Health sector has carried out key for the open sharing of information, tools, and COVID-19 response initiatives. The recently adopted best practices; and accelerated collaboration among governments, industry players, and ASEAN Comprehensive Recovery Framework and its communities in combating the pandemic. Implementation Plan lay out wider strategies for ASEAN towards a swift and more robust recovery from the Notwithstanding the challenges of vaccine distribution and delivery, all eyes are now pandemic’s socio-economic impacts. on the recovery, including in ASEAN.

A Community-Wide In today’s world, rapid changes are Comprehensive Exit Strategy becoming the norm. Yet no one could The ASEAN Comprehensive Recovery have predicted how much the world Framework and its Implementation Plan would change in just a year. As 2020 were adopted by ASEAN Leaders at the comes to an end, there is much to reflect 37th ASEAN Summit and officially released on the achievements and challenges in on 12 November 2020. The two documents the COVID-19 pandemic and the plans serve as the region’s exit strategy from ahead for recovery. the COVID-19 crisis. They do not replace national and sub-national efforts or global As of this writing, positive results have and multilateral cooperation. Instead, they been reported on at least three vaccines in identify directions and steps that the region the advanced trial stage. The United Kingdom can take and add value for a swift and robust has become the first country to approve the recovery. Extensive stakeholder consultations use of one for the imminent rolling out of were undertaken, both internal and external, vaccination. The Russian Federation has in the course of their development. likewise announced the plan to start mass vaccination in the country. Acknowledging the COVID-19 crisis’ multidimensional impact , the Framework While these point to the long-awaited is comprehensive in scope; going beyond light at the end of the tunnel, the impact just health or economic recovery and of COVID-19 will not be undone overnight. Some of the health impacts can be long- lasting. Additionally, some socio-economic costs may become permanent, from the weakening of human capital through a lost The ASEAN Comprehensive Recovery year of schooling or children dropping out of school, small firms going out of business, Framework and its Implementation Plan to foregone investment and jobs. were adopted by ASEAN Leaders at the 37th ASEAN Summit and officially released At the same time, this year also has its share of hopeful stories. We have witnessed the on 12 November 2020. unprecedented pace of testing, diagnostic, vaccine, and treatment development; readiness

The ASEAN November-December 2020 Special Edition 47

encompassing community-wide recovery efforts. It focuses on strategies deemed Figure 1 critical for ASEAN through the recovery phases; starting from the safe reopening of ASEAN Comprehensive economies and communities, to recovery of sectors to regain their pre-COVID potential, Recovery Framework and striving for long-term resilience through better crisis preparedness and other actions. Maximising the potential of Intra-ASEAN market and broader The Framework communicates the objectives economic integration of the comprehensive recovery plan to Accelerating Strengthening inclusive digital internal and external stakeholders; mainly human security transformation to support the identification, prioritisation, and alignment of efforts towards recovery and facilitate coordination and collaboration among relevant parties. It sets out the five broad strategies for ASEAN recovery, which Advancing towards look at the strengthening of the region’s Enhancing a more sustainable health systems; safeguarding the health systems and resilent future multidimensional aspects of human security, from social protection, food security to gender Broad impact of COVID-19; maximising internal Strategies market potential and broader economic integration to support recovery; embracing the imperative of digital transformation in an inclusive manner; and striving for a more sustainable and resilient future (see Figure 1). Enabling Factors (i) Policy measures and responses, (ii) Financing and resource ASEAN’s strategy for recovery, as detailed mobilisation, (iii) institutions and governance mechanisms, (iv) Stakeholder in the Framework, is operationalised by the engagement and partnerships, (v) Effective monitoring Implementation Plan. The Plan identifies and consolidates existing, planned, and new initiatives and programmes to contribute to the Framework’s five broad strategies. of initiatives under the Framework, but of the second implementation phase of Each programme has its corresponding also the progress of recovery in ASEAN. the ASEAN Community 2025. This second implementing agency or agencies to The ASEAN Secretariat will provide the phase will take place in a post-COVID-19 ensure follow up. The Implementation necessary support in this regard. world that is different and uncharted. Plan is a living document as it was not possible to identify all possible Beyond COVID-19 Recovery: Indeed, global power dynamics will initiatives within the short timeframe Thriving as a Community be more complex. Multilateralism and of its development. It remains open Although the Framework and its international rules-based order can no to further initiatives and contribution. Implementation Plan do not cover longer be taken for granted but must everything that the ASEAN Community continue to be upheld. Despite the The effectiveness of the ASEAN needs to do to thrive in the world of setback the region experienced from Comprehensive Recovery Framework tomorrow, they help focusthe region’s COVID-19, it will remain one of the few will depend on its implementation. efforts and resources to areas that matter bright spots globally, as many major Two key aspects to note are resources most to recovery. At the same time, ASEAN economies will be playing recovery and monitoring. While existing and must remain steadfast in pursuing its catch up for some time. But there is no planned initiatives and programmes regional integration agenda as set out time for complacency. ASEAN must use may have identified resources, it is still in the ASEAN Community Vision 2025 and the recovery momentum to address the possible for external partners and other its corresponding Community Blueprints. vulnerabilities exposed by the pandemic, stakeholders to contribute to identified ASEAN recovery efforts coincide with undertake the necessary reforms, and be initiatives or propose initiatives that and will play a key role at the start ready to be a more active global player. are aligned with the broad strategies. Of equal importance is having an effective monitoring mechanism in place. Such a The ASEAN Comprehensive Recovery Framework Plan is available at: mechanism will need to be able to monitor https://asean.org/asean-comprehensive-recovery-framework-implementation-plan/ not only the progress of implementation 48 Special Edition

Understanding the COVID-19 • Improve social care services for the elderly, people with disabilities, and children effects on ASEAN livelihood • Use of digital solutions • Expand social insurance to informal workers

NOVIA D. RULISTIA Education AND THE ASEAN EDITORIAL TEAM The study reveals major two-fold challenges in ASEAN’s education sector during the pandemic. The pandemic, and the restrictions The COVID-19 pandemic affects every segment of life, it caused, created challenges for schools in but its impact on the livelihood of the ASEAN people managing children’s behaviour according to new parameters and social distancing has yet to be understood entirely. regulations. Schools’ closure and limited access to online learning and platforms for To support policymakers in understanding workers; training support; re-employment families also triggered a learning crisis. the impacts and developing inclusive policies programmes; job retention programmes; and for the people to resume their lives in the post- occupational health and safety programmes. The governments’ responses focus on the pandemic period, ASEAN recently launched following: (i) ensuring the health and safety the ASEAN Rapid Assessment: The Impact The report recommends some of these of students by, among others, providing of COVID-19 on Livelihoods across ASEAN. strategic paths out of the pandemic: schools with infection guidelines and The report reflects the ASEAN Member • Support job retention, especially in micro-, continuing school meal subsidies despite States’ responses in the education, labour, small, and medium enterprises, through school closure; (ii) offering remote learning and social welfare sectors. It identifies the grants, tax cuts, credit guarantees, or options for those with access, including challenges faced by the Member States and other forms of financial support developing guidelines on remote learning provides recommendations to move forward. • Register and provide social security and teaching, free access to online platforms coverage for informal workers and gig and resources, and teacher training on online As the education, labour, and social protection economy workers teaching; (iii) assisting disadvantaged learners sectors are deeply linked, addressing challenges • Provide training or retraining for workers by providing access to computers and network. in one sector is expected to address challenges who have lost their jobs and are in sectors in the other sectors. Therefore, the creation that are not likely to recover soon The report recommends the following of resilient and forward-looking policies in • Invest in digital infrastructure and close to improve the education system: these sectors is crucial in protecting the the digital gap • Increase investments to support remote people from the worst of the crisis. • Establish labour standards and legislation for learning through improved network and telework and work-from-home arrangements communication infrastructure and enhance Labour technological and network devices’ subsidies The pandemic has affected the labour sector Social Welfare • Provide learning support for students in four ways as follows: (i) lockdowns have According to the report, all population groups (including out-of-school children) from forced workers to either work remotely or face different vulnerabilities because of the vulnerable groups and marginalised not work all; (ii) physical social distancing pandemic and its economic impacts. The poor communities has affected contact-intensive works, such will be the hardest hit and will take longer • Create greater alignment of curricula as restaurants, public transportations, and to recover. Through cash transfers, social with the future of work shopping centres; (iii) reduced purchasing assistance is the dominant instrument taken power has led to less demand for goods and by the Member States to help people cover The report relies on publicly available data services, and hence downsizing or closure of their basic needs. Some Member States and analysis from various sources, including companies; and (iv) supply chain has been adapted their social insurance programmes government documents and information, disrupted due to border restrictions. to respond to the pandemic, such as by university databases, research from the waiving the mandatory contribution of United Nations, and media reports, collected The report states that the pandemic’s insured workers or increasing medical benefits until the first week of July 2020. It is jointly impact on workers in ASEAN countries is of insured workers infected by COVID-19. produced by the ASEAN Secretariat and compounded by the high level of informal The Asia Foundation and supported by employment in affected sectors, like The following are some recommendations The Rockefeller Foundation and the tourism, manufacture, and transportation. to support the poor, new poor, and other Australian Government’s Department Many women in specific sectors will likely vulnerable groups: of Foreign Affairs and Trade. lose their jobs too, as many are expected • Introduce and strengthen a large-scale, to focus on their households. national safety net that can be scaled up The ASEAN Rapid Assessment is available at: in times of crisis for Member States with https://asean.org/asean-launches-rapid-assessment- The responses to the challenges can be less-developed social protection systems covid-19-impact-livelihoods-across-region/ grouped into five: income support for affected • Include migrant workers in the response

The ASEAN November-December 2020 Special Edition 49

Conversation about the lessons, or the to practice the work by lessons are too hard. The themselves too. They worry students complain about about the money they need so Dy Sophorn paying, spending money to use they can chat on their phones. their phones, and the internet is Some of them are very poor Primary School Teacher too slow. Some students who so they don’t have the money don’t have phones borrow their to study online. When we Dy Sophorn teaches grade six students parents’ phones. Parents continued learning online, at the Kampong Chhnang Primary School in complain that their children the internet service was so Cambodia. She says online learning has been have to use their phones. I tell slow that they couldn’t contact challenging for her and her students. them their children need to the study group. So, this year has been quite bad. They complain to me, ‘teacher, Only about half of her when we go online, we don’t 61 students have access to study all the subjects.’ smartphones. Over the past eight months, Dy Sophorn “The Ministry of Education taught her class trying out gave all teachers in Cambodia different social media teaching videos that we can platforms and messaging show the students. They can apps. In April, Dy Sophorn study also by watching some gave informal classes at her TV channels. home for those unable to get online. That lasted over a “On 30 November, schools month and she made sure closed again and declared a the children practiced safe long holiday for the students. distancing and followed I haven’t stopped teaching. health protocols. I spend two hours in the morning and teach them This dedicated teacher is a online, sending exercises mother of two young boys, and work to the parents aged seven and three, who and students. I worry for my takes weekend online classes So, some do not have internet, study online because if they students because this year, for her Master’s degree in no electricity. don’t, they get nothing. It is learning has stopped many Education. Her workload better than nothing. times. A lot of my students has increased during the “I think that at first, they had a are very clever but I still pandemic but Dy Sophorn difficult time studying online “During the pandemic, both worry about them. still gives students extra with me. It was a new style of teachers and students have online lessons. studying, a new style of gained knowledge about “For 2021, I hope that COVID-19 teaching but I still tried to how we can use technology will disappear from our world. “The big challenge for me is motivate them and explained for teaching and studying. I hope that I can go to school the closing of schools because that it’s not only our country to be with my lovely children, I don’t have a chance to be with that is facing the pandemic. “Students don’t want to lovely teachers, my friends at my lovely students, with my So, we need to change and study online. They want school. I hope that there would friends at school and adopt new styles of learning to be in school with their be a little more peace in the working from home. and depend on ICT because lovely friends. Sometimes world, and more development. it is very useful in our lives. my observation is the students I wish that I can use all the “It’s not easy because in primary I always tell them that if there are not happy. For me, I just try measures to teach all my school all the children are very is anything that is not clear in to explain to them about the students in class.” small and many of them are the lessons, you can ask me, dangers of COVID-19. Studying new to technology. Many do you can chat or call me. is important but life is Interviewed by Mary Kathleen not own smartphones. For even more valuable. So, Quiano-Castro. This conversation example, in my class, I have 61 “At first, they complained that we study online to protect has been edited and condensed students but only about 30-40 they don’t understand our lives. for clarity. The views and opinions per cent have smartphones; the lesson, there is no one expressed in the text belong solely 50-60 per cent do not have around who can explain it to “It affects their emotions too. to the interviewee and do not smartphones and some of them at home. Sometimes, They want to learn face to face reflect the official policy or position

Photo Credit: © Dy Sophorn them live in rural areas. parents don’t know anything with their teachers. They want of ASEAN. 50 by by Mittaphap’s were stymied operations Mittaphap. on the fund of side the to projects partly Italsorunsasmallrestaurantprojects. nutritionhealth, and environmental volunteers and serves asthe site ofits operations. It nowoperations. as “friendship”) in2020,anon-profit the formation ofMittaphap (translated who wanted to lend to a hand. This led interest of foreigners staying in the area thriving tourist town, drew the soon ina Peter’s located project, fledgling inthe future.career and having agood of people, communicating withdifferent groups information, it isessential for accessing childrenfor Laotian to learn English as 10 to 16.Peter thinksthatitisimportant Laos PDR. Laos centre of Education of with the Ministry Education Center, this and registered theMittaphap Mittaphap established as well as environmental management. but also andhealth nutrition education, to include not English only free language organisation whose have goals expanded Province and hold Nathong, Vang Vieng, Vientiane rent the SaelaoRestaurant inBan From Monday to Friday, he would to childrenin2019. National UniversityofLaos,beganteachingEnglishinformally Peter Thipommajan,a23-year-oldeconomicsgraduatefrom and Coordinator Non-profit Founder Special Edition announced apausefor more thantwo months ofEducation March 2020, theMinistry “In Peter Thipommajan English class for interested classes, classes, cases started appearing inLaos. appearing started cases when the first COVID-19suspended and environmental were projects all the Saelao public It rented school facilities. to classes Conversation the COVID-19 pandemic. English health andhealth nutrition activities, Soon after,Soon it moved its English property as the base of its asthe base of its property houses the foreign a free two-hour two-hour a free children, aged children, aged

Ministry ofEducation in Ministry Vientiane and ingettingthe approvalour efforts ofthe thistime(lockdown),“During we spent were stillclosed. of foreign volunteers since ourborders was confrontedMittaphap by ashortage we wanted to resume theproject,but June,“In whenthesituation was better, income, we hadto letgoofstaff. cent ofourcustomers were tourists. With no didn’t have per enough customers. Ninety We hadto closetherestaurant because we were shutdown. affected wheneverything another from volunteer contributions. Both onefromprojects: therestaurant and “We have two income streams for our and returned backto theirhomes. flights. staffOur localproject tooka break since theywere worried abouttheirregular returnedprojects to theirhomecountries “Many foreigners whovolunteered for our teaching onthesite. activity.project We totally stopped main our needed to closeEnglishclasses, contain thespread ofCOVID-19. Mittaphap for to allschoolsthroughout thecountry Peter Thipommajaniskeentocontinue Mittaphap’s projectsdespitesetbacks caused bytheCOVID-19pandemic English classes volunteers to of classessince we don’t have enough “But, we have to cutthenumber what we do best. anditis ofMittaphap is at theheart whatever ittakes. As Isaid, education just want to resume theEnglishclasses, We don’t have muchincome butwe stuck inLaos, we beganteaching again. of afew foreign volunteers whowere September,“In gatheringateam after developing ideasonpost-COVID activities. other officials and forournew projects policy or position ofASEAN. orposition policy theofficial donotreflect and interviewee to solely the belong inthetext expressed condensed forclarity. Theviews opinions and conversation and edited hasbeen by Agbisit.Interviewed Joanne This in othervillages.” create amodelvillageandreplicate this obtain ‘grassroots’ financing. We want to and localcompanies and inourproject interest international NGOs, governments, about jobs, at Englishandgetinformation home;learn since many ofthemhave nowhere to study students cancome to dotheirhomework develop where astudyarea andlibrary “Post-pandemic, we would liketo physical andmental well-being. future ofourproject,andfor my own aboutthepresent (situation) and the worry and doingsite maintenance. mademe It local volunteers, teaching Englishclasses, care oftheneedsforeigntaking and ofproblems, allkinds including to tackle much longerhoursandhadto beready volunteers. Personally, Ihave hadto work building andmotivating ateam, andfinding educational goals, student participation, challenging timefor ourproject,affecting pandemichasbeenthemost “The accommodate allofthem. not disappeared, butwe cannot students. The desire to Englishhas learn we hadfour classesdailyandabout300 cost. Beforetransportation thepandemic, nearby to classes inonlyonefacility save on financially self-sustaining. We hope to We want to theprojects eventually be andsocialhabits. goodsanitary and practice The ASEAN November–December 2020 vocational training, andcareers; teach. We currently have three with 49students. We conduct

Conversation Melvin Chew Hawker Stall Owner

The hawker scene is an integral part of Singapore’s culture. “I also see that a lot of taxi drivers Locals and tourists throng hawker centres to enjoy local and private-hired drivers got no job during that time. After the government cuisine at affordable prices. But diners had to stop eating out agency gave green light that these when Singapore imposed circuit beaker measures in April to drivers could do food delivery, contain the spread of the coronavirus. The partial lockdown I started Delivery United group left hawker centres empty for months. so that hawkers can go inside this platform to use and do food delivery. At the same time, the drivers can also Melvin Chew, the second- get income during this period of generation owner of the Jin Ji circuit breakers. Teochew Braised Duck and Kway Chap stall at Chinatown Complex “We also faced supply problems Food Centre, decided to take action during this period. Supplies of to survive the pandemic. He created ingredients got delayed because the Hawkers United-Dabao 2020 quite a lot of ingredients were from Facebook group that allows hawkers China. There was also a short period to promote their food and services of time when food containers were on the platform. The group saw out of stock. When the demand is high 25,000 members sign in within and the supply is low, everything will the first 24 hours. Now, it has be expensive. But as I had to maintain over 280,000 members. the food quality, although it’s expensive, I still use the same ingredients. I maintain “I grew up in a hawker centre, and this the selling price; I don’t think it’s wise to food stall has raised me and my siblings. raise the selling price because everybody My concern is if the pandemic causes all is suffering. As long as we can survive hawkers to end their business, then I think “The power of the united is important. We during the circuit breaker period, our hawker culture will end. So I think might not be able to get things done alone, then it’s good enough. I have to play a part. The intention but together we can defeat the pandemic,” is to bring all hawkers into a platform, says Melvin “On food safety, we got extremely strict so people can know that they are still hygiene safety in Singapore. During the doing takeaway and delivery. pandemic, safety level is our top priority; we always wash our hands and wear masks. Every now and then, “Lots of our hawkers are about 60-80 years old. Even though there will be an inspector to go around the hawker centre, and if we have delivery platforms, their commissions are a bit too you do something that is not on their regulations, we can be high for them. They also don’t know how to use the technology. fined up to 10,000 Singapore dollars and also get suspended. One of the reasons I started this group is to tell them that they still can do the delivery by announcing it in the group. A lot of “Now, hawkers are doing quite well, but hawkers in the CBD hawkers started to post their business on the group and got good area are still doing quite badly because most office workers feedback on the business. I encourage people to do group buys; have not resumed work, or still work from home. There are if you’re staying in certain areas, people can volunteer to buy no tourists, and lots of workers who used to work in the CBD food from the hawkers for the households there. area had lost their jobs. Business is slightly better than during the circuit breaker, but it’s not what we expected. We’re just “But even before the circuit breaker, when we learned that holding on and hopefully after the pandemic and the whole the pandemic was going on in China and started spreading world opens up, tourists and workers can start coming all over the world, our business had been slightly affected. in again. In the meantime, we’re just enjoying this period My sales dropped about 70 per cent because my stall is in and helping each other out.” Chinatown, which is a commercial business district (CBD) area and a tourism spot. When we got no tourists and the Interviewed by Novia D. Rulistia. The conversation has been edited whole CBD was closed, that affected a lot of hawker centres. and condensed for clarity. The views and opinions expressed in the text The government subsidised rents and all the fees we need belong solely to the interviewee and do not reflect the official policy

Photo Credit: © Melvin Chew to pay for about five months, so it cut down our burdens a lot. or position of ASEAN. 52 Conversation me, my classmates andprofessors. PhD Our classissmall, andmy “Academically, hasbeenquite thepandemicperiod difficult for difficult forthem to travelart events and here. come to manymarket, are collectors from outside Thailand and now it’s still now, althoughthevisitors are mostlylocalpeople. terms ofthe In and international artists. Biennaleisalsoongoing The BangkokArt that we didn’t seebefore astheyusuallyheldevents for famous collaborations something between newandestablishedartists, normal, setupexhibitions that somegalleries feature were cancelled. When thecondition hadgradually returned to events thepandemicsince were during galleries closedandart “Artists, especiallythenewones, have beenstruggling sopeople cancome andexperience ourworks.aspects the detailswork. We to retain are theartwork’s trying aesthetic we haveimportant; to bethere to decidethings, andto make the exhibition likewhat we hadbeenplanning. upis Setting wedecided to postponeit. If keptongoing, we couldn’t setup wholives inAustralia andI co-artist Butmyon theothersideofacarpet. year for painted my paintings ofportraits “I was planningto have anexhibition this but alsoto experience them. just goto theevent to buyartworks, unlike onlineshopping, peopledon’t because isimportant you experience art andtheartists. the artworks The way to interact with will loseopportunities events becausetheaudience online art moved online. Iquite disagree with been postponed, whilesome others events communities. have Alotofart art pandemichasgreatly affected the “The and researchfor hisarts projects. Hong Kong, to adjusthisplans needed and ingalleries from Chiang Maito his works atthe Bangkok Biennale Art pandemic hit,Samak,who hasexhibited inthe society. Whenperspectives the understand the limitationsofgender tohomosexuality inMuslimsociety on researchHis recent focuses media, andvideos,amongothers,toreachawideraudience. communicates hisfindingsthroughphotography,mixed at theFacultyofSocialSciencesinChiangMaiUniversity in SouthernThailandformanyyears.ThePhDcandidate Samak KosemhasbeenresearchingonMuslimculture Artist andResearcher Samak Kosem Special Edition With allthechangesthatfollow pandemic, Samaksaysthat2020 is animportantperiodtolearn

because thesocialsystem haschanged.” the box. toThis period learn year becomes animportant travelling, education, trading, etc, butnow we gobackto Before, Iloved how through peopleinASEANconnected do thingsinASEAN,asifwe gobackto livinginabox. “Regionally, Ithinkthepandemichascutway we in thefuture. It’s interesting willbeshapedby allthis to seehow arts also needto thinkalotonhow to expose the artworks. digital form to reconnectfairorganisers withtheaudience. Art different ways; how we mustgothrough all thevisualsin forced to thinkabouthow to engagetheaudience through to work to find ways to dealwiththese restrictions. They are policy or position ofASEAN. orposition policy theofficial donotreflect to and solely theinterviewee belong text condensedand forclarity. Theviews inthe opinionsexpressed and byInterviewed Novia D. Rulistia. Theconversation edited hasbeen

GERD dueto my eating problems. examinations, itwas found that Igot I coughed alot. After several rounds of was suspiciousofme, questioningwhy and at that time, Ifelt likeeverybody I sleptlate, andate late. Icoughed often, health too, becauseIworked alot, stay-home affected period my “The for somepublications. I could finishall my pendingarticles I wrote and thisperiod alotduring can’t come backhere. Onthebrightside, can’t gobackto theircountries, orthey foreign students whostudyhere; they complete it. The pandemicalsoaffected and Ineedto thinkofback-up plansto have affected my field research alot I see how art communities continue I seehow art to reconnect. sector,While intheart evolved anditcreated newpossibilities sector, platforms thelearning have changes inthesociety. theeducation In the COVID-19 pandemichasbrought “From what I’ve beenobserving, research, andthetravel restrictions comeprojects together withmy professional online. art inworking My But we adaptandslowly become personal interaction intheclass. online becauseheisoldandprefers professor was notusedto teaching The ASEAN November–December 2020

Conversation Ain Bandial Editor and Co-Founder of The Scoop

With a focused passion to uphold the integrity and quality of well-being of groups who faced particular journalism, Ain Bandial and three colleagues made the brave social isolation – such as children learning move of starting Brunei Darussalam’s first digital only media from home, the elderly, or people with company in September 2017. disabilities – also hasn’t been properly examined. Consistently listening to these stories of hardship was at times Eyebrows may have been difficult and emotional, but it is raised as such a venture our responsibility to report on had yet to be undertaken. what is happening on the ground Three years on, the Scoop accurately, despite the upbeat now has a monthly readership assessments of other parties. of 80,000 viewers, with 70,000 social media followers. “A lot of people reached out to us on social media out of “Our company is founded and desperation. Through the daily run by journalists who see this as press conferences, they saw us an essential public service, and our as having a direct line of appeal values are to put our readers and to cabinet ministers. Many newsroom first. This can be difficult people who reached out had as we are particular to the types been let go or furloughed by of advertising or investments that their employers, others had we can take. We have intentionally paid leave deducted from kept our structure and team small their contract even when to maintain our independence they were under mandatory and agility. Ain shares that many readers reached self-isolation. There were lots out through the various social media of issues regarding how COVID-19 “Reporting in Brunei tends to be very platforms out of desperation restrictions had affected employment top-heavy, and doesn’t necessarily reflect and labour rights that we tried to raise the experience of ordinary Bruneians. readers on the latest developments during the press conferences. We want to see stories about ordinary throughout the day. We found it better to citizens reflected in the media we centralise information in a live document so “Continuing to work and keep our own consume. This platform allows us to people could access all relevant information staff paid during the pandemic has also engage in a longer form of journalism, in a single location. This way our readers not been easy. From mid-March to July, providing more analysis and context into could learn about new restrictions being we worked for 110 days without a day issues being experienced by this community. introduced and how it would impact off. At the beginning of the domestic people’s lives. We saw that as our role. outbreak, our reporters faced heightened “During COVID-19, accurate and timely news The live blog was a break away from our risk by reporting in the field or at health reporting became even more important. usual feature of posting articles during facilities. We lost over 90 percent of Public panic contributed to misinformation, the work week. With COVID-19, we now advertising revenue between March which spread quickly through social media work seven days a week. and July. All these factors have taken and messaging services. The velocity with a significant toll on our company and which fake news could spread did prompt “We took a human interest angle to see staff. But we wouldn’t do it if we didn’t a greater degree of transparency from the how COVID-19 has impacted people, not believe in our mission to serve and government, with the health ministry just from a health perspective. We looked inform our community. chairing press conferences every day, at how COVID-19 impacted different which helped combat misinformation sectors of the community, in particular Interviewed by Kiran Sagoo, PhD. by keeping people up to date with small businesses. Lots of people lost their The conversation has been edited and the latest developments. jobs, especially those in the private and condensed for clarity. The views and opinions informal sectors, but this isn’t necessarily expressed in the text belong solely to the “The Scoop started a live blog when COVID-19 reflected in government data. The impact interviewee and do not reflect the official

Photo Credit: © Ain Bandial first hit Brunei, so we could update our of COVID-19 restrictions on the mental policy or position of ASEAN. 54 Nguyen Duc Qui Conversation we hadfive floorsso ranlotsof initsfirst incarnation— gallery space thatalternative hada art “Tadioto asan was started malaise. pandemic andothersocial process theimpactof patrons toponderand but alsoasanoutletfor only forartisticexpression, Tadioto openasaspacenot challenging times,hekept staff. Throughthese stay afloatandretainhis adjust hisoperationsto measures. Duchadto COVID-19 control has beenupendedby businesses inHanoithat Tadioto isoneofthemany local andforeignalike. visual artists,andpoets— musicians, performers, established andbudding showcase theworkof also becomeaplaceto Over theyears,Tadiotohas food, drinks,andmusic. while partakingofgood up thebar’screativevibe mingle, tossideas,andsoak in VietNam.Theycometo artists, writers,andliterati the favoritehauntof iterations, ithasbecome in 2007,andafterseveral the US.DucopenedTadioto Nam afteryearsoflivingin decided toreturnViet American writerwho published Vietnamese- Nguyen QuiDuc,awell- Tadioto isownedby space locatedinHoanKiemdistrict—hasquicklybecomeoneofthem. Hanoi ishometomanyiconicsites,andTadioto—theedgybarart Owner.Business ArtsAdvocate.Writer. Special Edition and environmental damages. designers to thinkofwaste encourage architects and with localmaterials that or buildingsimplestructures with usinrecycling things, Switzerland whoworked from HongKongand people found us, likearchitects rock concerts. We were lucky to Spain,to jazzand punk from Lanka Sri music, poetry able to promote experimental venues where we’ve been but allinwe’ve hadmany we lease, lostleaseafter evolved into other spaces as The barwas populartoo. We with localandvisitingartists. to exhibitions andconcerts films to workshops for artists, programs from screenings of Duc saysthatthepandemichasledpeopletostepback and reexaminetheirliveschoices hosting a gallery andmusic hosting agallery Viet Nam,whichwas also sister venue inHoiAn, Central financially becauseofit.Our of COVID-19 andsuffered thefirst monthwave after “We closeddown for over a hemisphere.Southern talents inAsia, orinthe programs—we focus on screening films:likeourmusic generation. We are also that appealto ayounger international music, orideas stage to promote jazz,blues, designers whouseour writers andpoets, and to diverse attract musicians, exhibits butwe have beenable restaurant andnospace for “We currently have a

The ASEAN November–December 2020 on thepoliticalsituation inthe We’ve haddiscussion groups specific dances andtheatre. shows, andplanningsite- We’re helpingto curate music political, musicalandartistic. focused onevents: cultural, situation, we’ve become more oftheCOVID-19“Because enjoy ourvenue. and foreign who journalists We dohave somediplomats it meansalotto people. It’s alotofwork butwe think and give background stories. we printprogram notes translate andpoems; lyrics attention to themusic. We it’s focused, andpeoplepay us. Although it’s asmallstage, are happyand eat. with Artists music aspeoplecome to drink simply having background serious. We’re happy we’re not it’s asmallcrowd buttheyare our musicevents andlectures; loyal clientele that comes for “We’re pleasedthat we have a reducing theirsalaries. staff employed without We’re to fortunate keepthe seem lesswillingto spend. tourists andthelocalexpats We can’t rely onforeign improvement for ayear orso. and don’t foresee avast less clients thanever before financial stability. We have toprojects ensure acertain day. Ipersonallytakeonother hoursevery slightly shorter “We are now operating on that peoplein. bring programs, talksandscreening we now have music weekly that lining was inthefact flow going, but thesilver personally to keepthecash borrow somemoney retain allthestaff. Ihad to been ableto reopen andto March. We’re to have lucky venue, hasbeenclosedsince

Photo Credit: © Nguyen Qui Duc Photo Credit: © Nguyen Qui Duc playing a willing part in playing awillingpart recognising thedangerand how peopleaccept quarantine, careful. Iamastonished to see others becamemuchmore media, andby extension vilified inthenews, onsocial the spread oftheviruswere to have beentheconduit for from abroad andwere thought on,thosewhocame “Early underCommunism. century traditions, andfrom a nearly fromauthorities Confucian There isalsoanacceptance of into communal civicactions. turn timecanquickly normal threat. Arelaxed attitude in confronted by acommon as aunited when community for toknown act theirability The Vietnamese have been the ‘success’ of Viet Nam. “Many contribute factors to have beenastounding. andlocalpeople of theartists financially, butthe resilience term, Ithinkwe allwillsuffer that we are safer. For thelong architectural now projects) projects, concerts, (public art events, andpublicgatherings a lotofexhibitions, art months, itseemsthere’s confinement. Butin recent first wave of and COVID-19 for many the months after seemedtoo depressed artists andother “Vietnamese to beableto dothis. history, etc., andwe’re thankful anti-immigration policies, chance to talkaboutracism, programs into turn often a US andEurope. music Our importance forasocietyunderthreat.” arts asameansofexpressionandits energy. Ihopethere’smorefaithinthe this crisiswithrenewedandmorethoughtful “I hopetheartsandartistswillriseoutof or influence. still maintain lotsofcontrol to theirfamilies, andelders entitlement. People are close don’t insistonasenseof one. TheVietnamese wearing aroundeveryone meis without amaskwhen going to thesupermarket I’dactions. feel ashamed individual thoughts and of shamethat prevents and alsoastrong sense harmony, for community, is astrong tradition for Confucianism there“With for thecommon good. measures deemednecessary submitting themselves to Special eventsatTadiotofeaturingartistsandperformers West isto come to abaffling— in many countries inthe to takecare ofpeople, etc., andunwillingnessinability here to thelossoflife, the compare oursituation the COVID-19 threat. To quite safecountry from “I feellivingina lucky spread ofthevirus. measures to control the enterprises to accept strict hospitals andstate-owned airlines,can easilydirect by thestate; thegovernment etc., remain largely controlled health care facilities, schools, communication channels, tourist industry, “The

be isolating.” together inatimethat can force, allowing usto come All ofitbecomes agalvanising wounds inthesedifficulttimes. alleviating ourpsychological crucialin activities—become music to theater to visual “Of course, thearts—from under threat. for asociety its importance as ameansofexpression and there’s more faithinthearts thoughtful energy. Ihope with renewed andmore outofthiscrisis will rise andartists “I hopethearts choices, etc. their lifestyles, theirbusiness person seemsto berethinking aren’t,rich buttheaverage conglomerates and super slowing down. The big etc., of are allthinking gains. friends, My colleagues, desire for quickmonetary long-term plans, andthe of development without of uncheckedcapitalism, all to rethink ouradoption feel thathasledus thiscrisis “On theotherhand, Ialso who have gonebust. and beverage industries, tourist, hospitality, orfood inthe no debts. plenty Iknow andhaveI amstillfunctioning worse losses. Ifeel fortunate invested alotmore andsuffer I feel badfor thosewhohave “As abusinessowner, careless, orcallous. leaders are incompetent, grieve for nations whose andI shocking—moment, position of ASEAN. ofASEAN. position or policy theofficial not reflect do toand solely theinterviewee belong inthetext expressed clarity. Theviews opinions and condensed and for edited The conversation hasbeen by Agbisit.Interviewed Joanne Special Edition

55 56 Syed AbdulSyed Rahman Nadira Ramli and Conversation with theagriculture industry. “ to growother plantsoncewe aremorefamiliar the farmatareasonable price.Wearealsolooking neighbours, byselling freshchilliesstraightfrom profit. Iwouldlike tohelpsmall restaurantsand “For me,farming chillies goesbeyondmakinga me to flyingschool. and bothmy parents thensent he saw how determined Iwas, soon changedhismindwhen could beunpredictable, he dangerous astheweather caution that flying could be too While my father didinitially was setonbecoming apilot. family loves animalsmy heart becoming aveterinarian, asmy other career options, suchas the family. Though Iconsidered he could befullypresent with home, butwhenhewas home, week ortwo before hecame it would takehimsometimes a When hewas away for flights, I loved hiswork-life balance. pilot, andwhilegrowing up, Nadira: away fromthecockpit. how theynavigatelife their passionforflyingand husband-wife teamshare shut, thisinspiring boarding gatesremain COVID-19 pandemic.While times causedbythe are stillfacingturbulent the aviationindustry Many employeesin Captain AbdulRahman’sjourneyoverthepastfewmonths. Flying theskiestonurturingearthsumsupCaptainNadiraand Pilots. Entrepreneurs. Special Edition My dadisaretiredMy

and findithighlyfulfilling to happy that Iamableto doit wanted to flyjetplanes. I feel young boy, Ihave always of becoming apilot. As a which planted theideainme pilot. Hespokealotaboutit but was unableto become a dad hadaninterest inflying ForAbdul Rahman: me, my and look forward to being up in the clear blue skies on a regular and lookforwardtobeingupintheclearblueskiesonaregular Abdul Rahman (left) and Nadira (right) share a love of flying Abdul Rahman(left)andNadira(right)sharealoveofflying basis onceagain. per month andto behonest, it twofly oneor domesticflights toDue COVID-19, we now only work-life balance. way to contribute to holiday destinations, alsoasa bringing familiesto their back to theirhometowns, be ableto flythepassengers

The ASEAN November–December 2020 too focused andbusywithour for more than12years, being Nadira: We hadbeenflying for other opportunities. and we are opento exploring that flyingisnot everything ventures. ofusrealise Both the timeto explore other COVID-19 hasgiven us agriculture industry. more familiarwiththe other crops once we are We to grow are alsolooking atthe farm areasonable price. fresh chilliesstraight from and neighbours, by selling to helpsmallrestaurants aprofit. I making would like chillies goes beyondfarming see positive results. For me, months andhopefullywill intwo orthree be harvesting based inSemenyih. We will onourfarm on LadangKita, farming. We now grow chillies with my colleagues, Istarted back to nature. together So This made meconsider going natural resources. our needscanbefulfilled by and we realised that mostof food, medicineandshelter, This was narrowed down to what we neededto survive. To cope, we hadconsidered been affected by thepay cut. to stay afloat, we have both pandemic, for thecompany and mentally. to Due this has affected usphysically

Photo Credit: © Nadira Ramli and Syed Abdul Rahman Photo Credit: © Nadira Ramli and Syed Abdul Rahman is actually necessary. isnot is actually It community, andconsider what involved withpeopleandyour inspire you. You have to get can provide ideasthat could andneighbours.friends They Talk to your parents, families, sitting at homeand hoping. something new, rather than that you have to start that IhaveSomething learntis affected by this pandemic. WeAbdul Rahman: are all to expand. for differentboth looking ways challenging position. We are field hasputusinthispresent inthesame both ofusworking yet. present Our situation of I have notgotmyself into it business,the farming in thefuture. While Ireally love ourselves inasimilarposition more prepared shouldwe find happen again. We want to be as somethinglikethiscan when we gobackto flying, our current ventures even We planoncontinuing with no matter how small. approaching anewbusiness, me theconfidence in hasalsogivenmarketing. It setinterms of new skill has enabledmeto develop a water. Engaging inthisventure microfiberquality clothand clean ahomewithjusthigh it ispossibleto effectively this venture, Ihave learntthat chemicals.of harmful Through thatproducts reduce theuse cleaning andpersonalcare effective, safe andsustainable into safe havens by creating into helpingtransform homes an income, my interest ismore time. While thisdoesprovide environment oneclothat a cleaning products, saving the environmental friendly venture dealingwith explored selling adirect we have timeto spare, I Now that other opportunities. job, we never didexplore to helpthoselessfortunate.“ have themeanstohelp,remember and hopefullyitworksout.Ifyou important totrysomethingnew, position asus.However,itis colleagues areinthesame at thistime,andmanyofour “It’s achallengetogetinvestors up intheair, withclearviews. I I domissflying and love being those lessfortunate. help, remember to help youIf have themeansto hopefully itworks out. somethingnew,try and However, to itisimportant in thesamesituation asus. and many ofourcolleagues are get investors at thistime, Nadira: It’s achallengeto the food business. farming, whileothersgotinto colleagues are alsoinvolved in into farming. ofour Some of research before getting field, andIneeded to doalot venture to into anew easy Nadira andSyedattheirchillyfarm.Thecouplelooks forward toasuccessfulharvest

December. we face rains heavy likein few years, where even inApril, weather patterns over thepast flight. I have noticed changing vision throughout thewhole where we hadabsolutely no Kuala Lumpur to Terengganu the monsoonseasonfrom challenging flight Ididduring they understand. Irecall a When you say badweather, are muchmore educated. accessible to many. People flying hadbecome more to seethat isheartening It fully ontheflight. being ableto concentrate having and nodistractions enjoy having thespace of

official policy or position of ASEAN. positionofASEAN. or policy official the donot reflect and interviewee to solely the belong text views inthe opinionsexpressed and condensedand forclarity. The The conversation edited hasbeen Kiran PhD. Sagoo, by Interviewed that flyingissafe. sure inmaking their part unwell. Everyone isdoing anyone onboard whomay feel identification andisolation of standard procedure, including which hasalways beena any medicalsituation inflight are well trained to assistwith Whereas onboard, ourcrew peace ofmindwhentravelling. technology to give ourguests prepared contactless systems, has theairline and hospitalgrade airfiltration deep cleansingtheaircraft, involved.of everyone Besides ensure thesafety andwellbeing on theground andintheairto measures all precautionary hasstepped upon industry once again. The airline everywhere, can flyeveryone in thefuture, Ihopethat we domestic flights now, but I amhappy that we are doing we landed. looked relieved when to them.Passengers certainly speak andexplain thesituation to panicandwe neededto Passengers naturally started from Kuala Lumpur to Penang. thepassage time during The aircraft shookthewhole instead dueto badweather. landingto Penangto divert Kuala Lumpur, butwe needed flight was fromMelbourne to a flight.Mymostchallenging challenges that may on arise successfully dealingwith fulfillment that comes from people, andmostofall, the colleagues, meetingnew to to talking goto work, the routine ofgettingready aboutflying.everything Imiss Imiss Abdul Rahman: Special Edition

57 58 Special Edition

ASEAN PLANS TO BOOST TRAVEL AMID A PANDEMIC. HERE’S HOW.

JOANNE B. AGBISIT AND THE ASEAN EDITORIAL TEAM

Changi Airport, recorded a 64 per cent decline in visitor small and medium enterprises, displacing Southeast Asia’s busiest arrivals during the first half of 2020 over the millions more workers. same period last year. This translates to airport with hundreds of billions of dollars of lost revenue for A Shift to Domestic Tourism thousands of passengers Southeast Asian economies. Data from the In recent months, ASEAN governments ASEAN Policy Brief indicate that Cambodia, have begun relaxing their lockdown on a typical day, sat Thailand, and the Philippines are likely to be measures and domestic travel restrictions near empty for months. the hardest hit, with their travel and tourism as health protocols were put in place and as The sprawling Angkor industries accounting for a large portion of COVID-19 cases became more manageable. their GDP, export revenues, and Wat complex, normally employment. Not far behind are Malaysia, National tourism authorities took this bustling with tourists Lao PDR, and Singapore. opportunity to shift their focus on the in the peak months of domestic market to resuscitate their In the travel and tourism value chain, the countries’ battered travel and tourism January to April, fell aviation industry is floundering the most. industry. Viet Nam was among the first silent. Several airlines in the region, from national to do so after successfully controlling the carriers like Singapore Airlines and Thai spread of the coronavirus. In early June, Airways to low-cost carriers such as AirAsia it introduced the “Vietnamese People These scenes, which and Cebu Pacific, have had to furlough or Travel in Viet Nam” programme which look straight out of a retrench staff, or cut working hours and encourages citizens to patronise local staff salaries to staunch financial bleeding. tourist destinations. Thailand followed dystopian movie, paint a Straits Times, for example, reported that suit, launching its “We Travel Together” dynamic region on pause. Singapore Airlines reduced the salaries of campaign in July, which offers Thai its pilots by as much as 60 per cent, and will nationals discounted rates for airline be eliminating 4,300 positions in the tickets, hotel bookings, and visits s COVID-19 cases began surfacing in coming weeks. to tourist attractions. various parts of the globe, ASEAN Agovernments imposed increasingly The hotel and restaurant sector is not Dr. Puvaneswaran Kunasekaran, stricter policies to limit people’s movement spared. Stay-at-home orders, restrictions Honorary Treasurer of the ASEAN Tourism and contain the virus. From a temporary against indoor gatherings, and booking Researchers Association and Associate entry ban on foreigners travelling from cancelations have forced hotels and Director of the Centre for Research and COVID-19-affected countries in January restaurants to close—some temporarily; Innovation in Tourism of Taylor’s University, and February, governments started others, for good. A hotel and restaurant Malaysia, said industry players have no implementing more drastic measures by association in Indonesia reported that some choice but to turn to domestic tourism with mid-March. They closed national borders, 550,000 hotel employees and one million international borders still closed. suspended visa issuance, prohibited the registered restaurant workers have been At the same time, demand is returning entry and transit of foreign nationals, and either furloughed or laid off since the start as local tourists are eager to travel. “For even banned outbound travel. of the pandemic. In Thailand, the number of example, when the Malaysian government laid off hotel employees has reached one lifted the inter-state travel ban in June, Travel Industry in the Doldrums million, a local hotel association estimated. we saw the number of domestic tourists Although draconian measures were necessary, they dealt a devastating blow to The pandemic’s ripple effects have also the travel and tourism industry in the been felt by tour operators, bus and car region. The United Nations World Tourism rental companies, souvenir shops, and a A secluded spot in Kalanggaman

Organization reports that Southeast Asia host of other tourism-dependent micro-, island, Leyte, Philippines Photo Credit: © Irah Ruth B. Borinaga Special Edition 59

increase. You couldn’t get a room in top tourist destinations for the weekend,” Kunasekaran said. THE PANDEMIC HAS GIVEN THE INDUSTRY AN EXTRA NUDGE TO RAMP UP DIGITALISATION NOT ONLY TO IMPROVE Reviving International Travel THE EFFICIENCY OF SERVICE PROVIDERS, BUT ALSO TO ENHANCE through Travel Bubbles Southeast Asian countries that came out THE TRAVEL EXPERIENCE OF CONSUMERS. relatively unscathed have started opening up their borders to other countries that were similarly successful in containing would want to go to Bali, but rather than for regulating foot traffic and contact- COVID-19. This exclusive arrangement, sending them there, industry players can tracing, and for digital restaurant called travel bubble or corridor, allows send them to unknown, unpolished ordering and cashless payment. people to move freely within the corridor locations,” he said. This will be appreciated sans the usual burdensome travel by a new generation of travellers who want The regional bloc recognises the vast requirements, such as mandatory an authentic tourism experience in lesser potential of digital solutions for revitalising two-week quarantine upon arrival. known, but “instagrammable” the travel and tourism sector in the midst Singapore, for example, has started setting destinations, Kunasekaran added. of the current crisis. ASEAN Leaders up reciprocal green lanes for essential seek to send a strong signal of support by short-term business and official travel Another strategy is to strengthen issuing the ASEAN Declaration on Digital with a number of countries in the region, road connectivity and travel between Tourism, which encourages Member including Malaysia, Brunei, and Indonesia. landlocked countries in ASEAN. States to cooperate on developing new “Not everyone can afford air travel. In digital platforms, database systems, and The regional bloc is hoping to build on Europe, half of the 250 million travellers value chain connections; create a favorable these initiatives and establish a region-wide travel by car, by land since road mobility environment to facilitate adoption of travel bubble. On 12 November, the ASEAN is good,” Kunasekaran said. This strategy digital technologies by MSMEs and Leaders took a decisive first step by issuing requires the cooperation of countries to tourism institutions; improve the digital the ASEAN Declaration on an ASEAN develop road networks, travel routes competence of the tourism workforce; and Travel Corridor Arrangement and itineraries, and special passes. use digital solutions to promote safe and Framework, which tasks the ASEAN seamless travel experience during and Coordinating Council, with support from Opportunities for Digital Solutions after the current COVID-19 pandemic. the ASEAN Coordinating Council Working In many ways, the travel and tourism Group on Public Health Emergencies, to industry is among the early adopters of Light at the End of the Tunnel take the lead in developing a regional digital solutions for business processes and Even with the impending vaccine roll-out, framework that includes a common set of consumer services. Consider, for example, the travel and tourism industry is not likely pre-departure and post-arrival health and online airline booking and ticketing, online to bounce back anytime soon. “According safety measures to protect ASEAN citizens. lodging platforms such as Airbnb and Vrbo, to various authorities, it will take three and travel planner apps such as TripIt, which years for the industry to reach the level While the travel corridor is initially have become ubiquitous over the years. it achieved in 2019,” Kunasekaran said. intended for business travellers, “It still depends on how good the Kunasekaran views this as a good starting The pandemic has given the industry an vaccine mobilisation will be.” point that will pave the way for ASEAN to extra nudge to ramp up digitalisation not harness the full potential of intraregional only to improve the efficiency of service In the meantime, domestic tourism, travel, which has been lagging even before providers, but also to enhance the travel digital tourism, and intraregional travel the pandemic hit the region. “We have 622 experience of consumers. With safety are offering the industry a way out of the million people in ASEAN, but I can tell you concerns foremost on the minds of slump and to gradually recoup its losses that intra-ASEAN travel—meaning visitors travellers, there is a huge gap to fill while waiting for the vaccines to work and from Singapore to Malaysia, Indonesia to in terms of developing “contactless” for pre-COVID normalcy to return. Thailand, etc—was only about 51 million in or “touchless” technology solutions. 2019. It was about 35 million 10 years ago,” he said. In contrast, he said, Europe’s Some countries have already started. In intraregional tourist flow is about 250 Singapore, a number of hotels are now Read the ASEAN declarations at the following links: million, a third of its 740 million population. using an AI-enabled digital concierge that can handle guests’ item requests, Kunasekaran said that one strategy take room service orders, book facilities, that governments can do is steer tourists to and answer queries on a 24/7 basis. hidden gems or off-the-beaten-path In the Philippines, the tourism department https://asean.org/ https://asean.org/ travel destinations that are far less ensured that accredited tourism asean-declaration-digital- asean-declaration-asean- tourism/ travel-corridor-arrangement- crowded and therefore much safer. “Let’s establishments and restaurants have framework/ say in Indonesia, international tourists free access to locally-developed apps 60 Special Edition

The ASEAN November–December 2020 Special Edition 61 A LANDMARK SUMMIT TO MARK AN EXTRAORDINARY YEAR

SARA ABDULLAH The difficulties posed by the pandemic ASSISTANT DIRECTOR, POLITICAL COOPERATION DIVISION 1, made clear that ASEAN’s strength lies ASEAN POLITICAL-SECURITY COMMUNITY DEPARTMENT in its power to convene discussions at the highest levels and to affect discussions on issues of global scale amongst all relevant parties. Given this, it became The 37th ASEAN Summit was concluded in early evident that as ASEAN Chair, Viet Nam November. It was part of a series of other Summits had to quickly find ways to pivot the regular modalities of ASEAN meetings and activities with ASEAN’s partners, held from and find new ways to exercise ASEAN’s 12th to 15th November 2020. convening powers on the global stage, whilst ensuring that its Chairmanship objectives and ASEAN’s Community- building goals continue to be accomplished this year.

Set against this backdrop, the 37th ASEAN Summit, was a culmination of ASEAN’s efforts throughout the year, shepherded by Viet Nam as Chair. The spectre of the impact of COVID-19 loomed large over the discussions among the ASEAN Leaders. All ASEAN Member States acknowledged the devastation caused by the pandemic on many various aspects of life. To that end, the Leaders acknowledged the cross-pillar and comprehensive responses of ASEAN to the pandemic, including the establishment of the COVID-19 ASEAN Response Fund, the ASEAN Regional Reserves of Medical Supplies, and the ASEAN Comprehensive Recovery Framework among others. While the COVID-19 ASEAN Response Plenary session of the 37th he series of Summits conducted Fund would function as a funding facility ASEAN Summit virtually was not the first of its for ASEAN’s initiatives in response to Tkind this year. A succession of COVID-19, the ASEAN Leaders also meetings of this scale, coordinated reminded of the need to encourage and conducted online was largely partnership in responding to the impact unprecedented. Indeed, credit is due of the pandemic through collaboration to Viet Nam for being a pioneer in the in initiatives such as the COVID-19

The ASEAN Regional Reserve of Medical Supplies was officially launched at the sidelines of the 37th ASEAN Summit. The proposed ASEAN Centre for Public Health Emergencies and Emerging Diseases, which was also announced at the sidelines of the series of Summits, and the ASEAN Standard Operating Procedures for Public Health Emergencies underscore the importance of cooperation and coordination among the ASEAN Member States and their partners, in responding resolutely to this pandemic and future public health emergencies.

The ASEAN Leaders also announced the official release of the ASEAN Comprehensive Recovery Framework (ACRF) and its implementation plan. track in pursuing the ASEAN Community Opening ceremony of the 37th A comprehensive plan that engages Vision 2025 despite the challenges of ASEAN Summit and related Summits most sectors in responding to the impact the pandemic. Some of the critical of COVID-19 to build back better for the deliverables of 2020 highlighted by region, the ACRF and its implementation the Leaders include the Mid-Term comprehensive, high-quality, plan will be complemented by Reviews of the ASEAN Community and mutually beneficial economic other ASEAN initiatives in response to Blueprints 2025 and the Masterplan partnership that will facilitate the COVID-19, including the ASEAN Travel on ASEAN Connectivity 2025, expansion of regional trade and Corridor Framework. The ASEAN Travel kickstarting the process of drafting an investment while contributing to Corridor Framework is part of the various ASEAN Post-2025 Vision, and promoting global economic integration, growth, steps ASEAN is taking to jumpstart ASEAN awareness and identity. and development. Once it enters into our flagging economies by encouraging force, it would be one of the biggest, the resumption of business travel in Most noteworthy in this respect if not the world’s biggest free a coordinated and controlled system was the signing of the Regional trade agreements. that safeguards the public health Comprehensive Economic Partnership gains attained by the region in (RCEP). The ASEAN Economic Ministers, The ASEAN Summit is an occasion combating COVID-19. alongside Australia, China, Japan, for ASEAN Leaders to come together Republic of Korea, and New Zealand, to not only take stock of how far ASEAN At the 37th ASEAN Summit, the Leaders signed the RCEP Agreement, witnessed has come and reflect on the achievements also lauded the achievements of Viet by their respective Leaders, at a virtual of the year, but in coming together, Nam as Chair in pushing through timely ceremony on 15 November. The RCEP ASEAN Leaders are also reaffirming bonds initiatives, which has kept ASEAN on Agreement aims to establish a modern, of solidarity and community—especially significant when considering the many regional and international issues which ASEAN contends with. Convening the ASEAN Summit, in the face of an ongoing CONVENING THE ASEAN SUMMIT, IN THE pandemic, signals to the global audience that ASEAN is not only undaunted by FACE OF AN ONGOING PANDEMIC, SIGNALS the challenges of COVID-19, but that it is stronger in coming together and TO THE GLOBAL AUDIENCE THAT ASEAN IS NOT more resolute in its shared values ONLY UNDAUNTED BY THE CHALLENGES OF and purpose as a Community. This has undoubtedly been an extraordinary COVID-19, BUT THAT IT IS STRONGER IN COMING year, with ASEAN achieving even more accomplishments. Against the TOGETHER AND MORE RESOLUTE IN ITS SHARED remarkable backdrop of all the newly VALUES AND PURPOSE AS A COMMUNITY. launched initiatives this year, the region’s future is clear and holds promise

The ASEAN November–December 2020 Special Edition 63

AMIDST THE PANDEMIC, ASEAN CONTINUES TO STRENGTHEN EXTERNAL ENGAGEMENTS

FIFI ANGGRAINI ARIF SHERLY MOLLE SENIOR OFFICER, EXTERNAL SENIOR OFFICER, EXTERNAL RELATIONS DIVISION 1 RELATIONS DIVISION 2 ASEAN POLITICAL-SECURITY ASEAN POLITICAL-SECURITY COMMUNITY DEPARTMENT COMMUNITY DEPARTMENT WHAT IS ASEAN The successful convening of the 37th ASEAN Summit and related summits, albeit conducted virtually on CENTRALITY? 12-15 November 2020, has been essential for ASEAN ASEAN centrality is a dynamic process which envisages ASEAN to realise its 2020 key deliverables and map out as the central and progressive future cooperation. force in promoting and maintaining a peaceful, productive, prosperous, and s part of the summit series, support for ASEAN Centrality and shared inclusive Southeast Asia. This is the ASEAN Leaders met with the importance of the principles set out achieved, among others, by Atheir counterparts from Australia, in the ASEAN Outlook on the Indo-Pacific. ASEAN becoming a leading China, India, Japan, New Zealand and the They also looked forward to cooperating player and a respected partner Republic of Korea. There were also Summits with ASEAN in the four key areas outlined in the global community that with the U.S. and the UN. In addition, the in the Outlook through existing advances regional interests and 23rd ASEAN Plus Three Summit (APT) ASEAN-led mechanisms. shapes dialogue on important and the 15th East Asia Summit (EAS) global issues and trends that were also convened on the margins of the This year’s series of Summits welcomed impact on the future well-being 37th ASEAN Summit. A special feature of the successor plans of action for 2021-2025 of the peoples of ASEAN. series was the convening of the ASEAN-New between ASEAN and its Dialogue Zealand Leaders’ Commemorative Summit Partners, namely, Canada, China, India, to mark the 45th anniversary of the the Republic of Korea, New Zealand, dialogue partnership. and the U.S as well as with the UN. The ASEAN Leaders also issued several joint Against the backdrop of unprecedented statements with Dialogue Partners to Nine months into the COVID-19 crisis, challenges posed by the pandemic highlight key milestones as well as to ASEAN and its key partners shared the and global uncertainties, the ASEAN mark the breadth and depth of the importance of strengthening joint efforts Leaders reaffirmed their commitment respective partnerships. In addition, towards regional recovery, maintaining to upholding multilateralism and rules- ASEAN and Australia agreed to convene supply chain connectivity, building based international order in maintaining annual ASEAN-Australia Summits starting resilience for public health emergencies, peace and stability. In the same vein, in 2021, to mark a new chapter of as well as ensuring the affordability and ASEAN’s Dialogue Partners reaffirmed their ASEAN-Australia Strategic Partnership. accessibility of COVID-19 vaccine as a 64 Special Edition

extremism and terrorism, cybersecurity, and women empowerment. The Leaders also underscored the importance of digital technology and transformation to expedite socio-economic recovery and to prepare for the fourth industrial revolution. Several Dialogue Partners rolled out new initiatives to support ASEAN’s priorities, including scholarships and training, cyber and critical technology capabilities, as well as infrastructure initiatives including smart cities partnerships.

At the 23rd APT Summit, the Leaders underlined the role of the APT as a main platform to promote practical cooperation in East Asia, and to respond to emerging challenges, including the pandemic. Towards this end, they issued a joint statement on strengthening APT cooperation for financial and economic resilience in response to emerging challenges. At the 15th EAS, the Leaders adopted the Ha Noi Declaration on the 15th Anniversary of the EAS, which reaffirms their commitment to strengthening the EAS process as the Leader-led forum for dialogue and cooperation on the region’s strategic, political, and economic issues. The EAS countries also agreed on the need to further promote practical cooperation in areas of common interest through the current EAS Plan of Action, as well as to respond to emerging issues and challenges. In addition, the Leaders adopted a global public good. In this spirit, the Top number of statements to enhance EAS ASEAN Leaders welcomed Dialogue 11th ASEAN-UN Summit collaboration, including on promoting Partners’ support for ASEAN’s key initiatives marine sustainability; epidemics prevention Bottom on this front, such as the COVID-19 ASEAN and response; women, peace and security; Signing ceremony of the Regional Response Fund, the ASEAN Regional Comprehensive Economic Partnership and steady growth of regional economy. Reserve of Medical Supplies for Public Health Emergencies, and the ASEAN The convening of virtual summits with Comprehensive Recovery Framework development across the region. Together, Dialogue Partners amidst the pandemic and its Implementation Plan. The Dialogue these RCEP participating countries account and despite the different time zones Partners’ support for ASEAN’s undertakings, for about 30 per cent of the global GDP speaks to the value and relevance of including for the ASEAN Centre for Public and one-third of the world’s population. ASEAN’s convening power as well Health Emergencies and Emerging as its leadership in facilitating regional Diseases was also appreciated. The Leaders also discussed the future cooperation and discourse. The direction of the relations between constructive discussions during the The historic signing of the Regional ASEAN and its Dialogue Partners. summits contributed significantly to Comprehensive Economic Partnership They shared the importance of pursuing the strengthening of ASEAN centrality, (RCEP) Agreement, the largest trade partnerships that are “adaptive and reinforcement of rules-based regional deal in the world, on the margins of responsive” to the current situation. architecture, and most importantly, the 37th ASEAN Summit, signifies the In this vein, they agreed to reprioritise enhancement of collective efforts in the importance of free and open trade and relevant strategies on key issues, such fight against the pandemic as well as investment for post-pandemic recovery, as human security, climate change, disaster in the pursuits of peace, stability, and

regional integration, as well as economic management, transnational crime, violent prosperity in the region and beyond. Secretariat/Kusuma Pandu Wijaya Photo Credit: © ASEAN

The ASEAN November–December 2020 Special Edition 65 ASEAN LEADS THE WAY THE REGIONAL COMPREHENSIVE ECONOMIC PARTNERSHIP

ANNE ROBENIOL DIRECTOR, MARKET INTEGRATION DIRECTORATE ASEAN ECONOMIC COMMUNITY DEPARTMENT

A historic ASEAN-led free trade agreement is set to create new opportunities, raise living standards, and improve the general welfare of the peoples in the region.

The Regional Comprehensive Economic Partnership (RCEP) Agreement Twas finally signed after eight long years of intensive negotiations. On 15 November

Photo Credit: © Avigator Fortuner/Shutterstock 2020, Leaders from 15 RCEP participating countries—the 10 ASEAN Member States, Australia, China, Japan, Korea, and New Zealand—witnessed their Ministers sign the landmark RCEP Agreement. It is touted to create the largest free trade area in the world. 66 Special Edition

The signing of the RCEP Agreement comes earlier FTAs, e.g., intellectual property, Access Schedules wherein rights and at a time when the world is facing the electronic commerce, competition, obligations could be classified into three COVID-19 pandemic, a global crisis like and government procurement. broad categories: market access, rules no other. In a statement released after RCEP streamlines the rules so that and disciplines, and economic and the 4th RCEP Summit, the Leaders said, only a single set of rules and procedures technical cooperation. In general, the “the signing of the RCEP Agreement will be applied for exporters to enjoy RCEP Agreement will: (i) improve market demonstrates our strong commitment to tariff preferences. access for trade in goods, services, and supporting economic recovery, inclusive RCEP will make the region an attractive investment; (ii) streamline rules and development, job creation and investment destination, and could procedures for accessing markets within strengthening regional supply chains as translate into more employment the region; (iii) establish new rules for well as our support for an open, inclusive, and market opportunities. electronic commerce, intellectual property, rules-based trade and investment RCEP could serve as a platform competition, MSMEs, and government arrangement.” They also acknowledged where members could engage in procurement; and (iv) provide a platform the role that RCEP could play in building the dialogue on trade and economic for economic and technical cooperation, region’s resilience as countries go about their issues relevant to the region. which will provide the development post-COVID-19 economic recovery process. dimension of the RCEP Agreement. What are the key benefits of the RCEP? Some of the key benefits from RCEP What is the RCEP? The RCEP Agreement comprises 20 are as follows: RCEP is a mega-regional trade Chapters, 17 Annexes, and 54 Market arrangement negotiated by a diverse mix of economies in the region in terms of their level of economic development, i.e., developed countries (Australia, Japan, and New Zealand) to least-developed ones (Cambodia, Lao PDR, and Myanmar) and, KEY BENEFITS in between, developing countries with FROM RCEP varying levels of development.

The RCEP is a modern, comprehensive, high-quality, and mutually beneficial DUTY-FREE TARIFFS ON A SIGNIFICANT PERCENTAGE economic partnership that aims to create OF GOODS TRADED IN THE REGION; SELF- the world’s biggest free trade area and DECLARATION FOR AUTHORIZED EXPORTERS; GREATER facilitate the expansion of regional trade TRANSPARENCY ON NON-TARIFF MEASURES and investment. The agreement could open up opportunities not only for businesses but also for peoples in the region. Once realised, the RCEP will create ENHANCED TRADE FACILITATION MEASURES, the biggest free trade agreement (FTA) in ESPECIALLY FOR AUTHORIZED OPERATORS; the world as it currently accounts for a third ADVANCED RULING ON TARIFF CLASSIFICATION, of the world’s population and global GDP. RULES OF ORIGIN AND CUSTOMS VALUATION

How significant is RCEP? While the significance of RCEP to the region and the world cannot be ELIMINATION OF RESTRICTIVE AND DISCRIMINATORY overemphasised, it would be noteworthy MEASURES ON AT LEAST 100 SERVICES SECTORS IN ALL to mention a few, as follows: MODES OF SUPPLY; TEMPORARY ENTRY/STAY RCEP demonstrates the capability OF NATURAL PERSONS TO BE FACILITATED of ASEAN to lead and drive negotiations for a mega-trade deal. RCEP goes beyond the consolidation of the ASEAN Plus 1 FTAs. It forges NON-DISCRIMINATION (MFN TREATEMENT); a trade deal between RCEP participating PROVISIONS FOR THE PROTECTION, LIBERALISATION, countries that did not have prior FTAs FACILITATION AND PROMOTION OF INVESTMENTS; between them, i.e., Japan-Korea, STANDSTILL AND RATCHET COMMITMENTS Japan-China. RCEP changes the character of the ASEAN FTAs which include elements that were not covered in most of ASEAN’s

Where is India? BALANCED AND At the 3rd RCEP Summit in November INCLUSIVE APPROACH 2019, Prime Minister Narendra Modi TO THE PROTECTION announced that India was pulling AND ENFORCEMENT OF out of the RCEP. It was an unfortunate INTELLECTUAL PROPERTY development because India was part of the (IP) RIGHTS; STREAMLINED RCEP when it commenced negotiations in PROCEDURES FOR 2012. Notwithstanding, India is an original ESTABLISHING CERTAIN RCEP participating country that could play IP RIGHTS a strategic and vital role in regional value chains. For this reason, the remaining RCEP participating countries agreed to give India a special status in RCEP. In the Ministers’ CREATING AN ENVIRONMENT CONDUCIVE FOR THE Declaration on India’s Participation in DEVELOPMENT OF E-COMMERCE IN THE REGION; the Regional Comprehensive Economic PROTECTION OF PERSONAL INFORMATION FOR Partnership, the Ministers affirmed that E-COMMERCE USERS, INCLUDING CONSUMERS India could accede to the RCEP Agreement any time after the Agreement enters into force. PROVISION OF TECHNICAL ASSISTANCE What next? AND CAPACITY-BUILDING The signatory states to the RCEP TO ENSURE THAT ALL ITS Agreement would have to work on MEMBERS ESPECIALLY THE the Agreement’s ratification and entry LDCS ARE GIVEN EQUAL into force. The RCEP Agreement will enter OPPORTUNITIES TO BENEFIT into force 60 days after at least six ASEAN FROM RCEP Member States and three non-ASEAN signatory states have deposited their instrument of ratification with the Secretary-General of ASEAN who serves as the depositary for the RCEP Agreement. 68 Special Edition WORKING TOGETHER FOR A STRONGER ASEAN Community, submitted by the ASEAN Ministerial Meeting on Social Welfare and Development (AMMSWD), and the ASEAN Declaration on the Strengthening of Adaptation to ASCC Drought, submitted by the ASEAN Ministerial Meeting on Disaster Management (AMMDM). KIRAN SAGOO, PhD AND THE ASEAN EDITORIAL TEAM The ASCC Council also endorsed the Narrative of ASEAN Identity, which was submitted by the ASEAN Ministers Responsible for Culture and Arts (AMCA). This narrative, which sets down the basis for ASEAN Identity, embraces a bottom up implementation process that engages ASEAN citizens, particularly those at the grassroot level. It seeks to include them shape the narratives of what it means to be ASEAN and make it more relevant their lives

Other documents endorsed by the 24th ASCC Council include the ASEAN Roadmap on the Elimination of the Worst Forms of Child Labour by 2025. The roadmap lays out strategies to prevent the exploitation of children, especially those living in remote rural areas, who work in the informal sector. Adopted at the 26th ASEAN Labour Ministers Meeting (ALMM), this initiative involved five ASEAN The ASEAN Socio- Heads of Civil Service Meeting sectoral bodies, two commissions, and one Cultural Community’s for the 20th ACCSM inspectorate. Three guidelines to improve labor conditions in the region were also (ASCC) strong endorsed by the ASCC Council. cohesiveness among The range of documents endorsed by the its 15 sectors enables 24th ASEAN Socio-Cultural Community The Roadmap of the ASEAN Declaration (ASCC) Council Meeting for elevation to on Human Resources Development for the pillar to respond the 37th ASEAN Summit, clearly reflects the Changing World of Work, translates to the region’s needs. the rich sectoral diversity within the ASCC. commitments in the said declaration into These documents include declarations, a concrete actions. This includes developing narrative, statements, roadmaps and human resources through closer ross-sectoral collaboration in health, guidelines. Close collaboration has been cooperation in education and lifelong labor and civil service, education, key in the successful development of learning and science and technology. Cyouth and sports, environment, some of these documents, and will be key Thirteen bodies consisting of ASEAN disaster management and humanitarian in their implementation. sectoral bodies, committees, and assistance, culture, and information has networks, are cooperating on this resulted in the development of concrete Declarations endorsed include the Hanoi initiative. Two ASCC sectoral bodies, the documents that address the region’s socio- Declaration on Strengthening Social ALMM and ASEAN Education Ministers

cultural needs. Work Towards Cohesive and Responsive Meeting (ASED), adopted this document at Secretariat/Kusuma Pandu Wijaya Photo Credit: © ASEAN

The ASEAN November–December 2020 Special Edition 69

the ASEAN High-Level Conference on Human Resources Development for the Changing World of Work hosted virtually by Viet Nam in SIEM REAP HAS BEEN September 2020. The ASEAN Technical and Vocational Education and Training DESIGNATED AS THE ASEAN (TVET) Council was also formally CITY OF CULTURE FOR launched at the conference. 2020-2022. In addition, the ASCC Council endorsed the Joint Statement of ASEAN Youth Ministers on Enhancing Youth Cooperation for a Cohesive and Responsive ASEAN Community, IMPROVING LABOUR CONDITIONS and the Joint Statement of the ASEAN Improving labour conditions is a priority Ministers Responsible for Information with the ASCC Pillar. The following guidelines (AMRI) to Minimise the Negative Effects were adopted by the 26th ALMM and notated of COVID-19. The ASCC Council also by the 37th ASEAN Summit endorsed a guideline to transform its public systems and the ASCC Mid-Term • ASEAN Guidelines on Effective Return Review Report. and Reintegration of Migrant Workers • ASEAN Guideline on Gender Mainstreaming The impact of COVID-19 on the region into Labour and Employment Policies remained high on the agenda at the towards Decent Work for All various ministerial-level meetings held • ASEAN Guidelines on Occupational by the ASCC over the past three months. Safety and Health Risk Management for The 24th ASCC Council Meeting recognised Small and Medium Enterprises in the the need for a whole-of-ASEAN approach ASEAN Member States to prepare and drive regional efforts in the recovery from the pandemic.

The 9th ASEAN Ministerial Meeting on Culture noted that the closure of TRANSFORMING PUBLIC SYSTEMS recreation and entertainment centres, ASCC continues to transform public systems including museums, cinemas, exhibition into dynamic, professional, efficient, and halls, and theatres, has impacted effective providers of services. The ASEAN the livelihoods of creative workers Public Service Delivery Guidelines were and entrepreneurs. adopted by the 20th ACCSM and notated by the 37th ASEAN Summit The 11th ASEAN Education Ministers Meeting acknowledged the severe effects of the COVID-19 pandemic and the 9th Meeting of the Conference The Ministerial Meetings also on the education sector. of the Parties (COP) to the AADMER reviewed their work plans for the noted the impact of COVID-19 on 2016-2020 cycle and were satisfied The 11th ALMM and 11th ALMM+3 disaster management. Natural disasters with the progress made. Work plans acknowledged the adverse impact that have occurred amid COVID-19 for the 2021-2025 cycle were either COVID-19 has had on workers’ employment have strained the resources of national adopted or discussed at the various and workers’ well-being in the region. disaster management organisations. meetings. Priorities for the ASCC Furthermore, international travel include public sector reform and The civil service role in addressing the restrictions have also made it modernisation, good governance, COVID-19 pandemic was discussed at the challenging for international relief youth entrepreneurship, human Heads of the Civil Service Meeting for organisations to deliver aid. resources development, the future of the 20th ASEAN Cooperation on Civil work, accelerating digital transformation, Service Matters (ACCSM) and ACCSM The meetings provided an opportunity and developing resiliency in times of Plus Three. for ASEAN countries to share their disaster, among others. There was experiences, emphasising best practices general agreement that COVID-19 The 8th ASEAN Ministerial Meeting that could be adapted at the regional has provided an opportunity for on Disaster Management (AMMDM) level to enhance cooperation further. ASCC to build back better. 70 Special Edition

CULTURE AND IDENTITY THE POWER OF STORYTELLING IMPLEMENTING THE ASEAN COMMUNICATION MASTER PLAN 2018-2025

PETER SCHOOF, PhD EXTRAORDINARY AND PLENIPOTENTIARY AMBASSADOR OF THE FEDERAL REPUBLIC OF GERMANY TO INDONESIA, ASEAN AND TIMOR-LESTE

In September this year, the German government published its Policy Guidelines for the Indo-Pacific Region—a region that over the past years and decades has constantly become more important for Germany, Europe, and the world.

hat is why we aim to strengthen our relations with this important Tregion and expand our cooperation. While for us the term “Indo-Pacific” is not a question of geography or a clear definition of borders, it is obvious that ASEAN is and remains the centre of the Indo-Pacific region. That is why we are proud to work together with ASEAN for many years now, even before we became its first development partner in 2016.

Germany is a passionate supporter of multilateral structures and international cooperation. But we are also aware that the multilateral order is put under enormous stress currently. That is why it is all the more important for international organisations such as the EU and ASEAN to communicate their decisions, explain their policies, and share their vision with the citizens of their member states. An international organisation can only thrive as long as its citizens can identify with it and support its basic objectives. And in order to do so, they need to know and learn about the organisation’s development, its

The ASEAN November–December 2020 Special Edition 71

An international organisation can only thrive as long as its citizens can identify with it and support its basic objectives.

In 1948, the French author Antoine de centred ASEAN Community, where the Saint-Exupéry wrote: “Building a boat isn’t peoples of ASEAN enjoy the benefits of about weaving canvas, forging nails, or community-building, reinforcing a sense reading the sky. It’s about giving a shared of togetherness and common identity. taste for the sea, by the light of which you will see nothing contradictory but rather a Part of this endeavour is to showcase how community of love. ” The builders, i.e. ASEAN citizens concretely benefit from states and organisations, need to give their the opportunities offered by the ASEAN citizens a taste of what the community Community. No matter where one lives, they are building will look like if they want be it in Thailand, the Philippines, or any them to engage with and support it. other ASEAN country, each individual can profit from the shared, equitable This is precisely what the ASEAN opportunities for business, community, Communication Master Plan 2018-2025 and personal growth that ASEAN offers. (ACMP II) aims to achieve. Its vision is to At the same time, all ASEAN citizens share realise a people-oriented and people- a responsibility to uphold these values. 72 Special Edition

Together with our partners at the ASEAN Secretariat, Germany recognises that, in order to achieve this kind of paradigm shift, ASEAN’s approach will have to shift from telling people what ASEAN is and how it works to showing how ASEAN benefits and helps people.

and the draw of influencers to engage citizens in a meaningful way. This effort has resulted in two key publications.

The ASEAN Champion podcast series features interesting stories of influencers across different ASEAN countries and their everyday experiences with ASEAN. The stories capture the values stated in the three community pillars of the ACMP II and target a younger audience. For instance, through podcast stories like “Environmentalism Without Borders” with Nadine Alexandra or “Lifting the Confidence of Women” with Yasmin Shahira, we showed ASEAN values and benefits at work.

The booklet, In Conversations with These values are closely connected to the involve us emotionally and intellectually, ASEAN Citizens, showcases human ASEAN Initiative on Culture of Prevention. put a human face on an issue, and help interest stories from all 10 ASEAN This initiative promotes ASEAN’s us connect and empathise with others. Member States. The stories educate and shared values of tolerance, mutual Ultimately, stories build and strengthen raise awareness about the ACMP II and understanding, and respect for life and our human connection. promote the culture of prevention by diversity in a cross-sectoral way. It aims to showing how these high-level ASEAN- initiate a paradigm shift, encouraging This is especially relevant for wide concepts influence the everyday ASEAN to act together as one community ASEAN’s engagement with influencers life of citizens and inspire individuals. and to accelerate ASEAN-wide efforts to and commentators of ASEAN. The Beyond the stories, the booklet contains protect our environment and humanity. ACMP II has defined influencers and important content about ASEAN for the commentators as “people who are general audience: historical overview, Together with our partners at the ASEAN writing about ASEAN and who are the story behind the ASEAN logo and the Secretariat, Germany recognises that, in considered influential either because motto of a “community of opportunities order to achieve this kind of paradigm of their position, because of their for all,” iconic landmarks in each Member shift, ASEAN’s approach will have to shift employer, or because of the size State, the principles of Culture of from telling people what ASEAN is and of their online following.” Prevention, and the fundamental how it works to showing how ASEAN community pillars of ACMP II. benefits and helps people. The ACMP II These influencers and commentators emphasises the importance of span across all audience groups. If ASEAN With these initiatives, we want to storytelling to demonstrate how can tap well-known personalities admired support ASEAN in its endeavour to the ASEAN Community is creating an and followed on social media by many become an ever closer community impact on the lives of citizens through ASEAN citizens, and make them agents and a community of opportunities for all, real life examples. of change for ASEAN core values through to promote a collective sense of pride storytelling, it can really put the ACMP II in ASEAN heritage and achievement. Storytelling, if done right, is powerful. objectives into practice. We also want to support cultivating In fact, the human brains is hardwired to this sense of pride by engaging with process and store information in the Thus, the ASEAN-German Cooperation on citizens to demonstrate the range of form of stories. That is why stories engage the implementation of the ACMP II aims opportunities and benefits offered by like little else. They stimulate our senses, to fully leverage the power of storytelling the ASEAN Community.

The ASEAN November–December 2020 Special Edition 73

BRINGING ASEAN TO THE PEOPLE, ONE STORY AT A TIME

JONATHAN TAN GLADYS RESPATI HEAD, CULTURE AND INFORMATION DIVISION PROJECT OFFICER, CULTURE AND INFORMATION DIVISION ASEAN SOCIO-CULTURAL COMMUNITY DEPARTMENT ASEAN SOCIO-CULTURAL COMMUNITY DEPARTMENT

In today’s digital age, compelling narratives can make a message stand out in a saturated media landscape. They can capture the imagination, build understanding, and forge emotional connections among people.

torytelling or narrative making is an important facet (Digital Marketing Institute blog, n.d.). Meanwhile, 64 per cent of of and essential tool for any organisation. It is doubly so people cite shared values as the main reason they establish Sfor an inter-governmental organisation such as ASEAN relationships with brands (Harvard Business Review website, whose work at the policy and regional level is often far detached 23 May 2012). Likewise, effective branding of an organisation from the everyday lives of ASEAN citizens, therefore, less requires creating compelling narratives that resonate with and understood and felt. engage people. It requires more than just content development and dissemination, but most importantly, how such content is ASEAN is the third largest economy in Asia and the fifth largest pitched and amplified through its engagements with the people. in the world, boasting a combined GDP of 3 trillion US dollars. Impressive as these numbers sound, the public may not be aware Cognisant of the importance of effective communications and of or fully understand the tireless work that ASEAN does to address storytelling, the ASEAN information sector has put in place the challenges and capture opportunities to turn the region into the ASEAN Communication Masterplan II 2018-2025 which governs economically dynamic and vibrant force that it is today. The peace how ASEAN engages, informs, and interacts with its citizens. and stability that the region is experiencing as a result of countries’ concerted efforts is also likely underappreciated by the public. The COVID-19 pandemic has accelerated digital adoption in multiple sectors, affecting various The 2018 ASEAN Awareness Poll, commissioned by the facets of our lives. Worldwide, more ASEAN Secretariat and supported by the Government of Japan than 4.5 billion people now use the through the Japan-ASEAN Integration Fund (JAIF 2.0), reveals stark internet, and social media users realities. While the overall public awareness of ASEAN is high at have passed the 3.8 billion mark. 96 per cent, fewer than one-third of respondents have extensive In the region, social media users knowledge and understanding of ASEAN. Moreover, only half of account for 63 per cent of our the respondents perceive ASEAN to be communicating effectively, total population. Recent data while a majority of businesses and civil society organisations found show us that there is an increase ASEAN lacking in terms of meeting their information needs. in online and digital activities during COVID-19—from Research shows that 45 per cent of a brand’s image is not just

Photo Credit: © rattana.r/Freepik Premium influenced by the “what,” but also by how a brand tells its story 74 Special Edition

A story on waste recycling is one of the inspiring stories featured in the publication In Conversation with ASEAN Citizens

exemplify the preventive mindset that we seek to embed in the DNA of our peoples, as stated in the ASEAN Declaration on Culture of Prevention. A good case in point is a compelling story about a waste recycling movement in Thailand contained in the In Conversations with ASEAN Citizens. Young students from Thailand, who spearheaded this groundbreaking waste- recycling movement, relayed watching and streaming movies and and publication, ordinary citizens from the important message of the videos, listening to more podcasts, to the 10 ASEAN Member States shared their power of individuals to contribute to the spending longer time on social media. rich experiences in bringing change to prevention of natural and human induced their communities, and in spreading disasters, and environmental degradation. These recent developments imply that we messages of hope, unity, and most have access to platforms and a receptive importantly, that ASEAN is a community To catch the digital waves, the ASEAN audience. It is an opportune moment for us of opportunities for all. Secretariat will be rolling out a new suite to position ourselves through storytelling of communication products including to engage people in the region. The pivot towards individual storytelling topical podcasts that inform our people in the podcasts and publication is a and focus on pertinent issues like climate To this end, the ASEAN Secretariat deliberate attempt for us to humanise change, efforts to combat fake news, and and officials are actively developing ASEAN. In doing so, we seek to translate cultural pessimism. In the pipeline, we will new ways to amplify the benefits of our the obscure aspects of ASEAN work into also jazz up ASEAN storytelling through community building efforts. For example, relatable conversations with ASEAN webtoons, animations, and 101 videos we are pitching the use of human-interest citizens and communities at large. These that will hopefully bring ASEAN closer to stories by ordinary citizens to share their communication products are positive proof the hearts and minds of its citizens. ideas about ASEAN Community building of the vibrancy and dynamism in ASEAN. efforts and the ways in which the They highlight the multitude challenges As we amplify ASEAN in name as in ASEAN Community has benefitted them that ASEAN is tackling, and the range action, we will continue to intensify personally as well as their communities. of opportunities that is available to the our communication outreach with more peoples if ASEAN citizens work collectively immersive and impactful storytelling Recently, as part of the ACMP, as one region and one community. so that we can create an inclusive the ASEAN Secretariat launched the climate of keen awareness and deep “ASEAN Champions” podcast series to These human interest stories in the understanding of ASEAN, one story better engage digital natives and youth. podcasts and publication further at a time. Also, we have published the inaugural In Conversations with ASEAN Citizens developed with support from the Listen to the “ASEAN Read In Conversations with German Government through Champions” Podcasts at: ASEAN Citizens at: Deutsche Gesellschaft für Internationale http://bit.ly/ASEANChampions_Pod https://bit.ly/InConversations_ASEANCitizens Zusammenarbeit (GIZ). In these podcasts

The ASEAN November–December 2020 Batu Caves Temple, Batu Caves, Malaysia

The ASEAN is deeply grateful to the Government of India, through the Indian Mission to ASEAN, for its support to the magazine.

This collaboration reflects the shared commitment of ASEAN and India to disseminate knowledge and information on socio-cultural development in ASEAN.

The A SEAN The ASEAN Secretariat ASEAN Socio-Cultural Community (ASCC) Department Jalan Sisingamangaraja 70A, Jakarta 12110, Indonesia