Executive Summary

The ASEAN region’s vulnerability to public health emergencies (PHE) due to infectious diseases and climate change’s impact on health (Miranda et al. 2021, p.1141; ASEAN, 2021c, p.131) calls for robust health security. WHO further emphasises that pandemics, health emergencies, and weak health systems pose risks to global Hence, building health system resilience–the ability to prepare for, manage, and learn from the shocks (Thomas et al. 2020, p.5)–is a prerequisite to addressing PHE and enhancing regional health security.
Ensuring a resilient health system (RHS) in ASEAN Member States will require improving health and non-health factors. The health factors include WHO’s six building blocks of the health system (service delivery, human resource for health, health information system, essential medical products and technology, financing, and leadership and governance), and the Universal Health The non-health factors include optimising Social Determinants of Health to support enabling environment, ensuring food security, and strengthening infrastructure.
ASEAN can implement several actions for RHS in the region, including promoting RHS through RHS assessment and development of guidelines for ASEAN’s RHS, utilising the supply chain approach, and strengthening the Primary Healthcare role as the cornerstones of RHS.

Introduction

Background, Objectives, Methodology, and Limitations

This trend report aims to review the strategy of building a resilient health system to strengthen regional health security in ASEAN through portrayals of the ambitions and progress of the ASEAN region and ASEAN Member States. This trend report will identify challenges and opportunities, both prevailing and emerging, that the AMS ought to overcome, explore, and capitalize on and provide an overview of regional progress against the ideals above.

This report was written using various methodologies: content analysis, comparative or gap analysis, and descriptive analysis for quantitative data. Each methodology was used to compare and analyse secondary data to give a perspective on the phenomena in ASEAN and AMS.

We acknowledged several limitations in writing this Trend Report, such as unequal capacity and availability, where some data is available in several but not all AMS, and a few are either outdated or incomplete. Therefore, this report’s internal validity and generalizability should be interpreted cautiously.

Results and Recommendations

Promoting Understanding and Implementation of Health System Resilience in the ASEAN Region

Initiating RHS in ASEAN requires a deeper understanding of health system resilience conditions in AMS and specific RHS characteristics needed to address PHE issues in ASEAN. Literature pertaining to the technicality of RHS and its linkage with other public health programmes is still scarce (WHO, 2022, p.59). Hence, pushing forward for R&D in ASEAN’s RHS is required. One crucial action is assessing the health system resilience level in AMS by utilising WHO’s Health Systems Resilience Toolkit. Other measures include identifying potential sources of vulnerability and planning for further action (Thomas et al. 2020, p.5) and carrying out simulations that ‘stress- test’ health systems in different scenarios (EIT Think Tank, 2022, p.17).

Supply Chain Approach for Health System Resilience

A study indicates that a supply chain approach may provide a better and more realistic approach to promoting RHS (Liu and Anbumozhi, 2022, p.S600). Case studies in Europe confirmed that extending upstream procurement or resource sharing among hospitals and countries leads to superior risk mitigation (Spieske et al. 2022, p.1). A supply chain approach will promote mutual support systems between national and international bodies through highly coordinated shared pools of health capabilities and capacity for deployment to face major health events (op cit.). In ASEAN, international humanitarian assistance is one of the successful examples of this approach. Hence, promoting supply chain connectivity for health system resilience and integrating the improving humanitarian assistance track with the national health track in each AMS may be beneficial.

Strengthening Primary Healthcare (PHC) through Integration of Climate and Disaster Health Management Initiatives into PHC’s Services

RHS has proven to be a cornerstone for PHC as the gatekeeper in the health system. Reform of PHC can promote health security and improve health system responsiveness through integrated public health and primary care capacity in the frontline (WHO, 2021, p.14). Countries have demonstrated the importance of integrated PHC networks, such as the Irish plan to operationalize the Community Health Network through PHC and the Greek plan to reform primary care and prevention (EIT Think Tank, 2022, p.54). Several recommendations for PHC’s resiliency may include developing an operational framework to support PHC’s role in PHE and climate impact assessment and climate-related disaster management, ensuring that the HRH trained in managing RHS is stationed in PHC, and utilising telemedicine for primary care (Thomas et al. 2020, p.15).