Theme 4: Social Welfare and Health

Public Services and Social Policy

The underlying message of this theme (and indeed across all themes) is the need to make social policies more effective, equitable and accountable. ASEAN policy makers have demonstrated their commitment to these goals through several key declarations but there appear to be some gaps.

In 2015, the ASEAN Cooperation on Civil Service Matters adopted the Putrajaya Joint Declaration on ASEAN Post-2015 Priorities towards an ASEAN Citizen-Centric Civil Service. The focus on a citizen-centric approach allows the acknowledgement of the needs of the population as the starting point and is driven by the choices and concerns of the community. The ASEAN Declaration on Strengthening Social Protection produced a revised Regional Framework and Action Plan in 2018. Its objectives are to reduce poverty and inequality; increase the capabilities of the vulnerable and directly address the needs of persons with disabilities, the elderly, and young children by ensuring sustainable and equitable access to public services.

As early as 2002, ASEAN put together a “Healthy ASEAN 2020” vision and established a Regional Action Plan on Healthy Lifestyles 2020, promoting the improvement of social determinants of health. The ASEAN Post-2015 Health Development Agenda (APHDA) has work plans arranged into four clusters: promoting healthy lifestyles; responding to all hazards and emerging threats; strengthening healthy systems and access to care; and ensuring food safety. The first also incorporates Universal Health Coverage (UHC) and Prevention and Control of Non-Communicable Diseases and addressing mental health. The second focuses on reducing the incidence and burden of these specific communicable diseases: Rabies (Vietnam), Dengue (ASEAN Dengue Day), and Malaria (Myanmar).

To examine the effectiveness of these commitments, health treatment and control through Universal Health Coverage and health prevention through Water and Sanitation are examined, as well as Sport and Leisure. Sport and leisure are underappreciated dimensions that can have significant impacts on inclusion and identity, not just on well-being.

Policy Recommendation

Water and sanitation

(i) A greater emphasis on sustainability in the water sector among the member nations, as all ASEAN countries are vulnerable to climate risks, though the degree of risk varies; (ii)To focus on treating wastewater before it is released into water bodies or re-used; (iii) To rationalize their water tariffs as part of a water conservation strategy; (iv) To reduce their NRW by improving the distribution and transmission infrastructure; (v) To make efforts towards improving their data systems, and collect and analyse data around water delivery, water quality and water levels of the source body.

Sport and leisure

(i) Inclusive build-up of football linked sporting events and platforms for all ages and groups to achieving wider participation in sport; (ii) Concerted, consistent and transparent program of communications on high visibility events, such as the World Cup in 2034, of programmes for community inclusion in the sports events and hosting of the sporting event; (iii) To strengthen gender equality and life skills development into the sporting programmes and use sports as a tool to promote gender equality and life skills development among youth; (iv) To increase the opportunities for persons with disabilities and for the older generation to enjoy ‘active living’ sporting programmes.

Key Findings

1. To a large extent, public health care is currently viewed as a national concern within ASEAN countries. In the face of new challenges, there is considerable scope to leverage regional commonalities and expertise.

2. Increasing revenues through taxes on unhealthy consumption and lifestyle elements that will also incentivize healthier behaviour. These taxes are likely to become effective when they are harmonized across the ASEAN nations to avoid parallel imports, etc.

3. Streamlining redundant processes and functions within and between the healthcare systems of the respective countries while effectively maximizing the patient-facing share of public health personnel and attempting to improve overall resource allocation.

4. Boosting awareness on key health risks among citizens and substantially increase resources for early diagnosis and prevention of major diseases to improve the patient’s chance for a healthy life and reduce their total healthcare costs.

5. Focusing on diseases that have high disability effects. Enable treatments that initially require higher budgets but reduce long-term burdens on patients and the healthcare system. This may include transplants and highly effective medical treatments.

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