From SARs to COVID-19: Reflections on ASEAN's collective response to public health crises

As the COVID-19 crisis was intensifying in the region in February and March, commentators from the media and academia noted that ASEAN was slow to act. Elsewhere in the international community, similar critiques of other international and regional organisations such as the World Health Organisation (WHO) and the European Union to act faster were also made. Disappointment was directed at the United Nations Security Council for not reaching a resolution on the COVID-19 pandemic.

Despite the many calls for these international bodies to do more, it remains unclear what it is that they are expected to do - is it funding, providing equipment such as ventilators and test kits, or sending personnel and other expertise?

If so, perhaps these expectations may be misdirected because on public health matters, international organisations can only offer advice and protocols to which states can choose whether to implement - for instance, the WHO's International Health Regulations (2005). No hard law obligation exists. On the supply of equipment and other resources, it really depends on what humanitarian compact was agreed on beforehand.

In a nutshell, international organisations are not meant to take over the primary functions and responsibilities of the state in protecting its people because these organisations have always been structured to not impinge on sovereignty when assisting members deal better with the situation.

This reality becomes stark during a pandemic. Every member state is besieged, there is little spare capacity or resources to help even if there is a desire to do so. At the same time, global competition for medical and food supplies complicates issues. It really is the state that bears primary responsibility to act in safeguarding public health.

If we look at different countries, we see that quick and decisive action and the preparedness of the state to prevent and contain infections seems to matter more than its development status and wealth. Drilling deeper, whether such prevention protocols have been practised by local governments also makes a real difference within national jurisdictions. Whether in terms of medical or economic health, COVID-19 has demonstrated the truth of the adage: Prevention is better than cure (which is invariably much more expensive and time-consuming).

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Recognising the multifaceted complexities of dealing with COVID-19, how has ASEAN supported its members in protecting public health during this pandemic? How does ASEAN carry out its functions equitably despite the differences and disparities among the member states in terms of geographical size, population size, population density, economic wealth, medical and technological resources, manpower capacity, and availability of food and equipment stockpiles?

Due to its previous experiences dealing with the severe acute respiratory syndrome (SARS) and the avian and swine flus, ASEAN members take pandemic threats very seriously because of their devastating health and economic impact and cooperation with its external partners has gone a long way in dealing with COVID-19.

Following the SARS outbreak in 2003, ASEAN members together with China, Japan, and Korea operationalised an action plan to prevent and control infectious diseases with protocols for three priority areas: (1) international travel, (2) information sharing among the members as well as public education, and (3) building alert and response capabilities.

Much effort has gone into strengthening these priority areas. Following the 2004 Indian Ocean tsunami that gravely impacted on many ASEAN coastal communities, members adopted the ASEAN Agreement on Disaster Management and Emergency Response (2005) to enable comprehensive cross-sectoral measures to be taken during disasters and other emergencies.

For instance, the ministries of health and agriculture from member states would be involved in the decision-making processes of the ASEAN Committee on Disaster Management, the ASEAN Secretariat Working Group on One Health would facilitate multi-sectoral coordination and resource mobilisation to combat pandemic influenzas and other emerging zoonotic diseases.

With the support of the United States Agency for International Development (USAID), the ASEAN Project on Pandemic Preparedness and Response has set baseline pandemic response standards for each ASEAN member according to the country's situation. These include the institution and review of national pandemic preparedness plans, establishing minimum requirements for pandemic preparedness and response, and developing cross-border resource-sharing plans in times of emergencies and building up individual pandemic response capabilities for the longer term.

In addition, ASEAN has established institutions to tackle regional disasters and emergencies, such as pandemic crises. These include: the ASEAN Coordinating Centre for Humanitarian Assistance on Disaster Management, the ASEAN Emergency Operations Centre Network, and the ASEAN BioDioaspora Regional Virtual Centre.

These pandemic preparedness protocols have been useful in regional efforts to counter COVID-19. In February and March when border controls were tightening to stem the spread of the disease, ASEAN members activated the Guidelines on the Provision of Emergency Assistance by ASEAN Mission in Third Countries to Nationals of ASEAN Member Countries in Crisis Situations to help one another facilitate the evacuation and repatriation of nationals back to their home countries in ASEAN.

Furthermore, one of the most critical things needed by all member states in this pandemic is information - the sharing of information and best practices has been the topmost priority for ASEAN members, as expressed by their leaders in every ASEAN meeting on COVID-19, ranging from the Special Summit of ASEAN leaders to ministerial meetings for health, foreign affairs, trade and economy, defence, agriculture and forestry, and tourism. These ASEAN bodies have convened to share their experiences and to provide the cross-sectoral, whole-of-government approach required to tackle the complex issues created by the pandemic.

Such exchanges are not only intraregional but with partner states, especially in initiatives such as the ASEAN Plus Three Field Epidemiology Training Network (ASEAN+3 FETN), and international organisations.

In particular, the ASEAN Emergency Operations Centre Network led by Malaysia and supported by the ASEAN Secretariat give daily situational updates while the ASEAN BioDioaspora Regional Virtual Centre led by the Philippines works on big data analytics such as air travel, demography, population density - factors relevant to disease spread. Both centres are supported by Canada and the results of these data analyses are publicly available on the ASEAN website, facilitating member states' insights on the global situation regarding COVID-19 as well as the potential spread of the virus in the region.

Such information is vital for timely and adequate mitigation measures against virus importation. More broadly, information sharing has been important as new things are discovered about COVID-19 and agencies need to be aware to react. Some of these include the protocols on testing, isolation, and tracing; the awareness of COVID-19 symptoms; campaigns against disinformation, fake news, stigma and discrimination against COVID-19 patients and healthcare and other frontline workers; treatment protocols; and other clinical measures healthcare institutions need to implement such as access to hospitals. For the longer term, there are also policy discussions on drugs and vaccines, self-reliance, and how the ASEAN pandemic response mechanisms can be strengthened even after COVID-19.

In terms of the economy and broader protections of ASEAN societies, the economic ministers have cooperated to keep the markets open and supply chains moving to maintain external and internal confidence in the region as a trade and investment hub. Apart from curbing export restrictions and addressing trade barriers intra-ASEAN and in relation to China and Japan, ensuring adequate food and reserves through the ASEAN Food Security Information System and ASEAN Plus Three Rice Emergency Rice Reserve has also been a priority for the economic, agriculture, and forestry ministries.

ASEAN ministers and private industries have realised that the region's drive towards economic integration, technology, and digital trade are more important than ever. In fact, the economic disruption caused by the COVID-19 pandemic is accelerating regional integration, evidencing the importance of speeding up supply chains through using the ASEAN Single Window and other digital platforms. There is recognition that the rush towards digitalisation is hard for micro, small, and medium enterprises, so extra help for this group to assimilate into e-commerce is acknowledged. Moreover, attention has also been focused on helping the tourism sector - a core economic driver in many ASEAN states - to recover when travel restrictions begin to be lifted. These include technical support and financial stimulus as well as cooperation with ASEAN dialogue partners and industry leaders.

A brief survey has shown that many member states have so far set in place economic relief plans including the loan extension, support to businesses, and other measures that help workers to keep their jobs. While the grave economic effects of COVID-19 are admittedly only slightly mitigated by these policies, the fruit of such regional cooperation is perhaps manifested at a more macro level when seen in the relative socio-political and fiscal stability within the ASEAN region especially against the backdrop of disruptions in the global supply chains, increasing unilateralism demonstrated by larger states, and the frictions among trading powers.

Just as previous epidemics have spurred closer ASEAN cooperation, the COVID-19 pandemic has similarly led ASEAN members to recognise the current limitations within the region and even greater effort must be made for the future to collectively build up regional and individual (national) resilience during health crises.

At the Special Summit on Coronavirus Disease 2019 (COVID-19), ASEAN leaders proposed that available existing funds be reallocated to regional efforts countering COVID-19. They also encouraged ASEAN external partners such as the United States, China, and Japan to provide technical and financial support, especially in the proposed establishment of the COVID-19 ASEAN Response Fund.

ASEAN leaders also acknowledged the need to improve pandemic healthcare protocols such as the implementation of the WHO's International Health Regulations, strengthening the early warning systems, and perhaps even setting in place a regional standard operating procedure for public health emergencies.

On biosecurity, in addition to considering a tabletop exercise on public health emergency response with the ASEAN Centre of Military Medicine, the ASEAN defence ministers called upon the regional chemical, biological and radiological defence experts to cooperate to manage future infectious disease outbreaks. For the longer term, the Special ASEAN Plus Three Summit on Coronavirus Disease 2019 (COVID-19) discussed in greater detail measures on how to enhance national and regional healthcare capacities and ensure adequate essential medical supplies and equipment.

Suggestions included the development of regional and ASEAN Plus Three reserves of essential medical supplies, strengthening scientific and technical cooperation, and assembling a network of experts on public health emergencies.

Given the frank proposals that ASEAN leaders have mooted to supplement the existing regional measures countering COVID-19, it is evident that while ASEAN has learned a lot from previous healthcare crises and has actively implemented regional public health protocols, a lot more needs to be done - not only to deal with the current and foreseeably long-lasting effects of the pandemic.

In this, the ASEAN Coordinating Council, supported by its Working Group on Public Health Emergencies, has been tasked to oversee the numerous cross-sectoral programmes and give a proper accounting and recommendation to the ASEAN leaders at the 36th ASEAN Summit.

Notwithstanding critiques of ASEAN being a 'talk shop', previous crises - the Asian Financial Crisis, dot com bust, SARS, and the global financial downturn of 2008, to name a few - have also evidenced that they are the galvanising forces that drive member states to closer cooperation. If these experiences are anything to go by, then COVID-19 with its serious consequences for the livelihoods and health of ASEAN peoples and the economies of ASEAN states will prove to be another important juncture of growth for ASEAN solidarity and integration.

The writer is Senior Research Fellow at NUS Centre for International Law, and Assistant Professor at NUS Faculty of Law.