dialogue above more concrete forms of cooperation. Although this has played an important role in fostering trust and confidence it has sometimes left a gap
between words and deeds, ”
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became much stronger. As Reuters noted, the World Health Organization has tried to persuade Indonesia and other countries to share
their samples of avian flu H5N1 with the international scientific community. “Previously, Indonesia had declined to do so under a principle its government
called „viral sovereignty,‟ by which it meant that microbes found in Indonesia belonged to the state and did not have to be shared with outsiders.”
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On one hand this stand is confirming the strong sense of sovereignty that exists within ASEAN
states, and that stand is keeping them away from the political integration Haas was mentioning, but
not as far from Deutsch‟s security community that doesn‟t required so formal institutions as long as they are contributing to the peaceful
transition among the states. On another hand the the stand is rising the concern among international community. If Thailand and Jakarta were denying existence
of terrorism within its territories and then faced with bomb attacks, does it mean that refusing to give an insight into the microbes is a denial of bio potentials that
would, eventually, lead to bio-attack?
5.5. Fighting bioterrorism with health mechanisms
As it was mentioned in the Chapter IV, in the of filed medicine, the attention is on doctors and basic medical stuff, which are the first ones in the line of dealing
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Marti J., I ple e ti g Resolutio : The Role of Regio al Orga izatio s ,
UNIDIR20088, United Nations, p.61
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Bioterroris - A
Pu li Threat:
Bioterroris he
a d here ,
http:www.medindia.netbioterrorismbioterrorism_public_threat.asp , [24.06.2013]
with the already infected people, to be able to recognize the treat and make the first step in fight against it or prevention of its further spreading.
In order to prevent developing of the situation, liberalization of health service sector was conducted in the context of the four mode of service supply from
service providers to service users: provision of remote health services, health tourism, presence of foreign service domestically, and export of medical
personnel. After it, according to the Trade Minister of Republic of Indonesia, Mari Elka Pangestu,
“the health sector was increasingly prepared to face ASEAN single market
”
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. Standards in the health sector, agreed by ASEAN countries, namely meant the professional standards of dental assistants and nurses, but the
problem was that compatibility of those standards enabled Indonesian physicians or nurses to practice in other ASEAN countries, and vice versa but harmonization
of standards of nursing care, competence, educational curricula, and training as well as developing nurses‟ capacity in providing nursing care towards a global
standard has been signed through the ASEAN Mutual Recognition Arrangement on Nursing Services in December 2006. Now, the integration of the sector was
planed, but its implementation was delayed due to the lack of supporting scientific data.
After such experience, it came to the conclusion that teamwork and solid commitment from all the members are something necessary. Strong countries
were expected to assist the weaker ones. However, ASEAN has not been capable
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A ar A.,
, Di e sio s of A“EAN Cooperatio i Health De elop e t of “outheast Asia ,
http:fhukum-unpatti.orgartikelhukum-internasional83-dimensions-of-asean-cooperation-in- health-development-of-southeast-asia.html, [19032012]
of dealing with such idea. In practice, by 2007, the strong ASEAN member countries were getting stronger, while those weaker ones were remained at the
same position. That gap in economic growth had an impact on the creation of health development gap among them. It was directly proportional to health care
disparities and uneven distribution of physicians, especially specialists; it represented difficult obstacles to overcome by relatively weak countries in the
region. Therefore, several ASEAN member countries that were enable to achieve the Millennium Development Goals in all areas of maternal mortality, the low
quality of sanitation and clean water, an increasingly uncontrolled rate of HIVAIDS transmission, and the rising foreign debt burdens.
When it comes to the case of Asia Pacific region, it appears that infectious diseases and poverty continue to affect health related human security. Within the
domain of human security, health security emphasizes on taking preventive measures to protect people from infectious diseases, so the regional health
community is focusing its effort on cooperation of pandemic preparedness and response. Asia Pacific Economic Cooperation APEC established the Health
Task Force in October 2003 to handle the health related threats. Later, it brought the “Health Security Initiative” and the “2005 Enhancement of APEC Work on
Preventing, Preparing for and Mitigating the Effects of Avian Influenza and Influenza Pandemic Ini
tiative.” Most common infectious diseases over the ASEAN region are HIV and AIDS,
tuberculosis, malaria, and dengue. But, in 2003, they faced with the issues of the SARS and the Avian Influenza, too. Dealing with SARS, ASEAN countries in
April 2003 worked collectively to make sure that the region became SARS-free. It was the first region in the world to respond to SARS on a region-wide effort.
ASEAN tried to expand that cooperation to China, Japan, and South Korea. In 2004, that contributed to the ASEAN+3
Health Minister‟s Meeting which created the ASEAN+3 Health Ministers hotline, the ASEAN+3 List of Contact Points for
Communicable Diseases, and the ASEAN Disease Surveillance.net website. But after it, H5N1 became the most urgent pandemic to be noticed and monitored.
According to the WHO, Vietnam, Indonesia and Thailand had the most cases in the region so the good surveillance on global and regional levels become critical
and required the preventive measures which will, collectively, ensure human security of their own people. But, the general impression is that readiness, in both
developing and developed countries, is still not enough. This situation meant that health security is now becoming really concerned with health care and health
policy as well for the health system in times of emergency, such are pandemics. Yes, most of the countries in Asia do have pandemic preparedness plans and
coordination with each other, but the attention has to be put on operability and effectiveness. For this reason, all regional organizations should share information,
make coordination of responses, control outbreaks through International Health Regulation network and help in capacity-building. It is necessary to be understand
that “national health security is a state in which the Nation and its people are prepared for, protected from, and resilient in the face of health threats or incidents
with potentially negative health consequences. ”
84
84
Kaplowitz G.Lisa, National Health Security Workforce , U.S. Department of Health and Human
The SARS outbreak in April 2003, caused social and economic impacts in many countries in the ASEAN region, posing challenges to international public
health, threatened regional and global prosperity, confidence and stability. The epidemic showed the need for more effective and coordinated response at the
regional level. In the cooperation of Member Countries, and WHO, ASEAN they were able to combat the spread of the disease and is now a SARS-Free region.
Yogyakarta Declaration, signed on April 2002 by the Health Ministers of ASEAN countries, declared HEALTHY ASEAN 2020 in order to make the
Southeast Asian region as a center for health development and to entirely ensure the creation
“of a physically and mentally healthy ASEAN community, living in harmony in an environment of safe Southeast Asia region
”
85
. But, unfortunately, until today, health development in ASEAN region had limited progress for most
of the countries. Local health security was aimed by the ASEAN plus 3 Health Ministers
Special Meeting against SARS in Malaysia, in April 2003, APEC Health Ministers Meeting, in June 2003 in Thailand. Product of all of them was
agreement to share diseases information and to collectively take actions to apply the same principles on health check for immigration.
In the Japan-ASEAN Commemorative Summit in December 2003, the Japan- ASEAN Tokyo Declaration and the Japan-ASEAN Plan of Action were
promulgated, in which the leaders agreed to “enhance cooperation in the areas of
Services, p. 1
85
Anwar A., 2011, Di e sio s of A“EAN Cooperatio i Health De elop e t of “outheast
Asia , http:fhuku -unpatti.orgartikelhukum-internasional83-dimensions-of-asean-
cooperation-in-health-development-of-southeast-asia.html, [19022013]
disarmament and non-proliferation of WMD and their means of delivery, and related materials.” Moreover, at the meeting of BWC state parties in December
2003, Japan distributed the English translation of its national BWC implementation law as a reference for those countries that have not yet enacted
their own national implementation law. The dramatic situation happened again in 2009 when Influenza AH1N1 in the
whole Asia-Pacific region claimed a lot of victims, proving that it is not just the issue of the Southeast Asia, but that can easily transmit and become the issues of
the whole Asia-Pacific. The same flu was noted in the other parts of the world, too. Palestine, Norway, and Yemen, together with reported US states, Minnesota
and South Carolina, showed that they are not immune. At their 8th meeting on June 21 2006 in Yangon, the Health Ministers of the ASEAN countries pledged to
make every effort necessary to ensure that their communities were prepared to address bioterrorism.
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Until now, pandemic preparations and strategies are on a much higher level that bioterrism ones are. It is understandable that Japan had
much stronger laws and strategies of dealing with the issues, since Tokyo attack made them aware of the danger. It is understandable that Australia has one of the
strongest border controls since, being an island a bioattack can be devastating toward her population, economy and politics. ASEAN never dealt with a
bioterrorism attack, but has much wider territory, more difficult to control in the
case an attack happens.
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People daily,
ASEAN health
ministers meeting
opens in
Myanmar ,
http:english.peopledaily.com.cn20060621eng20060621_275989.html , [04.07.2013]
CHAPTER VI CONCLUSION AND RECOMMENDATIONS
6.1 Conclusion
