Susan Hubbard: East Asia Regional Cooperation on Global Health
Susan Hubbard is a senior associate at the Japan Center for International Exchange where she focuses primarily on global health and human security issues.
In the spirit of the current World Cup mania, I am reminded of the historic decision that Korea and Japan made to combine their competing bids to host the 2005 World Cup. By doing so, they successfully won the bid, and the World Cup was cohosted by two countries for the first and only time in its history. The idea for combining the bids was originally proposed in 1995 at a meeting of the Korea-Japan Forum, a track 2 dialogue organized by the Japan Center for International Exchange and the Korea Foundation. The decision came at a time when the two countries were in a fierce battle over issues dealing with history and territory. But the games allowed the people of both countries to turn their attention away from geopolitical tensions and focus instead on their shared interests.
East Asia is again experiencing an escalation of seemingly intractable conflicts over territory and history that threaten to undo gains that have been made in building regional institutions and promoting cross-border engagement. We need another watershed moment of cooperation at the people-to-people level to help open up new avenues of communication across countries in the region.
Health is a field that is ripe for that kind of cooperation. As anyone who has done any work in health policy knows, it is a far cry from being a “nonpolitical” field. But health is one area of our lives that is truly universal: every single one of us faces challenges to our health at some point in our lives. Having more resources can protect many of us from the devastating effects of some of those challenges, but it does not offer full protection. And health, unlike other issues that dominate the headlines in the region these days, is not a zero-sum game.
Two health challenges in Asia—communicable diseases and the detrimental health effects of pollution—are by nature cross-border threats that require the engagement of all countries in the region. Asia has been the origin of some well-known communicable diseases in recent decades, most notably SARS and avian influenza, and new ones continue to emerge. The rapid movement of people within and across national borders means that infections have the potential to spread rapidly and put everyone at risk.
According to the Global Burden of Disease Study, ambient air pollution was the fourth most common risk factor for deaths, years of life lost, and disability-adjusted life years in East Asia in 2010. For women in East Asia, it was the third most common risk factor. Even when one looks at only high-income countries in Asia Pacific, ambient air pollution remains in the top ten list of risk factors and is consistently higher for women than for men. This reality makes robust pollution control measures an important regional public health strategy.
Dealing with both of these challenges requires more than just regulations at the governmental or inter-governmental level. It also requires changes at the local, industrial, community, and individual levels. For example, surveillance and prevention measures for communicable diseases ultimately depend on vigilance and behavior change at the individual level. On the environmental health side of things, it is the cumulative impact of many daily activities, particularly industrial operations, that causes pollution on a scale that threatens the health of people throughout the region. Communities and other nongovernmental actors need to be engaged in a process to find acceptable ways of changing lifestyles and business practices in ways that minimize the spread of infections and of toxic pollution without jeopardizing the livelihoods and standards of living of local populations.
What we need now is a regionwide platform for cooperation to address these pressing health issues. The first step to creating this platform should be a multilateral dialogue that will involve stakeholders from all sectors of society and propose several concrete activities that countries in the region can take to address these challenges, setting realistic short- and medium-term goals. One key will be to involve experts—healthcare providers, activists, academics, and others—who have a vested interest in finding solutions rather than in scoring political points. Discussions should be based on scientific evidence and focus on future outcomes rather than on placing blame for current challenges. This does not mean that the governmental sector is irrelevant. On the contrary, sustainable change will not be possible without strong government commitment, and ideally the dialogue would turn into a track 2 process involving both the public and private sectors. But we cannot wait for public officials to take the lead at a time when geopolitical tensions prevent them from engaging in constructive dialogue with their counterparts in the rest of the region. Nongovernmental actors have an opportunity now to initiate discussions even when their political leaders are prevented from engaging with their counterparts. They should come together to open new avenues of communication and score a victory for the health of everyone in Asia.