An extraordinary health crisis
The outbreak of COVID-19 pandemic has caught the global community by surprise. Described as an extraordinary, once-in-a century pandemic, COVID-19 continues to rage in most parts of the world and has already caused untold human sufferings to millions of people globally. To date, COVID has resulted in over 3.8 million deaths and approximately 176,785,667 confirmed cases globally1. Since its outbreak in 2020, the pandemic has upended people’s lives, cost millions of jobs, severely restricted people’s mobility and resulted in an economic downturn not seen since the global recession in the 1930s.
To be sure, the failure to contain COVID-19 early and at source, before it could spread across the globe, was viewed as a serious challenge to global governance. As most parts of the world continue to grapple with the huge task of ending the pandemic, the message could not be clearer: global health security is fundamental to international peace and security. Addressing existential challenges brought on by COVID-19 and other infectious diseases requires no less than effective governance of health security at multiple levels from the local to the global arena.
COVID-19 as a Threat Multiplier
The COVID-19 pandemic has been a threat multiplier. As countries introduced a string of strict public health measures to contain the spread of the disease, from social distancing, lockdowns to closing of borders, the health crisis rapidly became an economic crisis of global proportions.
• Economic Crisis
The Covid-19 pandemic resulted in rapid economic decline in the world economy. Reports from the World Bank and the Asian Development Bank projected a global economic contraction of up to 8 -10 per cent, resulting in the worst downturn since the Great Depression of the 1930s.
Lockdowns and restrictions on people’s movements had caused layoffs and pay-cuts by companies, leading to, among others, huge losses in the retail, dining and hospitality services. Border closures have resulted in USD 200 billion loss in the global tourism industry, decimated the aviation industry and severely disrupted the supply chain causing shortages in goods and commodities (Ozli and Arun, 2020). The severe consequences of the sudden economic downturn included job losses of over 80 million in the Asia-Pacific alone, a figure that does not include the millions more lost in the informal economy.
• Food Insecurity and Undernourishment
By the International Food Policy Research Institute’s (IFPRI) estimates, the global economic contraction likely led to an increase of 150 million people in extreme poverty by the end of 2020 (Swinnen and McDermott, 2020), adding to the 135 million people who were already in the brink of starvation even before the COVID-19 pandemic occurred (World Food Programme, 2020). COVID-19 pandemic therefore has seriously threatened food security. The risks in food security are compounded when one examines the impact of the pandemic on the 3 basic elements of food security (Caballero-Anthony et al, 2020).
o Food Availability. The control of movements of people domestically and internationally amid lockdowns, can impact on the supply of labour and inputs to food production. This constraint to getting the needed workers and agricultural inputs they commonly use in their cropping process (e.g., fertilizers, seeds or pesticides) can lead to a failure of the cropping season altogether, and to a reduction in yields (CGIAR, 2014).
o Physical Access to Food. Travel and transport restrictions during the COVID- 19 pandemic can make it more challenging for farmers to transport their produce to markets, whether by sea or air (Teng, 2020). Furthermore, the supply chain of food requires that food is stored in sufficiently safe environments, lest it becomes vulnerable to pestilence (e.g. rodents, or insects), to crops rotting, and ultimately, to food being wasted.
o Economic Access to Food. Delays in the transport of food, can cause delays to supermarkets in replenishing their food stocks, with impacts particularly acute for food importing countries. Whenever physical access is limited and food becomes scarcer within these local settings, food prices increase, potentially placing food beyond the grasp of poorer populations. For instance, during the 2007-08 food crisis, the World Bank estimates showed between 100 million and 200 million more individuals being classified as food impoverished, leading to an increase of 63 million undernourished individuals (Independent Evaluation Group, 2020).
Undernourishment is a serious threat as it is already a known contributor to morbidity and mortality, especially for children, and including greater vulnerability to infectious diseases as a result of micronutrient deficiency (Gwela et al., 2019). In fact, today’s ‘lockdowns’ have deprived millions of daily-waged workers of their ability to purchase food in Asia, with an estimated 109-167 million falling to unemployment regionally (ADB, 2020), and 140 million falling into extreme poverty globally (Laborde et al., 2020). It is anticipated that there will be increased hunger and malnutrition in many developing countries.
• Environmental Security
Despite a stronger focus on the environment, the COVID-19 pandemic has worsened waste problems. Increased use of disposable masks clearly means increased medical waste (Kassam, 2020), and lockdowns have generated more plastic waste coming from takeaway and delivery food packaging (Elangovan, 2020). Although reusable masks can potentially reduce the amount of plastic waste, a recent development that has seen the spread of more virulent virus strain is likely to result in increased use of disposable masks (Chew, 2021). COVID-19 is thus likely to reverse years of ongoing efforts to reduce plastic waste (Benson, 2021). This situation reflects most evidently the perennial challenge in protecting the environment in view of securing human needs.
The COVID-19 pandemic has brought mixed consequences on environmental issues. First is increasing attention on the need to protect the environment. Degraded nature has been perceived as a reason behind the spread of zoonotic diseases (Patz and Confalonieri, 2005). The current public health crisis has thus re-affirmed this theory and has resulted in concepts such as Planetary Health, which has been advocating for the care of the planet for the sake of human health since 2015 (Whitmee et al., 2015), gaining greater relevance of late. UNESCO, for example, illustrates how the health of the ocean can help to fight COVID-19 and contribute to human health in general (UNESCO, 2020).
A similar take is also observed in climate change discourse. At the height of the pandemic in mid-2020, UNEP declared the term ‘triple planetary crisis,’ which essentially emphasises the interconnected nature of climate change, biodiversity loss, and pollution, and proposed nature- based solutions as the way forward (UNEP, 2020). Nature-based solutions basically mean restorations of degraded ecosystems. What the future holds for the environment post-COVID- 19 pandemic thus remains to be seen.
Responding to the crisis: Lessons from East Asia
For a region that is no stranger to pandemic outbreaks, COVID-19 and its severe consequences, serve as a grim reminder of the fragility of peace and security in Asia. In Southeast Asia, COVID-19 has raised questions about regional stability and the prospects of health security governance in view of the lingering consequences of the pandemic and concerns about the possibility of more pandemic outbreaks in the future.
One of the key lessons drawn from the region’s experience with the SARS crisis in 2003 is the inevitable regionalisation and globalisation of diseases. The region’s experience has shown that viruses do not recognise any borders. The SARS crisis therefore highlighted the need for more vigilance and surveillance of disease outbreaks among ASEAN countries, and emphasised the importance of institutionalising norms and regional mechanisms to respond collectively to a shared security threat (Caballero-Anthony, 2018).
Setting standards and norms in Pandemic Preparedness and Response
In the first quarter of the COVID-19 outbreak, many analysts have observed that countries like Singapore, Vietnam, Malaysia and Thailand have responded swiftly to the pandemic and were able to ‘flatten the curve’ of infections early. Most of these countries introduced similar public health measures like mandatory mask wearing, social distancing and strict restrictions on travel and movements of people including closing of borders. Massive testing and contact tracing were carried out, and isolation and quarantine measures were also implemented at the very early stage of the pandemic outbreak.
Arguably, the region’s ability to mitigate the spread of the pandemic has much to do with its experience in pandemic preparedness and response put into practice. The norms of pandemic preparedness, information sharing and capacity building provided the foundations for better regional health governance. These shared norms further paved the way for ASEAN to establish the ASEAN Coordination Centre for Public Health Emergencies and Emerging Diseases which was launched in November 2020.
Strengthening Regional Cooperation in Health Security
Regional cooperation is critical in helping countries contain the pandemic. Before the WHO declared COVID-19 a pandemic, the regional mechanisms on health security were already deployed in anticipation of a wider global outbreak. These included:
ASEAN Emergency Operating Centres (EOCs) Network for Public Health Emergency which facilitates timely and accurate exchanges of information and technical inputs on the nature of COVID-19 virus and the health protocols to observe such as testing, contact tracing, isolation, and quarantine.
ASEAN BioDiaspora Virtual Centre which produces Risk Assessment for International Dissemination of COVID-19 across the ASEAN region.
Regional Public Health Laboratories Network (RPHL) which facilitate exchanges on laboratory readiness, technical and material support, as well as laboratory surveillance. This mechanism is supported by China, Japan, and South Korea.
ASEAN Risk Assessment and Risk Communication Centre which disseminates preventive and control measures, including combatting false news and misinformation. The mechanisms proved to be extremely helpful in getting countries to enact early measures to prevent and curve the spread of COVID-19.
In order to deal with the specific situations of COVID-19, ASEAN also created several ad-hoc agencies including the ASEAN-China Ad-Hoc Health Ministers Joint Task Force and held ad- hoc meetings including the ASEAN Special Summit on COVID-19 to inform and coordinate their COVID-19 response. The ASEAN Special Summit held in April 2020 discussed how member states could coordinate their COVID-19 response to bolster national and regional epidemic preparedness and response. The ASEAN Plus Three summit (with China, Japan and South Korea) was also convened and where an agreement to build an ASEAN stockpile of essential medical supplies and equipment, as well as setting up an ASEAN Recovery Fund to assist member states were inked. There were also commitments to ensure the smooth flow of essential goods by refraining from imposing non-tariff measures (NTMs) during the pandemic and strengthen supply chain connectivity and resilience, including making trade facilitation more effective.
Addressing Impediments and Weak Links to Regional Health Security
It has been more than a year since the COVID-19 spread across the globe and while East Asia appears to have managed the pandemic better than other regions, the progress among countries remains uneven. With the emergence of new variants of COVID-19 virus, some countries have done much better compared with others in the region. While there is no perfect system of governance, there are a number of factors that explains why some countries have fared better while others continue to struggle. Among these are strong national leadership, speedy and decisive pandemic response, more centralised and/or better coordination at all levels from the national to the local levels. There are also intangible factors that played a critical part. One of these is the trust that citizens have in their government which helped significantly in public compliance of strict public health measures.
Although sustaining progress in disease control is contingent on national efforts, another critical element is the capacity of national public health systems. What this long-drawn COVID-19 pandemic has revealed is the uneven capacity of public health systems among countries within and outside Southeast Asia. It has been long recognised that strong and resilient health systems are essential, not only in effectively addressing severe pandemic but also as defence against other communicable and non-communicable diseases. Thus, the need to build stronger health systems at the national level to improve basic health care services cannot be overemphasised.
Finally, on vaccine access amidst vaccine nationalism. Along with the emergence of new variants like the more virulent delta variant (B.16172), the resurgence of infections across the world have raised alarm bells on whether existing vaccine production can meet global demand, not mention the issue of access. The current capacity of vaccine production to meet global demands is likely to fall short against the estimated 12 billion doses needed to achieve some level of herd immunity across the board. This underscores the need to keep supply chains open and removing barriers to trade in essential medical supplies and materials required for vaccine production. Thus, no less than global leadership and solidary are needed to address this existential threat to humanity.
Professor Mely Caballero-Anthony is Professor of International Relations and holds the President’s Chair in International Relations and Security Studies, S. Rajaratnam School of International Studies at Nanyang Technological University, Singapore. Her research interests include regionalism and multilateralism in Asia-Pacific, human security and non-traditional security, nuclear security, conflict prevention and global governance.
Prof Anthony has served as the Secretary-General of the Consortium on Non-Traditional Security Studies in Asia since 2008. From 2015-2017, she was Vice President at-large of the Governing Council of the International Studies Association (ISA) and is currently member of the ISA’s Global South Task Force. She had held visiting fellowship at the Elliott School of International Affairs, George Washington University in 2015. From 2013-2017, Prof Anthony was a member of the UN Secretary-General’s Advisory Board on Disarmament Matters (ABDM) and served at its Chairperson in 2016 and currently member of the Asia-Pacific Leadership Network on Nuclear Non-Proliferation (APLN). She was also Director of External Relations at the ASEAN Secretariat from 2011-2012.
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