Washington — The United States has vital interests in helping to improve health among hundreds of millions of people in Southeast Asia, currently vulnerable to emerging disease threats. That is an important objective of the Obama administration’s initiative to “rebalance” policies toward Asia, and one receiving new endorsement from a prestigious international relations research organization.
The Center for Strategic and International Studies (CSIS) issued a report July 29, A Greater Mekong Health Security Partnership, urging the Obama administration to increase U.S. engagement with Southeast Asian governments to improve health. Based upon extensive research and interviews, the CSIS authors recommend expanded efforts to help strengthen the region’s medical capacity, notably in the areas of pandemic preparedness, malaria control, noncommunicable diseases, women’s health and child survival.
In a variety of actions since 2011, the Obama administration has expressed the intent to “rebalance to Asia,” bringing greater focus to an array of issues, including economics, human rights, democracy, trade, health and development. The CSIS focus on the health issues is a “very, very important part, and sometimes an overlooked part,” of the overall intent, said Deputy Assistant Secretary of State for East Asian and Pacific Affairs Michael Fuchs. He was a member of a panel of U.S. government officials who discussed the CSIS recommendations as they were unveiled to a Washington audience.
“The collaborations from our government to host governments are highly valued,” said Rear Admiral Scott Dowell, director of the Division of Global Disease Detection & Emergency Response at the Centers for Disease Control and Prevention (CDC). “Really, there is almost nothing else that we can do that is more valued” than helping a partner nation respond to a public health crisis, Dowell said.
He held a CDC post in Thailand in 2004 during an avian influenza scare, when people began dying from a disease that had previously only been seen in birds. Local health officials, the media and the public became alarmed about the possible onset of a new flu pandemic. Dowell joined Thai health officials as they rushed to investigate cases of ill and dying people. The actions taken in the midst of that outbreak have become a template for other health agencies to follow when disease might be making a leap from animals to humans, Dowell said.
The key steps are early detection of the disease-causing agent, quick response to the unfamiliar illness, and tapping the expertise of health professionals from different specialties, Dowell said.
In an area vulnerable to emerging diseases, as Southeast Asia is, public health officials also have learned the value of speed in responding to a potentially fast-moving pathogen, Dowell said. Treating sick people and isolating others who may have been exposed to them are both now recognized as important responses.
Dowell agreed with the CSIS findings that the United States has “a window of opportunity” to help develop health infrastructure in Mekong River nations on the brink of greater economic expansion. This field-tested specialist in global health suggests that the United States design a focused plan to develop regional facilities and personnel in epidemiology and laboratory capabilities. U.S. assistance of this kind, these experts argue, not only builds goodwill with other nations, but also controls infectious disease outbreaks before they become transcontinental hazards.
Fuchs added that the United States also has an important role to play in opening lines of communication between Mekong-basin governments to better coordinate responses to transnational health issues.
Southeast Asia has experienced the spread of a malaria strain that is resistant to treatment with the artemisinin class of medications, which is currently the first-line drug used to treat the disease. The CSIS report makes a case that the United States must help the region in malaria-control programs to prevent the wider spread of what could become an uncontrollable strain of the disease.
“Artemisinin resistance is a global public health emergency at this time,” said Dr. Bernard Nahlen, the deputy coordinator of the President’s Malaria Initiative, which is targeting malaria in African countries. “There are no other drugs in the pipeline at the moment that will be available [as a new treatment] in the next five or 10 years.”
The CSIS report finds that U.S.-backed civilian and military health programs in East Asia in recent years have built a strong foundation to expand future global health capabilities in the Mekong River nations. One current program, the Lower Mekong Initiative, has already laid groundwork on health coordination. Launched in 2009 by then–Secretary of State Hillary Rodham Clinton, the initiative is a partnership among Cambodia, Laos, Myanmar, Thailand, Vietnam and the United States to create integrated subregional cooperation among the five partner countries across six thematic “pillars,” including the robust health pillar.
By Charlene Porter