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The Politics of Regional Health Cooperation

Apr 21, 2020

Common sense deserves a place in discussions about how the COVID-19 pandemic was managed in China and how regional affairs unfolded.

Memories of the SARS epidemic — with those who were children in 2003 now having become parents themselves — have played a significant role in easing the Chinese government’s ability to enforce quarantine measures. Awareness of secondary traumatic stress in emergency medical care limits the degree of direct participation by doctors from other countries.  

In other words, what has happened within China, and between it with the rest of world, is more likely than not what is feasibly allowable. Like virtually all other countries, China is on a steep learning curve in handling the myriad challenges posed by the virus outbreak.

In terms of international health cooperation, COVID-19 is a powerful reminder of the burden infectious diseases bring to the world, with the ecological interactions of people and animals and the live animal trade between China and neighboring countries being the most obvious targets for enhanced action. The development and distribution of vaccines is another desirable area for international collaboration. 

Amid the crisis, the foreign ministers of China and the Association of Southeast Asian Nations met in Vientiane, Laos, in February to pave the way for their health ministers to continue mapping out the specifics of cooperation. The foreign ministers of China, Japan and South Korea jointly made similar pledges a month later. Subnational actors, including sister cities, investors and ethnic diasporas formed a backbone of empathy and support among the people of these nations.

In East Asia, “health security” has entered the routine lexicon of diplomacy between ASEAN and China, Japan and Korea (ASEAN+3) in the wake of the SARS outbreak. Substantial progress has been made in controlling deaths of both humans and animals that result from infectious disease. Networks of consultation and cooperation nestle well with such programs as the World Health Organization’s global influenza surveillance and response system (since 1952) and its global outbreak alert and response network (since 2000). COVID-19 ought to help open the door wider to expert-driven cooperation toward strengthening health surveillance, analysis and reporting.

Health data sharing is not without its share of controversy. In 2007, when the Indonesian Minister of Health refused to share samples with the WHO after the outbreak of a strain of bird flu, the trade-offs between data sharing and access to medicine and vaccines was brought into sharper focus. A series of negotiations organized by the WHO resulted in Indonesia reversing the policy in 2008. But the issue is far from resolved.

On one hand, it has proven vital for the world’s scientific and medicine-making communities to have fast and full access to autopsy-specific data regarding causes and effects inside the body, including physical samples. On the other hand, jurisdiction-based legal consideration and commercial competition, on top of national pride associated with breakthroughs in medical technology, complicate the reality of pledges of responsible cooperation. 

It is useful to note that viral sovereignty is not unique to developing countries. For example, courts in the United States confirmed the patentability of genetic products in the 1980s. China passed legislation last year to strengthen governmental oversight over international sample sharing. The pattern of behavior of the United States under the Trump administration, as well as key member governments of the European Union securing medical equipment to address COVID-19, leans heavily toward the notion that “the strong survive” as a crisis management philosophy.

Some countries may be more prone to outbreaks of viruses that migrate from animals to humans. But the assurance of fair play when it comes to access to medicines and other treatments developed based on identified samples is certainly desirable.

Realistically, though, in the geostrategic environment that exists across the Asia-Pacific today, diplomatic advances in public health cooperation are not on the horizon. Frictions and rivalries between the United States and China, the two actors capable of leading the rest, show few signs of abatement.

The unfortunate fact that the United States is topping the world in cases of infection and deaths understandably wounds the pride the leaders and elites of that great nation. Such emotional factors need to be taken seriously in probing future cooperation.

All in all, though, the world does still have one network after another made up of science and health interests that do not always require political/diplomatic approval by a sovereign state. Preserving the professional integrity of these cross-national networks, in an ironic way, may well be a surer path to a less worrisome future.

To what degree such cooperation can effect change in geostrategic considerations remains to be seen. 

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