issue no. 12 | december 2017 health sector commemorates ... · (unicef) and international...

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e-Health BulletinIssue No. 12 | December 2017

In 2017, the Association of Southeast Asian Nations or ASEAN celebrated its golden anniversary after it was founded on 8 August 1967. Fifty years after its foundation,

the Philippines led the celebrations as the Chair of the ASEAN. Last 15 January 2017, President Rodrigo Roa Duterte led the National Launch of the Philippines’ Chairmanship, with the theme “Partnering for Change, Engaging the World,” reflecting the Philippines government’s advocacy to promote unity with and among ASEAN Member States and its global partners.

The Philippines’ Chairmanship of ASEAN has six (6) Priorities, namely:1. Placing our people at the core2. Working for regional peace and stability3. Pursuing maritime security and cooperation4. Advancing inclusive, innovation-led

growth5. Strengthening ASEAN resilience 6. Promoting ASEAN as a model of

regionalism and as a global player

To mark ASEAN’s Golden Anniversary, the Department of Health of Philippines hosted a year-long series of meetings and commemorative events, which reflect the Philippines’ commitment to the ASEAN Post-2015 Health Development Agenda.

This ASEAN e-Health Bulletin Special Edition on ASEAN’s 50th Anniversary highlights the following activities and events participated by ASEAN Member States.1. ASEAN Multi-Sectoral Collaborative

Workshop on Nutrition Security held on 7-9 March 2017, in Manila, Philippines

2. Special Session on HIV during the Preparatory Meeting for the Youth Intergace with the Leaders, held on 27 April 2017, in Manila, Philippines

3. Consultative Meeting to finalize the ASEAN Leaders; Declaration on Antimicrobial Resistance (AMR), held on 10-11 May 2017, in Manila, Philippines

4. Side Event on the Role of Regional Cooperation in the Regulatory Reforms for Noncommunicable Disease (NCD) Prevention and Control during the 70th World Health Assembly, held on 22 May 2017, in Geneva, Switzerland

5. ASEAN Breastfeeding Forum, held on 3-5 August 2017, in Manila, Philippines

6. Traditional Medicine Conference – Milestone Achievements on Traditional & Complementary Medicines of ASEAN Member States, held on 26-27 September 2017, in Manila, Philippines

7. ASEAN Conference on Non-Communicable Diseases (NCDs), held on 25-27 October 2017, in Manila, Philippines

This Bulletin also published the three Health Declarations adopted by the ASEAN Leaders during the 31st ASEAN Summit on 13 November 2017, in Manila, Philippines, namely:1. ASEAN Leaders’ Declaration on Ending All

Forms of Malnutrition2. ASEAN Leaders’ Declaration on

Antimicrobial Resistance (AMR): Combating AMR Through “One Health Approach”

3. ASEAN Leaders’ Declaration on Disaster Health Management

Health Sector CommemoratesASEAN’s 50th Founding Anniversary

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On the occasion of the ASEAN’s 50th founding anniversary, the Philippines, as Chair, leads the region in adopting the ASEAN

Leaders’ Declaration on Ending All Forms of Malnutrition toward “a community that is healthy, caring, sustainable, productive, and one that practices a healthy lifestyle”.

The declaration aims to address malnutrition in the region by engaging all ASEAN governments starting with its leaders to commit and strategically accelerate multi-sectoral cooperation to scale up nutrition-specific and nutrition-sensitive interventions and increase public and multi-sectoral investments.

Technical discussions on the zero draft leaders’ declaration commenced during the ASEAN Multisectoral Collaborative Workshop on Nutrition Security hosted by the National Nutrition Council of the Philippines’ Department of Health on 7-9 March 2017 in Manila. Thirty-five delegates

from the ASEAN Member States attended the workshop representing the sectors of agriculture, social welfare, and health and nutrition and joined by the ASEAN Secretariat, including resource persons from the World Health Organization (WHO), Food and Agriculture Organization (FAO), United Nations Children’s Fund (UNICEF) and International Federation of the Red Cross and Red Crescent Societies (IFRC). The resource persons shared technical updates and areas for possible

complementarities with the ASEAN Post 2015 Health Agenda, particularly along the health priority “Promotion of good nutrition and healthy diets”.

The workshop also generated an initial stakeholders map indicating the various nutrition and nutrition-related projects and the various stakeholders in the Region. The participants also discussed forward steps for the establishment of the ASEAN Nutrition Surveillance System.

Workshop Chair, Assistant Secretary of Health, Maria-Bernardita T. Flores, Philippines’ Department of Health, Undersecretary Gerardo V. Bayugo, Workshop Co-Chair, Indonesia’s Ministry of Health-Nutrition Directorate, Deputy Director Giri Wurjandaru during the Opening Program of the ASEAN Multisectoral Collaborative Workshop on Nutrition Security, 7-9 March 2017.

ASEAN Join Hands to End All Forms of Malnutrition

Photo credit: Department of Health, Philippines




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AMS Gathered to Finalize the ASEAN Leaders’ Declaration on AMR

The emergence of Antimicrobial Resistance (AMR) in the Southeast Asia is a rising concern. Multi-drug resistant pathogens have been

widely disseminated, both in hospitals and throughout communities across many countries. The prevalence rates of methicillin-resistant Staphylococcus aureus (MRSA), macrolide-resistant Streptococcus pneumoniae, and multi-drug resistant enteric pathogens are increasing due to the recent growing number of extremely drug-resistant Gram-negative bacilli in the region.

The ASEAN community recognizes the need to have a holistic, multi-sectoral, and multi-disciplinary approach to address the increasing threat of AMR which is a significant public health threat that causes major health and economic consequences both in human and animal health, and affects trade and global security. The AMS have agreed to take on the “One Health” strategy in combating the AMR problem.

The Philippines government has created an inter-agency committee for the formulation and implementation of a National Action Plan to Combat AMR which brought together all involved key partner agencies geared towards identifying and implementing concrete efforts and plans to mitigate and control AMR. Stipulated in the action plan are the country strategies that focus on the following core areas: leadership and governance; surveillance and laboratory capacity; access to essential medicines of assured quality; awareness and promotion; infection prevention and control; rational antimicrobial use among humans and animals; and research and development.

In relation to the Philippines advocacy to combat AMR, the national government hosted a multi-sectoral consultative meeting in order to finalize the ASEAN Leaders’ Declaration on AMR on 10-11 May 2017 in Pasay, Philippines. It was attended by the technical officers from

Shortly, thereafter, in April 2017, the workshop outcomes were endorsed by the Senior Officials on Health Development, and by September 2017, the ASEAN Health Ministers formally endorsed the ASEAN Leaders’ Declaration on Ending All Forms of Malnutrition for the adoption by the ASEAN Leaders during the 31st ASEAN Summit on 13-14 November 2017.

A workshop to formulate the Regional Framework for Action on Nutrition and

Strategic Plan to operationalize the declaration is set in March 2018 in Manila, Philippines.



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The Declaration then received endorsement by the Seniors Official Meeting on Health Development (SOMHD) and elevated to the ASEAN Health Ministers Meeting (AHMM). Upon receiving the endorsement of AHMM, the Declaration was then submitted to the coordinating bodies of the ASEAN Socio-Cultural Community (ASCC) the Senior Officials Meeting for the ASCC (SOCA) and the ASCC Council for adoption at the 31st ASEAN Summit in November 2017.

the ASEAN Member States (AMS) who represented the human health, animal health, agriculture, food, trade, and environment sectors. Representatives from development partners such as the World Health Organization, Food and Agriculture Organization, and World Organisation for Animal Health who discussed the global and regional situation of the AMR problem were present as well.

The first day was dedicated to the presentation of the draft Declaration to the whole panel prior to the conduct of break-out sessions. The participants were divided into four groups representing the following sectors: human health and trade; animal health; agriculture and environment; and, food. Guide questions relevant to their field of expertise were provided and each group was tasked to delegate a rapporteur.

Inputs from the break-out sessions were synthesized and significant comments were incorporated in the Declaration which was finalized the following day. Differences in the regulatory structures of the AMS which will affect the management of antimicrobials and other medicines available in the market were noted. AMR is not a priority concern for some sectors and undertaking relevant initiatives with limited support is also a challenge.

Gathering political commitment to combat AMR from their respective leaders was stressed during the conclusion of the meeting. The AMS also agreed to align their AMR initiatives and foster an environment that will enable sharing of best practices.



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The Philippines, as the Chair of the ASEAN, spearheaded the hosting of a side event on the Role of Regional Cooperation in the Regulatory

Reforms for Noncommunicable Disease (NCD) Prevention and Control during the 70th World Health Assembly (WHA), in commemoration of the 50th Founding Anniversary of the ASEAN. The 70th WHA was held on 22-31 May 2017 in Geneva, Switzerland. This event is the highest level of global public health discussions, which gathered 194 Health Ministers, various International Organizations, Regional Organizations, NGOs, Observers and other stakeholders. The nine-day conference brought together almost 3,500 delegates year to advance international public health in the era of the 2030 Agenda for Sustainable Development.

The 70th WHA was a landmark year for WHO Member States elected a new Director General of the World Health Organization – the first time a democratic election process

was applied since its founding in 1948. Dr Tedros Adhanom Ghebreyesus was elected as the new Director-General of WHO for the next five years. Previous Directors General were selected by the Executive Board of the WHO and appointed by acclamation by the Assembly.

This official WHO side event on the Role of Regional Cooperation in the Regulatory Reforms for Noncommunicable Disease (NCD) Prevention and Control was hosted by the Philippines, as Chair of ASEAN on its 50th year, together with the ASEAN Member States and with the support of Italy. This is the first time that ASEAN Member States as a whole will be represented in the World Health Assembly in Geneva. Secretary of the Department of Health, Philippines Dr. Paulyn Jean Rosell-Ubial led the Philippines delegation, supported by the Philippines Mission to the United Nations and other International Organizations in Geneva.

The Side Event discussed the following:• Global setting - NCD prevention in

the context of the “Preparation for the third High Level Meeting of the General Assembly on the Prevention and Control of Noncommunicable Diseases” to be held in 2018

• Regional cooperation and how the WHO has been instrumental in the ASEAN regional efforts to the achievement of global goals in the context of public health

ASEAN Hosted Commemorative Side Eventat the 70th World Health Assembly into One Line



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the world, advocating the global goal of “Sustaining Breastfeeding Together.” Numerous partners connected with one another to attract worldwide support on The 2017 ASEAN BREASTFEEDING

FORUM (#ASEANBFF2017) was on full swing as it celebrated breastfeeding and life around

ASEAN Ugnayan: One Community Protecting, Promoting, and Supporting Breastfeeding

Photo credit: ASEAN Secretariat

• Regional challenges on NCD efforts and the regional response

• National contexts and good practices• Expression of commitment of the

Philippines to take the lead in pursuing ASEAN and global initiatives on regulatory reforms for NCDs with the end view of its inclusion in the agenda of the WHO Executive Board Meeting in 2018

The side event agreed on the following next steps:• Development of an ASEAN Regulatory

Framework on NCD, aligned with the 2013 Bandar Seri Begawan Declaration on NCDs;

• Follow-up activities to the WHA side event should be conducted to emphasize the focus on regional cooperation for regulatory reforms; and need to continue the discussions in the ASEAN Conference on NCDs and other fora and platforms.


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Photo credit: ASEAN Secretariat Photo credit: ASEAN Secretariat

ASEAN Highlights Best Practices on Traditional and Complementary Medicine

October 26 to 27, 2017, Pasay City, Philippines—the ASEAN Member States (AMS), ASEAN Secretariat, ASEAN Socio-Cultural-Cluster

(ASCC) 3 members, T&CM Medical and Non-Medical Practitioners, Members of the Academe, Civil Society groups, Researchers, and other distinguished guests from Philippines Government Agencies were joined by the Department of Health and

the Philippines Institute of Traditional and Alternative Health Care (PITAHC) to celebrate the “ASEAN Commemorative Conference on Traditional and Complementary Medicine”, to share experiences and best practices, review different gaps and issues, and to mark the achievements on T&CM of the ASEAN Member States.

The conference was filled with cultural experience during the opening rituals and parade of colors. Throughout the first day of the conference, topics such as: T&CM on ASEAN context by WPRO representative Dr. Yu Lee Park on the Quality Assurance System of T&CM in Western Pacific Region, and Assistant Director/Head of Health Division of the ASEAN Secretariat, Dr. Ferdinal M. Fernando on the ASEAN Member States Report; and Sharing of Best Practices on T&CM presented by

breastfeeding and the health and nutrition of women and babies around the world.

#ASEANBFF2017 was conducted on 3-5 August 2017 with the theme “ASEAN Ugnayan: One Community Protecting, Promoting and Supporting Breastfeeding.” The first two days assembled health, economic, and development experts from the 10 ASEAN Member States (AMS), namely, Brunei Darussalam, Cambodia, Indonesia, Lao PDR, Malaysia, Myanmar, Philippines, Singapore, Thailand, and Viet Nam, at the Blue Leaf Filipinas, Parañaque City. They discussed and highlighted the interventions, innovations, successes, and areas for improvement regarding financing and managing


national programs on breastfeeding and complementary feeding in the ASEAN region.

On the third and last day, August 5, 2017, Hakab Na! (The Big Latch On) 2017’ event was held at the Smart–Araneta Coliseum. This event was made possible through the partnership of ASEAN Breastfeeding Forum, the Department of Health of the Philippines, and Breastfeeding Pinays. To passionately drive the creation of a breastfeeding nation, the big latch movement gathered thousands of mothers from different parts of the country as they breastfed their children together for one minute in support to all breastfeeding moms.

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Through the sharing of best practices and benchmarking for T&CM, this will help the AMS realize the Goals, Strategies & Targets of Traditional Medicine in ASEAN—by taking to account the achievements and constraints of each AMS in regulating, research, and integration of T&CM practices, practitioners, and products into the health system. Moreover, sharing of knowledge, success, and challenges in the implementation of the Goals, Strategies & Targets of ASEAN in T&CM may promote innovation and encourage leadership among ASEAN Member States.

The event was part of the program/project activities from 2016-2020 of the ASEAN Health Cluster 3: Strengthening Health System and Access to care—since, the Philippines have been the lead country of Health Cluster 3 in 2016-2017 and will be replaced by Singapore in 2018-2019.

Indonesia, Malaysia, Myanmar, Philippines, Singapore, and Thailand respectively.

Likewise, the second day was rich with learning experiences through the Benchmarking for T&CM presentations on: integration of T&CM in health facilities in China; integrative medicine in Thailand; T&CM use in Malaysia in the recent decades; research program on Medicinal Plants in the Philippines; and Gaps/Issues on ASEAN T&CM.




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The Philippines Department of Health, in collaboration with the Association of Southeast Asian Nations (ASEAN) Member States and other local and

international partner agencies, hosted the historic ASEAN Conference on Non-Communicable Diseases (NCDs) with the theme, “Working Together towards an Enabling Environment for a Healthy Lifestyle in the ASEAN Region,” on 25-27 October 2017 in Manila.

The three-day commemorative event, held during the ASEAN Chairmanship of the Philippines and the 50th Founding Anniversary of the ASEAN, was in fulfillment of the country’s international commitment to the ASEAN Health Cluster 1 Work Programme 2016-2020 on Promoting Healthy Lifestyle, duly endorsed by the ASEAN Health Ministers. This was also in line with the commitments set in the Political Declaration of the High-level Meeting of the United Nations General Assembly on the Prevention and Control of NCDs, based on World Health Organization (WHO) set targets and the United Nation’s initiative on achieving Sustainable Development

Goal number 3: Ensure Healthy Lives and Promote Well-being for All at All Ages. Topics discussed include priority health issues related to the promotion of healthy lifestyle as contained in the ASEAN Post 2015-Health Development Agenda namely: the prevention and control of NCDs; the reduction of tobacco consumption and harmful use of alcohol; the prevention of injuries; the promotion of occupational health; the promotion of mental health; the promotion of healthy and active ageing; and the promotion of good nutrition and healthy diet.

The regional event was prompted by the ASEAN Member States’ (AMS) growing concern over the increasing number of younger people from the Region’s low and middle-income groups who are dying prematurely because of NCDs. These factors contribute to the rising global risks for mortality and disability which resulted in the issuance of two important declarations in separate events: first, during 6th ASEAN Health Ministers’ Meeting on “Healthy ASEAN Lifestyle” in March 2002, and secondly, the Bandar Seri Begawan Declaration on NCDs in ASEAN

ASEAN Member States Hand in Hand towards an Enabling Environment for a Healthy Lifestyle




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action is needed, and Governments must take the initiative and be at the driver’s seat to bring in civil society, academia, business, legislators and policy-makers, and other stakeholders to promote health. Beating NCDs requires a comprehensive approach,” stressed OIC-Health Secretary Herminigildo V. Valle.

1. WE, the Heads of State/Government of the Member States of the Association of Southeast Asian Nations (ASEAN), namely Brunei Darussalam, the Kingdom of Cambodia, the Republic of Indonesia, the Lao People’s Democratic Republic, Malaysia, the Republic of the Union of Myanmar, the Republic of the Philippines, the Republic of Singapore, the Kingdom of Thailand and the Socialist Republic of Viet Nam, on the occasion of the 31st ASEAN Summit held in Manila, the Republic of the Philippines on 13 November 2017;

2. WELCOMING nutrition security-related commitments such as the 2015 United

Nations General Assembly declaration of 2016 to 2025 as the Decade of Action on Nutrition which calls for the implementation of the Rome Declaration and its Framework for Action, endorsed by 170 countries during the Second International Conference on Nutrition (ICN2) in Rome on 19-21 November 2014; the 2025 Global Voluntary Targets for the prevention and control of Noncommunicable Diseases adopted by the World Health Assembly in 2011; the 2025 Global Nutrition Targets for Improved Maternal, Infant and Young Child Nutrition adopted by the World Health Assembly in 2012, both of which

ASEAN Leaders’ Declaration on Ending All Forms of Malnutrition

in October 2013. These declarations are both aimed towards the prevention and control of the spread of NCDs in the Region by accelerating actions to reduce the risk factors for NCDs through the WHO-recommended cost-effective interventions.

Around 400 participants attended this conference composed of delegates from Brunei Darussalam, Cambodia, Indonesia, Lao PDR, Malaysia, Singapore, Thailand, Viet Nam and Republic of Korea as well as representatives from the ASEAN Secretariat, and development partners such as the WHO, UNICEF, Southeast Asia Tobacco Control Alliance (SEATCA), World Bank, among others, and local delegates from various regions in the Philippines.

“There is a pressing need to step up actions against NCDs and their risk factors in the ASEAN Region. Coordinated



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were adopted by the UN General Assembly in 2011 and 2015, respectively, and the Bandar Seri Begawan Declaration on Noncommunicable Diseases in ASEAN adopted by ASEAN Leaders on 20 October 2013;

3. GUIDED by the 2030 Sustainable Development Goals (SDGs) adopted in September 2015 by the UN General Assembly which explicitly included nutrition through the SDG 2, “End hunger, achieve food security and improved nutrition and promote sustainable agriculture”, and reaffirming the 2030 Agenda for Sustainable Development, building on the gains achieved on the Millennium Development Goals and identifying nutrition alongside poverty eradication, health, education and food security as continuing velopment priorities;

4. COMMITTED to the ASEAN Socio-Cultural Community 2025 which envisions to be “inclusive, sustainable, resilient and dynamic, engaging and benefiting the peoples”;

5. ACKNOWLEDGING that the ASEAN Socio-Cultural Community Blueprint 2025 recognizes that towards an inclusive community, and “complementing the inclusive growth agenda of the ASEAN Economic Community, concerns of all ASEAN people on matters related to social protection, women empowerment, gender equality, promotion and protection of human rights, equitable access to opportunities, poverty eradication, health, decent work, education and information” shall need to be equally addressed;

6. RECOGNISING that the ASEAN Socio-Cultural Community Blueprint 2025 includes a strategic measure “to promote a community that is healthy, caring, sustainable and productive, and one that practices healthy lifestyle resilient to health threats and has universal access to healthcare”;

7. DEEPLY CONCERNED that various forms of malnutrition as defined in the 2016 Regional Report on Nutrition Security in the ASEAN Vol. 2 affect a staggering proportion of people worldwide, of which the same report indicated that

among children under-five, 17.9 million are stunted, 5.4 million are wasted and 4.5 million are overweight, and 21 million suffer from anaemia, and various types of micronutrient deficiencies, thus presenting a serious public health and socio-economic concern through increased child illnesses and even death, disabilities, cognitive and learning deficits, and noncommunicable diseases later in life;

8. NOTING THAT the most vulnerable, poor and disadvantaged groups, including children, older persons, adolescents, pregnant and lactating women, persons with disabilities, other marginalised groups, people living in at-risk areas and populations in geographically-isolated and disadvantaged areas are particularly affected by undernutrition;

9. NOTING FURTHER that the general population is affected by problems of overweight, obesity, and imbalanced intake of nutrients, also traceable to intrauterine and early childhood malnutrition, contributing to an increased burden of diet-related noncommunicable diseases such as diabetes mellitus, cardiovascular diseases and some cancers;

10. EQUALLY CONCERNED as highlighted above, that ASEAN is affected by a double burden of malnutrition;

11. COMMITTED that addressing malnutrition and diet-related noncommunicable diseases globally and across ASEAN requires well-coordinated and coherent regional and sustained multi-sectoral inter-linkages and partnerships, without which nutrition goals may not be achieved;

DO HEREBY DECLARE THAT WE:

12. AGREE on the urgent need to accelerate evidence-based multi-sectoral actions, and scale up interventions to reduce and ultimately end all forms of malnutrition, particularly among the most vulnerable, poor and disadvantaged groups of ASEAN;

13. EXPAND AND INTENSIFY EFFORTS to engage with relevant sectors and stakeholders to accelerate the adoption of coherent policies, interventions and nutrition-enhancing actions, while

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1. WE, the Heads of State and Government of the Member States of the Association of Southeast Asian Nations (ASEAN), namely Brunei Darussalam, the Kingdom of Cambodia, the Republic of Indonesia, the Lao People’s Democratic Republic, Malaysia, the Republic of the Union of Myanmar, the Republic of the Philippines, the Republic of Singapore, the Kingdom of Thailand, and the Socialist Republic of Viet Nam, on the occasion of the 31st ASEAN Summit in Manila, Philippines on 13 November 2017, have come together to jointly cooperate in combating antimicrobial resistance (AMR) through a multisectoral and multidisciplinary approach within the framework of “One Health”;

2. RECOGNIZING the Global Action Plan on AMR adopted by the World Health Organization (WHO) Member States at the 68th World Health Assembly in May 2015, which was developed in collaboration with the Food and Agriculture Organization of the United Nations (FAO) and the World Organisation for Animal Health (OIE)

and served as the basis for the political declaration of the High-Level Meeting of the General Assembly on Antimicrobial Resistance agreed by all United Nations (UN) Member States on 21 September 2016 during the UN General Assembly;

3. REAFFIRMING Asia Pacific Bi-Regional Commitment on the ‘Communiqué of Tokyo Meeting of Health Ministers on AMR in Asia’ adopted in Tokyo, Japan on 16 April 2016 which called for commitment among WHO Member States in the Western Pacific and South East Asia Regions to urgently address the damaging threats of AMR through multisectoral and multidisciplinary actions at the regional and national levels within the “Asia-Pacific One Health Initiative on AMR”;

4. ACKNOWLEDGING ASEAN commitment envisioned in the ASEAN post-2015 Health Development Agenda endorsed at the 12th ASEAN Health Ministers Meeting in Ha Noi, Viet Nam on 18 September 2014 which serves as a working basis for ASEAN Health Cooperation post-2015;

ASEAN Leaders’ Declaration on Antimicrobial Resistance (AMR): Combating AMR through One Health Approach

safeguarding against possible conflicts of interest, to achieve synergies in action and impact in addressing the multi- factorial causality of all forms of malnutrition;

14. FORMULATE a multi-sectoral regional framework and strategic plan aimed at ending all forms of malnutrition to guide country policies, interventions and set minimum standards for service delivery, implementation, monitoring and evaluation, and promote regional cooperation across ASEAN pillars and across ASEAN Member States;

15. SCALE UP evidence-based nutrition-sensitive and nutrition-specific actions and interventions that target the vulnerable and disadvantaged groups;

16. COMMIT to increase public and multi-sectoral investments to improve nutrition and ensure healthy diets, and increase the level of cooperation through mutual pursuit of initiatives;

17. STRENGTHEN human and institutional capacities to enhance skills on multi- sectoral program planning and evaluation, policy analysis and advocacy, health and nutrition research, nutrition surveillance and diet-related noncommunicable diseases surveillance, human resource development and service delivery;

18. TASK the ASEAN Health Ministers to monitor the progress of this Declaration and support the delivery of quality nutrition-specific and nutrition-sensitive interventions and programs towards the eventual achievement of the 2025 global nutrition and diet-related noncommunicable diseases targets, ICN2 Rome Declaration and Framework for Action, and SDG 2 and other SDGs relevant to nutrition;

19. ADOPTED in Manila, the Republic of the Philippines on this Thirteenth Day of November in the Year Two Thousand Seventeen, in a single original copy in the English language.

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5. RECOGNIZING that the AMR problem is accelerated and exacerbated by inappropriate use of antimicrobials in humans, animals, aquaculture and crops, limited regulatory systems across sectors, inadequate good quality microbiology laboratories, scarce resources, absent or ineffective use of AMR surveillance data to guide clinical and policy decisions, maldistributed and insufficient infectious disease and infection prevention and control experts, inadequate infection prevention and control measures in health facilities and communities, limited development of new antimicrobials, and antibiotic residues in environmental components, leading to uncontrolled variation in the food chain, risk to the environment and human health;

6. RECOGNIZING that antimicrobials are the cornerstone of modern medicine and that AMR threatens every fundamental armamentarium that mankind has worked and invested on for many years in saving millions of lives from infections around the world;

7. RECOGNIZING further that countries, particularly those with inadequate healthcare systems, and are currently burdened with healthcare-associated infections, tuberculosis, HIV and malaria are affected more because of AMR;

8. RECOGNIZING that the scale of the AMR situation extends beyond public health with socio-economic and environmental health impacts which threatens global health security and the achievement of the Sustainable Development Goals (SDGs);

9. EMPHASIZING that AMR demands urgent, concerted, multisectoral and multidisciplinary collaboration at the national, regional and global levels;

Do hereby declare our commitments to develop an ASEAN strategic plan to combat AMR with the following key priority areas:

10. FORMULATING AND EXECUTING a national action plan adopting One Health approach on combating AMR by advocating high level support and with the following features: comprehensive multisectoral responsibility and governance; inclusive mechanisms to actively engage the participation of relevant stakeholders; defined objectives and goals that are aligned with the overarching Global Action Plan; activities and strategies will

be sustainably financed by governments and other stakeholders; and, effective monitoring and evaluation mechanisms;

11. PROMOTING awareness and advocacy through a multisectoral and multidisciplinary commitment with stakeholder participation; celebrating the annual World Antibiotic Awareness Week and conducting other campaigns;

12. STRENGTHENING training and educational programmes for relevant professionals and students to enhance the knowledge, attitude and practices on appropriate antimicrobial prescribing, dispensing and use, and on infection prevention and control measures;

13. STRENGTHENING the regulatory systems, pharmaceutical and food supply chain management, health financing mechanisms, agricultural value chain management to ensure equitable, timely and sustainable access to safe, efficacious, affordable and quality antimicrobials, environmental management of antibiotic residues and impacts;

14. IMPLEMENTING antimicrobial stewardship programs and infection prevention, control and treatment measures at all levels of healthcare and the community to effect positive behavioral changes on appropriate prescribing, dispensing and use and to contain and reduce the burden of infection towards the overall improvement of patient outcomes;

15. ENHANCING regulatory mechanisms towards a no prescription-no antibiotic sales as decided by the national authority in human and veterinary medicine; phasing out the use of antibiotics as growth promoters in animals in the absence of risk analysis;

16. STRENGTHENING national and regional laboratory capacity, surveillance and monitoring systems for AMR, antimicrobial consumption and use (AMC and AMU), and drug residues, moving towards an integrated AMR surveillance and promoting research on impact of AMR on environment and agriculture that will guide relevant sectors in the development of policies and regulations as well as evidence-based and effective treatment guidelines to optimize the use of antimicrobials;

17. STRENGTHENING national and regional capacity to encompass research and development of new antimicrobials and

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WE, the Heads of State or Government of the Member States of the Association of Southeast Asian Nations (hereinafter referred to as “ASEAN”), namely Brunei Darussalam, the Kingdom of Cambodia, the Republic of Indonesia, the Lao People’s Democratic Republic, Malaysia, the Republic of the Union of Myanmar, the Republic of the Philippines, the Republic of Singapore, the Kingdom of Thailand, and the Socialist Republic of Viet Nam, on the occasion of the 31

st ASEAN Summit in Manila, Philippines, on 13 November 2017;

REAFFIRMING our commitment to implementing the ASEAN Community Vision 2025, and pursue the Sustainable Development Goals of the 2030 Agenda for Sustainable Development, of which Goal 3 calls for strengthened capacity of all countries in health risk reduction and management; the Sendai Framework for Disaster Risk Reduction (2015- 2030); ASEAN-UN Joint Strategic Plan of Action on Disaster Management (2016-2020) as well as the World Health Assembly Resolutions WHA64.10 Strengthening National Health Emergency and Disaster Management Capacities and Resilience of Health Systems;

REITERATING regional collective commitments in the promotion of Disaster Health Management as emphasized in the Cha-am Hua Hin Statement on East Asian Summit (EAS) Disaster Management of 2009; the ASEAN Agreement on Disaster Management and Emergency Response (AADMER) of 2005 and the AADMER Work Programme 2016- 2020; the Declaration on Institutionalising the Resilience of ASEAN and its Communities and Peoples to Disasters and Climate Change of 2015; the

Declaration on One ASEAN One Response: ASEAN Responding to Disasters as One in the Region and Outside the Region of 2016;

EMPHASIZING the importance of strengthening capacity in Disaster Health Management in ASEAN which was identified as an area for collaboration and reflected as a priority area in the ASEAN Post-2015 Health Development Agenda;

RECOGNIZING the critical role of humanitarian assistance in reducing the loss of lives, minimizing disability and preventing infectious disease outbreaks through rapid deployment with full respect of sovereignty and consent of the affected countries, while appreciating the contribution from the relevant ASEAN Sectors, international, regional or national institutions/agencies, and, various development partners;

RECOGNIZING ALSO the need to take urgent action to strengthen Disaster Health Management System at national and regional levels, which are critical for improving health outcomes from emergencies, minimizing health hazards and vulnerabilities, ensuring access to health care, and that health services remain functional when they are most needed, thus strengthening community resilience;

Hereby declared to:

1. STRENGTHEN close coordination and collaboration with relevant ASEAN Sectoral Bodies and other partners in enhancing capacities of ASEAN Member States and the region that facilitate rapid deployment of regional and national medical relief, maintain continuous health services and perform disease surveillance that serve

ASEAN LEADERS’ DECLARATION ON DISASTER HEALTH MANAGEMENT

other alternatives, diagnostic health technologies and vaccines;

18. ENGAGING all relevant stakeholders and development partners in the implementation of the ASEAN strategic plan to combat AMR.

19. TASKING the ASEAN Health Ministers Meeting (AHMM) with support from the Senior Officials Meeting on Health

Development (SOMHD) and related subsidiary bodies and sectors to develop and monitor the implementation of the ASEAN strategic plan to combat AMR.

Adopted in Manila, the Republic of the Philippines on this Thirteenth Day of November in the Year Two Thousand and Seventeen, in a single copy, in the English language.

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to reduce morbidity and mortality due to injury and other non-communicable and communicable diseases in the disaster affected population, including health impact of climate change;

2. SUPPORT the development of relevant Standard Operating Procedures for Regional Collaboration on Disaster Health Management in order to create effective regional collaboration mechanism of Disaster Health Management and to promote the organization and coordination for International Emergency Medical Team (I-EMT) as appropriate to individual AMS context in line with the AADMER and ASEAN Standard Operating Procedures for Regional Standby Arrangements and Coordination of Joint Disaster Relief and Emergency Response Operations (SASOP);

3. ENCOURAGE the development of national Standard Operating Procedures for the coordination of the International Emergency Medical Team (I-EMT) and effective mechanism to facilitate the operation of I-EMT, including the coordinating body, information management and logistic system;

4. STRENGTHEN all-hazards health emergency and disaster risk-management programmes as part of national health systems, supported by relevant legislation, regulations and other measures, as appropriate, to improve health outcomes, reduce mortality and morbidity, protect health infrastructure and strengthen the resilience of the health system and society at large, and mainstream a gender perspective into all phases of these programmes;

5. PROMOTE public and private investment in disaster risk reduction to support the resilience of new and existing critical infrastructure, including hospitals and other health facilities, to ensure that they remain safe, effective and operational during and after disasters in order to provide live-saving and essential services;

6. ENDEAVOR TO BUILD hospitals and health facilities that are safe, resilient, and capable of delivering medical care

and life saving services during and after a disaster through structural and non-structural disaster mitigation measures, ensuring these essential services and infrastructures serve the affected communities;

7. STRENGTHEN the cooperation and enhancement of active Academic Network among Disaster Health Management Programme to conduct researches and extract lessons learned from Disaster Health Management in multiple events and countries, in support of the development of new solutions and innovation;

8. ENHANCE national and regional capacities in Disaster Health Management, including through the establishment of a Regional Disaster Health Training Center and designed simulation and joint operations, to increase capacities of health workers and disaster health-related personnel;

9. INCREASE efforts to operationalize financial resources to fill gaps in national responses including promoting national and sub-national coherent Disaster Health Management strategic plans and operations; improving efficiency in the use of existing resources;

10. CALL ON development partners, including the UN system, other relevant inter- governmental, regional organizations and other stakeholders as well as concerned ASEAN Sectoral Bodies, to support the implementation of this Declaration, in particular the promotion of designed regional mechanisms, resource mobilization and the priority actions stated in this Declaration;

11. TASK the concerned ASEAN Sectoral Ministerial Bodies as well as other relevant bodies to monitor the implementation of this declaration towards achieving the aspirations of this Declaration.

Adopted in Manila, the Republic of the Philippines on this Thirteenth Day of November in the Year Two Thousand and Seventeen, in a single original copy, in the English Language.

ASEAN @ASEAN www.asean.orgASEAN

ASEAN: A Community of Opportunities

ASEAN HEALTH COOPERATION: BEYOND ASEAN@50,TOWARDS ASEAN 2025

As we end the celebrations for the 50 glorious years of ASEAN since its foundation, it is hoped that these commemorative events and activities will push ASEAN member states to partner and engage with each other further towards stronger regional cooperation in health. With outcome documents relevant to the health sector adopted by our ASEAN Leaders, it is imperative that further actions be undertaken to sustain our commitments and enable change towards our common ASEAN vision of “a one healthy, caring and sustainable community.” Our continuing work in the health sector to address the priorities under the ASEAN Post 2015 Health Development Agenda necessitates greater collaboration and deeper partnerships among ASEAN member states for it realization. As we move forward to ASEAN 2025, we are forging ahead together with one vision, one identity and one community working towards a healthier ASEAN people. As a unified health sector, we aspire to contribute to our 2025 vision towards an inclusive community that is people-oriented, people-centered and promotes a high quality of life and equitable access to opportunities for all.

ASEAN e-Health Bulletin is produced semi-annually by the ASEAN Secretariat · 70A Jl. Sisingamangaraja · Jakarta 12110 · Indonesia | Tel : (6221) 7262991, 7243372 · Fax : (6221)

7398234, 7243504Coordinator: Health Division of the ASEAN Secretariat

Editor and Focal Point: Department of Health, PhilippinesNote: The articles were contributed by the focal point from each of the ASEAN health subsidiary bodies.

The Association of Southeast Asian Nations was established on 8 August 1967. The Member States of the Association are Brunei Darussalam, Cambodia, Indonesia, Lao PDR, Malaysia, Myanmar, Philippines, Singapore, Thailand and Viet Nam.

The ASEAN Secretariat is based in Jakarta, Indonesia. General information on ASEAN appears online at the ASEAN Website: www.asean.org

Catalogue-in-Publication DataASEAN eHealth Bulletin. Jakarta: ASEAN Secretariat, May 2013631.059 ı 1. ASEAN - Public Health ı 2. Health - Personal Health

ISSN 2301-6809

issue no. 12 | december 2017 health sector commemorates ... · (unicef) and international...

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