Bridging Borders: Advancing Healthcare through ASEAN Medical Collaboration
July 16, 2024
Bridging Borders: Advancing Healthcare through ASEAN Medical Collaboration
By Iverson Jury Abellaneda, UPCM Class 2028, and Charlene Divine Catral, UPCM Class 2027
Nestled in the embrace of the Pacific and Indian Oceans, 10 Southeast Asian countries are forced to face the tides of time while relying on one another to stay afloat. Hence, the Association of Southeast Asian Nations (ASEAN) was formed by Brunei Darussalam, Cambodia, Indonesia, Laos, Malaysia, Myanmar, the Philippines, Singapore, Thailand, and Vietnam. Originally, ASEAN was conceived to promote political and economic cooperation in the region, aiming to reduce trade barriers and encourage cross-investment. However, it soon became evident that the economic and socio-geopolitical landscape of the ASEAN network is deeply intertwined with a common set of health challenges.
Non-communicable diseases such as cardiovascular illnesses and diabetes are increasing steadily, yet the biomarker thresholds used for diagnosis and monitoring remain predominantly derived from Western populations. Neglected tropical diseases such as schistosomiasis and malaria also continue to plague the region’s most impoverished populations yet limited research chains the rural poor to a lifetime of disease and hunger. Furthermore, infectious diseases like tuberculosis (TB) continue to spread like wildfire in congested slums and deficient health communication allows TB to haunt the urban poor one lung at a time. Meanwhile, the perils of climate change near the equator lurk as silent assassins, claiming lives through a myriad of means from flood-borne leptospirosis to scorching heat waves.
ASEAN Medical Dean’s Summit last 2015
Undoubtedly, when ASEAN stands united, it becomes an unstoppable force, much like a mighty ocean tide, capable of confronting these common challenges together. However, should division arise, the region will resemble an ocean losing its cohesion, with each country becoming vulnerable to the harsh currents.
The Struggle Towards ASEAN’s Medical Liberation
For years, certain Southeast Asian countries, like the Philippines, have unfortunately served as outsourced labor hubs and sweatshop hosts for well-developed countries from other parts of Asia or the Western world. This designation stems from factors such as cheap real estate and abundant manpower, which attract businesses seeking to bolster their production capacities at lower costs. This trend has resulted in the gradual disempowerment of already struggling local production capacities. Consequently, it has also led to a dependence on foreign-led manufacturing, largely owned by multinational corporations. This dependency was highlighted during the COVID-19 pandemic, where delays in vaccine rollouts were often due to the need to import vaccines from more technologically advanced countries, as many ASEAN nations lacked swift domestic production capabilities or efficient vaccine deployment systems.
While countries like Indonesia, Thailand, and Vietnam have made notable progress in COVID-19 vaccine development, the sheer scale of research and development capabilities of more technologically advanced nations outside the ASEAN region have still undeniably made vaccine importation a more viable strategy during the early stages of the pandemic. Although foreign aid naturally warrants gratitude, the widespread importation trend, encompassing not only vaccines but also other pharmaceuticals and medical equipment, has rendered ASEAN countries beholden to the political influence of wealthier nations that provided essential support during times of crisis. The currently limited self-sufficiency in medicine impedes ASEAN from exercising full agency in decision-making during health crises.
Notably, the pattern of importing medical goods sharply contrasts with the trend of exporting medical human resources from ASEAN countries. It is common for Southeast Asian doctors and healthcare professionals to pursue opportunities in the Western world, a choice often driven by limited career prospects and healthcare systems that undervalue the medical profession. This perpetuates a cycle where, despite best efforts, ASEAN nations lag in medical advancements and quality of public healthcare compared to more powerful countries. As central hubs for training doctors and medical researchers, how can ASEAN medical schools collaborate to address shared challenges arising from common geographical factors and trends such as the import of medical goods and the export of human resources?
A Pact Among Neighbors
Recognizing the potential for neighboring nations to mutually benefit from cooperation in addressing common challenges, the ASEAN Medical Schools Network (AMSN) was founded in 2012. This coalition is the region’s prime collaborative organization that aims to forge strategic and innovative partnerships among ASEAN medical schools. Among its major thrusts are to allow medical education and healthcare to excel within the ASEAN community and beyond; and to share both human and intellectual resources through collaboration, exchanges, and capacity building. This aims to reduce reliance on countries outside the region and enhance ASEAN's self-sufficiency in healthcare. Included in their efforts is the commitment to hold the annual ASEAN Medical Dean’s Summit where deans, rectors, and medical education leaders from founding medical schools amongst the AMSN gather and exchange experiences, initiatives, and progress reports of their current projects and efforts in medical education and healthcare. Through this alignment of the collective ASEAN agenda, future joint efforts can be streamlined.
Last June 22-23, 2015 the ten member countries gathered for the ASEAN Deans’ Summit to institute the AMSN, with former Dean Agnes Mejia being one of the founding members where she shared UPCM’s current efforts in medical education research. During this meeting, Dr. Mejia recalled how one of the most striking realizations she had was that the UPCM curriculum properly aligned with other ASEAN medical schools. “All were outcome-based,” she said, noting how ASEAN-made doctors greatly focus on how they are able to apply what they learned in medical school in their training in order to provide their patients with the utmost quality of care. Amid the challenges and uncertainties in the region, there is comfort in knowing that these doctors wholeheartedly care for their patients to receive the utmost quality of health and care.
Dr. Agnes D. Mejia
Despite the long road ahead, it is still no question that UPCM has already come far in influencing movements in public health and medical education. This is reflected in its performance in the Times Higher Education World University Rankings (THE WUR) where it persistently ranked within the 126-150 percentile, among Asia’s Top 95 and Southeast Asia’s 4th best medical university with a research score of 11.9 — indicating its vast repository of publications [1]. Thus, with this newly established partnership with the ASEAN network, UPCM strives to further improve its performance in honing future medical professionals. Of the many potentials AMSN holds in bolstering collaborations through medicine amongst fellow ASEAN countries, Dr. Mejia mentions how student and faculty exchange between countries are among the projects AMSN envisions realizing. Should it be put into practice, similar to the various student and faculty exchanges currently in existence, a cultural and geopolitical trade in knowledge, skills, and practices would ensue.
Philippine Contributions in the ASEAN Health Agenda
Holding its end of the bargain, the Philippines’ medical contribution to the regional health scheme is vast, encompassing numerous public health issues and diseases. In UPCM, the Department of Pharmacology aligns their course outlines with the vision and mission of the college to produce 6-star physicians adept not only in clinical medicine but also research. They allow their faculty and students to conduct research aligned with the Department of Health’s Sampung Halamang Gamot where they seek to utilize Philippine plants that are found to have medicinal properties and study their potential for treatments in certain diseases. Another noteworthy project within UPCM is the Multi-Omics Research Program for Health (MORPH), spearheaded by students, professors, and graduates under the MD-PhD (Molecular Medicine) program of the college. MORPH attempts to bridge the gap between clinical data and translational research, maximizing Omics technology in acquiring health information. Among the studies they focus on are Alzheimer’s disease, TB, human immunodeficiency virus (HIV), human papilloma virus (HPV), and thyroid cancer, where they conduct a heterogeneous set of research strategies to elucidate good health outcomes.
Sampung Halamang Gamot
Provided that the country is known for its vast experience in dealing with TB cases, another contribution of UPCM in health research and clinical practice is its adept knowledge on its policy-making, clinical guidelines, and surveillance for TB. The UPCM TB Study Group, an organization composed of TB experts, is among the founding members of the Philippine Coalition Against Tuberculosis project (PhilCAT) that has contributed to said achievements.
“We have been able to publish the Philippine Textbook of Internal Medicine; The Philippines is only one of 2 countries in the ASEAN with this kind of text,” comments Dr. Mejia when asked on noteworthy achievements our country has achieved which she has been personally involved in. During her term as Dean in the College of Medicine, her flagship project was on patient safety, which she was able to establish as no prior efforts were conducted to focus on this. Additionally, Dr. Mejia was able to research healthcare quality and patient safety in collaboration with Dr. Diana Tamondong-Lachica.
Regional Healthcare Self-Sufficiency as Vector for Progress
Amid ongoing threats from global powers, drawn to ASEAN's abundant natural resources and strategic location, it is crucial to recognize that achieving regional healthcare self-sufficiency contributes not only to socioeconomic progress but also to enhanced geopolitical agency. Intuitively, fostering strong coordination among neighboring nations will bolster collaborative responses during health emergencies. Even more importantly, it will empower ASEAN countries to address their own challenges without relying solely on aid from global powers, potentially safeguarding against hidden agendas and unforeseen consequences. To put simply, we as Filipinos during times of crisis, would prefer enlisting the help of our next-door neighbors due to its swiftness and lower risk of unfavorable outcomes, as our neighbors understand the potential for mutual assistance in the future. We aim to steer clear of borrowing from loan sharks, as it may result in debts we might be unable to repay.
References:
[1] Quadra-Balibay (2020). University of the Philippines ranks in World’s Best Universities for Medicine. Retrieved last April 27, 2024 from https://www.goodnewspilipinas.com/university-of-the-philippines-ranks-in-worlds-best-universities-for-medicine/