BÖLGESEL SAĞLIK YÖNETİŞİMİ: ASEAN VE GÜNEYDOĞU ASYA’DA SALGIN HASTALIKLARLA MÜCADELE

Year 2023, Volume: 6 Issue: 12, 30 - 58, 29.06.2023

Samet Yılmaz

https://doi.org/10.59114/dasad.1299589

Abstract

Bu çalışma, Güneydoğu Asya Uluslar Birliği (ASEAN) bünyesinde bölgesel sağlık yönetişimine yönelik eylemleri, yakın dönemde Güneydoğu Asya’yı etkileyen SARS (Şiddetli Akut Solunum Yolu Sendromu), Kuş Gribi olarak da bilinen H5N1, Domuz Gribi şeklinde de adlandırılan H1N1 ve COVID-19 salgınları kapsamında ele almaktadır. İnsanlık tarihinin çeşitli dönemlerinde toplumlar, salgın hastalıklarla karşı karşıya kalmıştır. 20. yüzyılda tıp alanındaki ilerlemelerin ve aşılamanın yaygınlaşmasının sonuçlardan biri olarak bulaşıcı hastalıkların etkisi büyük ölçüde azaltılmakla birlikte, yakın tarihlerde gözlemlenen salgınlar, modern toplumun salgınlara karşı kırılganlığını göstermektedir. Bu bakımdan sağlık, siyasal aktörlerin dikkate alması gereken politika alanlarından biridir. Toplum sağlığının korunmasında, geleneksel olarak ulusal hükümetler birincil derecede sorumludur. Bununla birlikte devletler, artan oranda sağlık alanında çok taraflı iş birlikleri geliştirmekte ve bu hususta uluslararası kurumsal yapılanmalar oluşturmaktadır zira hareketliliklerin ve akışkanlıkların arttığı çağdaş dönemde bulaşıcı hastalıklar, sınırları aşabilmekte ve birden fazla devleti etkileyebilmektedir. Salgın hastalıkların belirli bir bölge boyunca toplumlar üzerinde olumsuz tesirler ortaya çıkarabilecek faktörlerden biri olması sebebiyle, bu durumla mücadele, devletlerin bölgesel düzeyde de ele aldığı konular arasında yer almaktadır. Bu hususta bölgesel örgütler, küresel ve bölgesel salgın hastalık risklerine karşı sağlık alanında bölgesel bir yaklaşım ve yönetişim yapısı geliştirmeye çalışmaktadır. Bu durum, sağlık sektörünün bölgeselciliğin gündemine dâhil olmasını beraberinde getirmektedir. Bu bağlamda çalışmada, gelişmekte olan coğrafyalarda bulunan devletler arasında kurulmuş bölgesel bütünleşme merkezli en eski örgütlerden biri olan ASEAN bünyesinde bölgesel sağlık yönetişimine ilişkin faaliyetler, Birliğin temel hedeflerini, sağlık sektörüne yönelik yaklaşımını ve kurumsal işleyişini de dikkate alarak, belirtilen salgın hastalıklar çerçevesinde ortaya konulmakta ve ASEAN’ın bölgesel sağlık yönetişimi içerisindeki konumu analiz edilmektedir.

Keywords

Bölgesel Sağlık Yönetişimi, Salgın Hastalıklar, Güneydoğu Asya Uluslar Birliği

References

• ADB (2022), Southeast Asia Rising from the Pandemic, https://www.adb.org/sites/default/files/publication/779416/southeast-asia-rising-pandemic.pdf, (E. T. 10.05.2023).
• AHA Centre (2023), About the AHA Centre, https://ahacentre.org/about-us/a, (E. T. 10.05.2023).
• ALVIAN, Rizky Alif (2018), “Governing Contagion: Emerging Infectious Diseases and the Medicalization of Insecurity in Southeast Asia”, 50 Years of Amity and Enmity: The Politics of ASEAN Cooperation, Poppy S. Winanti ve Muhammad Rum (Der.), Gadjah Mada University Press, Yogyakarta, s. 89-124.
• AMAYA, Ana B., ROLLET, Vincent ve KINGAH, Stephen (2015), “What’s in a Word? Then Framing of Health at the Regional Level: ASEAN, EU, SADC and UNASUR”, Global Social Policy, Cilt 15, Sayı 3, s. 229-260.
• ASEAN (1967), The ASEAN Declaration (Bangkok Declaration), August 1967, https://agreement.asean.org/media/download/20140117154159.pdf, (E. T. 10.05.2023).
• ASEAN (1976), The Declaration of ASEAN Concord, Bali, Indonesia, 24 February 1976, https://asean.org/the-declaration-of-asean-concord-bali-indonesia-24-february-1976/, (E. T. 10.05.2023).
• ASEAN (1987), Joint Communique: The Third ASEAN Heads of Government Meeting Manila, 14-15 December 1987, https://asean.org/joint-communique-the-third-asean-heads-of-government-meeting-manila-14-15-december-1987/, (E. T. 10.05.2023).
• ASEAN (1992), Singapore Declaration of 1992 Singapore, 28 January 1992, https://asean.org/singapore-declaration-of-1992-singapore-28-january-1992/, (E. T. 10.05.2023).
• ASEAN (2003/1), Joint Statement ASEAN + 3 Ministers of Health Special Meeting on SARS, Kuala Lumpur, Malaysia 26 April 2003, https://asean.org/joint-statement-asean-3-ministers-of-health-special-meeting-on-sars-kuala-lumpur-malaysia-26-april-2003/, (E. T. 10.05.2023).
• ASEAN (2003/2), Joint Statement of the Special ASEAN-China Leaders Meeting on the severe Acute Respiratory Syndrome (SARS), Bangkok, April 29, 2003, https://asean.org/joint-statement-of-the-special-asean-china-leaders-meeting-on-the-severe-acute-respiratory-syndrome-sars-bangkok/, (E. T. 10.05.2023).
• ASEAN (2003/3), Joint Declaration Special ASEAN Leaders Meeting on Severe Acute Respiratory Syndrome (SARS), Bangkok, Thailand, April 29, 2003, https://asean.org/joint-declaration-special-asean-leaders-meeting-on-severe-acute-respiratory-syndrome-sars-bangkok-thailand/, (E. T. 10.05.2023).
• ASEAN (2004), Joint Ministerial Statement on the Current Poultry Disease Situation, Bangkok, Thailand, January 28, 2004, https://asean.org/joint-ministerial-statement-on-the-current-poultry-disease-situation-bangkok-thailand/, (E. T. 10.05.2023).
• ASEAN (2005/1), Kuala Lumpur Declaration on the Establishment of the ASEAN Charter, Kuala Lumpur, 12 December 2005, https://asean.org/asean-charter/kuala-lumpur-declaration/, (E. T. 10.05.2023).
• ASEAN (2005/2), Joint Press Statement of the Twenty Seventh Meeting of the ASEAN Ministers on Agriculture and Forestry (27th AMAF) Tagaytay City, Philippines, September 29, 2005, https://asean.org/joint-press-statement-of-the-twenty-seventh-meeting-of-the-asean-ministers-on-agriculture-and-forestry-27th-amaf-tagaytay-city-philippines/, (E. T. 10.05.2023).
• ASEAN (2006/1), Declaration of the Eighth ASEAN Health Ministers Meeting, Unity in Health Emergencies, Yangon, 21 June 2006, https://asean.org/wp-content/uploads/images/2012/news/documents/Declaration%20of%20the%208th%20ASEAN%20Health%20Ministers%20Meeting.pdf, (E. T. 10.05.2023).
• ASEAN (2006/2), Joint Statement of the Second ASEAN Plus Three Health Ministers Meeting “Unity in Health Emergencies”, Yangon, June 22, 2006, https://asean.org/joint-statement-of-the-second-asean-plus-three-health-ministers-meeting-unity-in-health-emergencies-yangon/, (E. T. 10.05.2023).
• ASEAN (2006/3), Agreement For the Establishment of ASEAN Animal Health Trust Fund, https://agreement.asean.org/media/download/20140119103206.pdf, (E. T. 10.05.2023).
• ASEAN (2009/1), Joint Ministerial Statement of the ASEAN+3 Health Ministers Special meeting on Influenza A(H1N1), Bangkok, 8 May 2009, https://asean.org/joint-ministerial-statement-of-the-asean3-health-ministers-special-meeting-on-influenza-ah1n1-bangkok-8-may-2009/, (E. T. 10.05.2023).
• ASEAN (2009/2), Chairman’s Press Statement of the ASEAN+3 Health Ministers’ Special Meeting on Influenza A (H1N1), Bangkok, 8 May 2009, https://asean.org/chairmans-press-statement-of-the-asean3-health-ministers-special-meeting-on-influenza-a-h1n1-bangkok-8-may-2009/, (E. T. 10.05.2023).
• ASEAN (2012), ASEAN Plus Three Leaders’ Joint Statement on the Commemoration of the 15th Anniversary of the ASEAN Plus Three Cooperation, 19 November 2012, Phnom Penh, Cambodia, https://aseanplusthree.asean.org/asean-plus-three-leaders-joint-statement-on-the-commemoration-of-the-15th-anniversary-of-the-asean-plus-three-cooperation-19-november-2012-phnom-penh/, (E. T. 10.05.2023).
• ASEAN (2014), ASEAN Post-2015 Health Development Agenda, https://asean.org/wp-content/uploads/2021/01/APHDA-In-a-Nutshell.pdf, (E. T. 10.05.2023).
• ASEAN (2019), ASEAN Post-2015 Health Development Agenda (APHDA) 2021-2025, https://asean.org/wp-content/uploads/2022/07/Summary_ASEAN-Post-2015-Health-Development-Agenda-2021-2025_FINAL_adopted-15th-AHMM_May-202239.pdf, (E. T. 10.05.2023).
• ASEAN (2020/1), Joint Statement Special Video Conference of the ASEAN Health Ministers in Enhancing Cooperation On Coronavirus Disease 2019 (COVID-19) Response, https://asean.org/wp-content/uploads/2021/09/Adopted-Joint-Statement_SVCAHMM_COVID-19_20.04.07.pdf, (E. T. 10.05.2023).
• ASEAN (2020/2), Declaration of the Special ASEAN Summit on Coronavirus Disease 2019 (COVID-19) (14 April 2020), https://asean.org/wp-content/uploads/2021/09/FINAL-Declaration-of-the-Special-ASEAN-Summit-on-COVID-19.pdf, (E. T. 10.05.2023).
• ASEAN (2020/3), Joint Statement Special Video Conference of ASEAN Plus Three Health Ministers in Enhancing Cooperation On Coronavirus Disease 2019 (COVID-19) Response 7 April 2020, https://asean.org/wp-content/uploads/2021/09/Adopted-Joint-Statement_SVC.APTHMM_COVID-19_9-April-2020.pdf, (E. T. 10.05.2023).
• ASEAN (2020/4), Joint Statement of the Special ASEAN Plus Three Summit on Coronavirus Disease 2019 (COVID-19) (14 April 2020), https://asean.org/wp-content/uploads/2021/09/Joint-Statement-of-the-APT-Summit-on-COVID-19_14-April-2020.pdf, (E. T. 10.05.2023).
• ASEAN (2023), Health, https://asean.org/our-communities/asean- socio-cultural-community/health/, (E. T. 10.05.2023).
• ASEAN BioDiaspora Virtual Center (2023), COVID-19, Mpox, and Travel Advisories: Situational Report in the ASEAN Region, No. 479, May 5, 2023, https://asean.org/wp-content/uploads/2023/05/COVID-19-and-Mpox_Situational-Report_ASEAN-BioDiaspora-Regional-Virtual-Center_05May2023.pdf, (E. T. 10.05.2023).
• ASEAN Plus 3 FETN (2023), Background, http://www.aseanplus3fetn.net/whoweare.php#strategic, (E. T. 10.05.2023).
• BEESON, Mark (2009), Institutions of the Asia-Pacific: ASEAN, APEC, and Beyond, Routledge Press, London.
• BERGLEE, Royal (2016), World Regional Geography: People, Places and Globalization, 2016 Edition, Minneapolis, University of Minnesota.
• BIRN, Anne-Emanuelle, PILLAY, Yogan, HOLTZ, Timothy H. (2009), Textbook of International Health: Global Health in a Dynamic World, 3rd Edition, Oxford University, Oxford.
• BJÖRN, Hettne ve FREDRIK, Söderbaum (2006), “Regional Cooperation: A Tool for Addressing Regional and Global Challenges”, Achieving Global Public Goods (Der.), International Task Force on Global Public Goods, Foreign Ministry, Stockholm, s. 179–244.
• BROWN, Gordon ve SUSSKIND, Daniel (2020), “International Cooperation During the COVID-19 Pandemic”, Oxford Review of Economic Policy, Cilt 36, Sayı 1, s. 64-76.
• BURGOS, Sigfrido ve BURGOS, Sergio A. (2007), “Avian Influenza Outbreaks in Southeast Asia Affects Prices, Markets and Trade: A Short Case Study”, International Journal of Poultry Science, Cilt 6, Sayı 12, s. 1006-1009.
• CABALLERO-ANTHONY, Mely (2005), “SARS in Asia: Crisis, Vulnerabilities, and Regional Responses”, Asian Survey, Cilt 45, Sayı 3, 475-495.
• COKER, Richard J., HUNTER, Benjamin M., RUDGE, James W., LIVERANI, Marco ve HANVORAVONGCHAI, Piya (2011), “Emerging Infectious Diseases in Southeast Asia: Regional Challenges to Control”, The Lancet, Cilt 377, Sayı 9765, s. 599-609.
• DEMİRBAŞ, Çağrı Emin, AYDIN, Gülşen (2014), “Bir Örgütlenme Çerçevesi Olarak ‘ASEAN Yolu’nun Başarısı”, Uluslararası Hukuk ve Politika, Cilt 10, Sayı 37, s.71-107.
• EAGLES, D., SIREGAR, E. S., DUNG, D. H., WEAVER, J., WONG, F. ve DANIELS P. (2009), “H5N1 Highly Pathogenic Avian Influenza in Southeast Asia”, Rev Sci Tech., Cilt 28, Sayı 1, s. 341-348.
• FIDLER, David P. (2001), “The Globalization of Public Health: The first 100 Years of International Health Diplomacy”, Bulletin of the World Health Organization, Cilt 79, Sayı, s. 842-849.
• GENÇ, Fatma Neval (2021), Kriz Yönetimi: COVID-19 Pandemisi, Nobel Yayın, Ankara.
• GlobinMed (2021), Operationalisation of ASEAN Strategic Framework on Health Development (2010-2015), https://globinmed.com/atm/operationalisation-of-asean-strategic-framework-on-health-development-2010-2015/, (E. T. 10.05.2023).
• HOBBS, Joseph J. ve DOLAN, Andrew (2009), World Regional Geography, Sixth Edition, Brooks Cole Publication, Belmont.
• HOWE, Brendan ve PARK, Min Joung (2017), “The Evolution of the “ASEAN Way”: Embracing Human Security Perspectives”, Asia-Pacific Social Science Review, Cilt 16, Sayı 3, s. 1-15.
• HWEE, Yeo Lay (2020), “ASEAN and EU: From Donor-Recipient Relations to Partnership with a Strategic Purpose”, Koh Tommy ve Yeo Lay Hwee, (Der.), ASEAN-EU Partnership: The Untold Story, European Union Centre, Singapore, 3-12.
• JETSCHKE, Anja (2012), “ASEAN”, Routledge Handbook of Asian Regionalism, Mark Beeson ve Richard Stubbs (Der.), Routledge Press, London, s. 327-337.
• KENNES, Walter (2015), “ASEAN and the EU: An Evolving and Solid Development Partnership”, Drivers of Integration and Regionalism in Europe and Asia: Comparative Perspectives, Louis Brennan ve Philomena Murray (Der.), Routledge Press, London, s. 366-384.
• KILIÇDAROĞLU, Kerem (2021) “COVID-19 Sürecinde ASEAN Bütünleşmesi ve Güneydoğu Asya”, COVID-19 Salgını: Ülke Deneyimleri, Bölgesel Etkiler ve Küresel Yansımalar, Hatice Çelik ve Emre Demir (Der.), Nika Yayınevi, Ankara, s. 303-330.
• KOGA, Kei (2022), “Countering Emerging Infectious Diseases and COVID-19: The Development of ASEAN’s Institutional Arrangements and International Cooperation”, Public Health in Asia During the COVID 19 Pandemic: Global Health Governance, Migrant Labour, and International Health Crises, Anoma P. van der Veere, Florian Schneider ve Catherine Yuk-Ping Lo (Der.), Amsterdam University Press, Amsterdam, s. 45 61.
• KÜHNHARDT, Ludger (2010), Region-Building, Volume I: The Global Proliferation of Regional Integration, Berghahn Books, New York.
• KUMARESAN, Jacob ve HUIKURI, Suvi (2015), “Strengthening Regional Cooperation, Coordination, and Response to Health Concerns in the ASEAN Region: Status, Challenges, and Ways Forward”, ERIA Discussion Paper Series, 07 September 2015, https://www.eria.org/ERIA-DP-2015-60.pdf, (E. T. 10.05.2023).
• LAM, W. K., ZHONG, N. S. ve TAN, N. S. (2003), “Overview on SARS in Asia and the World”, Respirology, Cilt 8, Sayı 1, s. 2-5.
• LEE, Cassey, NEGARA, Cassey ve MAXENSIUS Tri Sambodo, (2020). “Covid-19’s Economic Reckoning in Southeast Asia”, Yusof Ishak Institute, No. 107. https://www.iseas.edu.sg/wp-content/uploads/2020/09/ISEAS_Perspective_2020_107.pdf, (E. T. 10.05.2023).
• LEINBACH, Thomas R. ve FREDERICK, William H. (2023), “Southeast Asia”, Encyclopedia Britannica, https://www.britannica.com/place/Southeast-Asia, (E. T. 10.05.2023).
• MACAR, Oya Dağlar (2020), “Geçmişten Günümüze Salgın Hastalıkların Siyasal ve Toplumsal Sonuçları ve Günümüze Yansımaları”, COVID-19 ile Birlikte Uluslararası İlişkilerde Değişim ve Süreklilikler: Tarih, Bugün ve Gelecek İlişkisinde Disiplinler Arası Bir Analiz, Oya Dağlar Macar (Der.), İstanbul Ticaret Üniversitesi, İstanbul, 4-9, https://www.ticaret.edu.tr/uploads/haberler/1378/SBU%C4%B0_YAPKO_Covid-19%20Analiz%20Rapor.pdf, (E. T. 10.05.2023).
• MARIANO, Karina, BRESSAN Regiane, FERREIRA Guilherme, (2022), “Latin American and Caribbean Regional Organizations facing the COVID-19 pandemic”, Contexto Internacional, Cilt 44, Sayı 2, s. 1-19.
• MCGREGOR, Andrew, LAW, Lisa ve MILLER, Fiona (2018), “Approaching Southeast Asian Development”, Routledge Handbook of Southeast Asian Development, Andrew McGregor, Lisa Law ve Fiona Miller (Der.), Routledge Press, London, s. 3-13.
• NIKOGOSIAN, Haik (2020), “Regional Integration, Health Policy and Global Health”, Global Policy, Cilt 11, Sayı 4, 508-514.
• ÖJENDAL, Joakim (2001), “South East Asia, at a Constant Crossroads”, Regionalization in a Globalizing World: A Comparative Perspective on Forms, Actors and Processes, Michael Schulz, Fredrik Soderbaum ve Joakim Öjendal (Der.), Zed Books, London, s. 147-172.
• ÖZHAZAR, Hüseyin (2022), “Tarihin Büyük Salgınları”, Küresel Salgın COVID-19: Birey, Toplum ve Dünya Üzerine Etkileri, Yahya Ayyıldız (Der.), TireKitap, İstanbul, s. 35-103.
• PHILLIPS, Douglas A. (2006), Southeast Asia, Chelsea House Publishers, New York.
• RÜLAND, Jürgen (2021), “COVID-19 and ASEAN: Strengthening State- centrism, Eroding Inclusiveness, Testing Cohesion”, The International Spectator, Cilt, 56, Sayı 2, s. 72-92.
• SANDLER, Todd (2006), “Regional Public Goods and International Organizations”, Rev Int Org, Cilt 1, Sayı 1, s. 5-25.
• SCHNEIDER, Mary-Jane ve SCHNEIDER, Henry S. (2017), Introduction to Public Health, Fifth Edition, Jones & Bartlett Learning, Burlington.
• TEMİZ, Süleyman (2021), ASEAN: Güneydoğu Asya Ülkeleri Birliği Siyasi Yapısı ve Gelişimi, Gazi Kitabevi, Ankara.
• The ASEAN Secretariat (2002). ASEAN Work Programme on HIV/AIDS II (2002-2005), Jakarta, https://www.hivpolicy.org/Library/HPP000084.pdf, (E. T. 10.05.2023).
• The ASEAN Secretariat (2008), The ASEAN Charter, https://asean.org/wp-content/uploads/images/archive/publications/ASEAN-Charter.pdf, (E. T. 10.05.2023).
• The ASEAN Secretariat (2010), Prevention, Control and Eradication of Avian Influenza in ASEAN: Strategies and Success Stories, Jakarta, Indonesia, https://asean.org/wp-content/uploads/2012/07/HPAI-Strategies.pdf, (E. T. 10.05.2023).
• The ASEAN Secretariat (2020), ASEAN Rapid Assessment: The Impact of COVID-19 on Livelihoods across ASEAN. https://asean.org/wp-content/uploads/2021/08/ASEAN-Rapid-Assessment_Final-23112020.pdf, (E. T. 10.05.2023).
• The ASEAN Secretariat, (2021), ASEAN Key Figures 2021, https://www.aseanstats.org/wp-content/uploads/2021/12/ASEAN-KEY-FIGURES-2021-FINAL-1.pdf, (E. T. 10.05.2023).
• THOMPSON, Denise D. P. (2012), “Leveraging Learning to Improve Disaster Management Outcomes”, Int. J. Disaster Risk Sci., Cilt 3, Sayı 4, s. 195-206.
• TUNÇARSLAN, Nilay (2019), “Fikirsel ve Normatif Bölgeselleşme: ASEAN Örneği”, Uluslararası Siyaset Bilimi ve Kentsel Araştırmalar Dergisi, Cilt 7, Özel Sayı, s. 38-52.
• UNDP (2023), Human Development Insights, https://hdr.undp.org/data-center/country-insights#/ranks, (E. T. 10.05.2023).
• WHO (2003), Summary of Probable SARS Cases with Onset of Illness from 1 November 2002 to 31 July 2003, https://www.who.int/publications/m/item/summary-of-probable-sars-cases-with-onset-of-illness-from-1-november-2002-to-31-july-2003, (E. T. 10.05.2023).
• WHO (2009), Pandemic (H1N1) 2009 - update 58, https://www.who.int/emergencies/disease-outbreak-news/item/2009_07_06-en, (E. T. 10.05.2023).
• WHO (2023), Cumulative Number of Confirmed Human Cases for Avian Influenza A(H5N1) Reported to WHO, 2003-2023, https://cdn.who.int/media/docs/default-source/influenza/human-animal-interface-risk-assessments/cumulative-number-of--confirmed-human-cases-for-avian-influenza-a(h5n1)-reported-to-who--2003-2023.pdf?sfvrsn=c6600b55_1&download=true, (E. T. 10.05.2023).
• WHO Regional Office for South-East Asia (2009), Pandemic H1N1 2009 Report of Regional Consultation on Pandemic H1N1 2009 and Strengthening Country Capacity for Pandemic Preparedness Bangkok, Thailand, 9-11 July 2009, https://apps.who.int/iris/bitstream/handle/10665/205605/B4399.pdf?sequence=1&isAl, (E. T. 10.05.2023).
• World Bank (2023), Countries and Economies, https://data.worldbank.org/country, (E. T. 10.05.2023).
• YARDIM, Mahmut ve PARLAK, Merve (2020), “COVID-19 Pandemisinin Bizi Getirdiği Nokta: Küresel Kamu Malı Kavramı ve Uluslararası Yönetişim ve Finansmanı Konusunda Sorunlar”, Sağlık ve Toplum Dergisi, Cilt 30, Özel Sayı, s. 133-136.
• YILMAZ, Samet (2022), “Avrupa Birliği’nin Asya’yla İlişkilerinde Bölgeler Arası Bir Etkileşim Biçimi Olarak Asya-Avrupa Diyaloğu”, KAÜİİBFD, Cilt 13, Sayı 25, s. 602-625.