26

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/
1
ISBN

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/

2556
978-616-279-187-1
500
P.A. Living

. . . 73170
02-4419040-3 02-4419044
www.aihd.mahidol.ac.th

:


26
: / ;
, . 1.- - :
, 2556.

52
ISBN 978-616-279-187-1

1. 2. -- 3. - 4.

I. . II. III. .

WA525 153 2556

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52





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CEO
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( : .)

20
...

(
() ..2541)

21 Global Health : Borderless Movement of

Diseases
Prof. Dr. Yasuhide Nakamura
(Graduate School of Human Sciences, Osaka University)

22

( )

[ 4 ] :

23 :

.
( )
24
..
( )
25

( )

26 15
2555


:

2556

2555 [ 5 ]

 26
:
(ASEAN Health Community: Opportunity and Challenge

15 2555

25 26

[ 6 ] :


:





2555

2555 [ 7 ]

 26

15 2555

2530

25
26

:

[ 8 ] :

 26
..
.. 2553


.. 2549 2552

(Regional Advisor, Communicable Disease Surveillance and
Response)


.. 2519 1
(FETP) .. 2523
2 Epidemic Intelligence
Service (EIS) training program
.. 2525 Emory University

FETP

..2532
.. 2533



2555 [ 9 ]

 (TUC)


,
(microbicide),

TUC
5 .. 2533 250 ..
2549

.. 2531 2533

.. 2547 .. 2548

[ 10 ] :

 26

2555 [ 11 ]






AIHD

26

WHO SEARO 14
21 10 .. 2543

(Public Health Recognition Award
Asia-Pacific Academic Consortium) .. 2534

[ 12 ] :

2




2-3

..2558
5

10

2555 [ 13 ]


600

1 Briefing of Global Health Agenda

Executive Board World Health Assembly (governing body)

2 Key Regional Health issues

3 Knowing ASEAN

.. 2551
[ 14 ] :


4 Opportunities and Challenges

6
3

And There Are Many Navigational Challenges

UN
Mandates

Country
Politics
Changing
economic
performance

ALLIANCES
Counterpart
PARTNERSHIPS Capacity
NETWORKS

Social
Determinants

Integration
System
Global
Initiatives

UN
Reform

2555 [ 15 ]

High Level Panel on Health MDG

75-100

60 3
(HIV) (TB)

Global Health
Agenda

1 (Global Health)

(Universal Health Coverage)

Dr. Margaret Chan
(World Health
Assembly) .. 2555 2
Universal coverage is the single
most powerful concept that public health has to offer
[ 16 ] :

 Dr. Margaret Chan

4
Universal coverage is the hallmark of a governments commitment, its
duty, to take care of its citizen, all of its citizens.

Definition embodies specific aims

(universal coverage objectives)
Access (reduce gap between need and utilization);
Quality (sufficient to make a difference); and
Financial protection

for all

3
1.

2.

2555 [ 17 ]

3.


(Out of Pocket)

Global Health Agenda
(Millennium Development Goals
MDGs) 8
Goal 1
Goal 2
Goal 3
Goal 4
Goal 5
Goal 6 HIV

Goal 7
Goal 8

8 3
4, 5 6
[ 18 ] :


MDGs
Goal 1
8 Goal
MDGs
189

MDGs
.. 2015
MDGs

(CLMV)
MDGs

.. 2015

MDGs MDGs



Post 2015 Development Agenda
.. 2555
2555 [ 19 ]

 .. 2015

International Health Regulations (IHR 2005)

International Health Security
IHR(2005), a paradigm shift

From diseases list to all threats

From control of borders to containment at source
From preset measures to adapted response

3 Global Health Agenda International
Health Regulations (IHR)

IHR .. 2549
.. 2550 IHR
.. 2512

[ 20 ] :

IHR
2


Public Health Events of International Concern
(PHEICs) PHEIC

2555 [ 21 ]

Climate Change and Health

Strength
ening
health
systems

.. 2552

4 ,
,

[ 22 ] :

Injury and Violence

Prevention (IVP) & Disability
and Rehabilitation (DAR)
To prevent the occurrence of injury through
violence & injury risk factor control in three
areas: road traffic injury, domestic
domestic violence &
disability prevention through good
management of first health response together
with inter sectoral & cross sectoral

partnership.

5

(Injury) Decade of Action

.. 2010-2020

34

6
(.. 2555)

.. 2554
2555 [ 23 ]


Global Action Plan
.. 2008-2013

5

4

4

.. 2003 FCTC (Framework Convention on Tobacco Control)

.. 2004 Global Strategy on

Diet, Physical Activity and Health (DPAS)

.. 2008
4

.. 2010
.. 2011
(Political Declaration on NCDs)

[ 24 ] :

Our Mandates to date

2000
2003
2004

Global Strategy for the Prevention and Control of Noncommunicable Diseases

Global Strategy on Diet, Physical Activity and Health

Action Plan on the Global Strategy for the

Prevention and Control of NCDs

2008
2009

Global Strategy to Reduce the Harmful

Use of Alcohol
WHO Global Status
Report on NCDs

2010
2011
2012+

Political Declaration on NCDs

Realizing the commitments made in the Political Declaration

15 67 (Global
Adult Tobacco Survey: Indonesia Report 2011)
FCTC
3
31
FCTC .. 2003
MPOWER
(Monitor),
(Protect),
(Offer quit),
(Warn),
(Enforce bans)
(Raise taxes)
2555 [ 25 ]

MPOWER
MPOWER strategy as recommended by WHO, can effectively
counter the tobacco epidemic.
The six policies of WHOs MPOWER
Monitor tobacco use and prevention policies.
Protect people from tobacco smoke.
Offer help to quit tobacco use.
Warn about the dangers of tobacco.
Enforce bans on tobacco advertising, promotion and
sponsorship.
Raise taxes on tobacco.

Global Health (Social Determinant of Health)

65
.. 2555



2




/

[ 26 ] :

 MDGs
2
3 (Public health emergencies disaster)
4
5
6 (Universal Health Coverage)
7 (Migrant
Health)
(Urban Health)

MDGs

.. 1990
MDGs
2 - 3

2555 [ 27 ]

Average life expectancy at birth in

southeast Asia, 19502010

.. 1950 .. 2010

(CLMV)

Population & Aging in ASEAN

Countries, 1980, 2000 & 2020

[ 28 ] :



..1980, ..2000
..2020
3.7 ..1980
4.8 ..2000 2
..2020 ..2050

2
(60-70 ) 70

174
7 5
Ring of fire

.. 2004



(Disaster Management Partnership)
NGO



2555 [ 29 ]

 SARS

Mekong Basin Disease Surveillance
H1N1 H5N1

WHO IHR
FAO

ASEAN Health Ministers Meeting (AHMM) 11



(Food Security)

E. coli
Avian
influenza

HIV/AIDS
ASEAN Task Force on AIDS (ATFOA)
2


(ASEAN Declaration on AIDS)
.. 2011
[ 30 ] :




Zero new
infection, Zero deaths HIV/AIDS Zero discrimination
8 (
)

Universal Health Coverage

PhilHealth Vietnams
health fund for the poor Health
Equity Funds
UHC

..

Health System




10



Compulsory licensing
2555 [ 31 ]

(CL) HIV

H5N1

Health Tourism

[ 32 ] :


(migrant health)

(Urban Health)
(Healthy Cities)
Healthy Settings
2555 [ 33 ]


Healthy University
(Healthy Cities)

3


10


ASEAN Bangkok
Declaration 8 .. 1967
.. 1999

(ASEAN Charter) .. 2007

.. 2008 ..
2009

[ 34 ] :

TRANSFORMATION OF ASEAN
Bali Concord II
2003
Vientianne Action
Programme
2004

ASEAN COMMUNITY
2015

ASEAN Political-Security Community

(APSC)
ASEAN Economic Community
(AEC)
ASEAN Socio-Cultural Community
(ASCC)

The Signing of
the ASEAN Charter
& Singapore Declaration
on the ASEAN Charter 2007

Entry into force

of ASEAN Charter
15 December 2008
ASEAN Secretariat
Jakarta

Cha-am Hua Hin

Declaration
on the Road Map for
the ASEAN Community
2009

43

5
.

One Vision,
One Identity, One Community ..
2020 .. 2015

Bali Concord II .. 2003 Vientiane Action
Plan .. 2004
ASEAN Vision 2020
ASEAN Politico-Security
Community (APSC)
ASEAN Economic
Community (AEC)

ASEAN Socio-Cultural
Community (ASCC)

2555 [ 35 ]

3
1. ASEAN Economic Community (AEC):
2. ASEAN Political Security Community (APSC):

3. ASEAN Socio-cultural Community (ASCC):

3
(Blueprint)
.. 2009
4
(B4: Social Welfare and Protection)
1.

2.
3.
4.
ASCC : Strategic objectives

UHC/NCD prevention/Health promotion

IHR /APSED

[ 36 ] :

ASCC: Strategic objectives

IHR /APSED

(caring societies)


(Vision) .. 2020
Bali Concord
(Charter) ..2007 ..2008
1



(Blueprint)

Dialogue Partners

10

2555 [ 37 ]

 Sectoral Dialogue Partner

Sector

External Parties South Asian Association for Regional Cooperation (SAARC)

(WHO), (UNFPA),
(UNICEF)
(UNAIDS)
Institutionalization on ASEAN
Health Development

Health and Communicable Diseases Division, ASEAN

Secretariat, Jakarta

2

+3 (, ) 3 4

SOMHD (Senior Officials Meeting on Health Development)
[ 38 ] :


SOMHD

working group task force
AREAS of ASEAN Cooperation on Health
(2010-2015)

Addressed 10 Health Issues

Communicable Disease (EID)
HIV/AIDS
Pharmaceutical Development
Food Safety
Tobacco Control
Pandemic Preparedness and Response
NCD
Mental Health
MCH
Traditional Medicine

Networking/Initiatives
ASEAN Plus Three Filed
Epidemiology Training Network
(FETN)

Health Impact Assessment

Increase access to healthcare

UHC

10




ASEAN Plus
Three Filed Epidemiology Training Network (FETN)
Health Impact
Assessment Universal Health Coverage
2555 [ 39 ]

Health and Communicable Diseases Division





, Framework
Convention on Tobacco Control (FCTC)

(IHR)
2 South East Asia Region (SEARO) Western Pacific Region (WPRO)
APSED Asia Pacific Strategy on Emerging
Diseases 2
IHR IHR

2

[ 40 ] :

4
Opportunities

10

2555 [ 41 ]



.. 2011
(ASEAN Declaration of Commitment: Getting to Zero
New HIV Infections, Zero Discrimination, Zero AIDS-related Deaths)



SOMHD ASEAN Task
Force on AIDS

ASEAN Cities Getting to Zeroes
13 8 (Demonstration Project)

(Joint Statements) SOMHD

WHO
5 2009-2013

[ 42 ] :




ASEAN Dengue
Day 15

2
(Joint Statement)

Global Health

Mutual
Recognition Agreement MRA MRA
MRA

ASEAN
Events Smoke Free

(ASEAN Connectivity Plan) 3

2555 [ 43 ]

 .. 2010
ASEAN Agreement on Disaster
Management and Emergency Response (AADMER)

.. 2012

ASEAN Community 2015: Opportunities and Challenges to Health,

2012 -2014 (Joint Statements)

Continue efforts on EID

Non Communicable Diseases
Universal Health Coverage
Tobacco Control
Malaria drug resistance
HIV/AIDS
Elimination of rabies by 2020

[ 44 ] :


ASEAN Resource Centre on Risk Communication

Joint Multi-sectoral
Outbreak Investigation and Response

Stockpile


(containment)

+3 (ASEAN Plus Three FETN) .. 2011

ASEAN Plus Three EID Website

+3

IHR 2005 Asia Pacific Strategy on Emerging Diseases One
Health



ASEAN University Network 26
2555 [ 45 ]

 10

5 Medical Network
(Senior Officials Meeting on Education) SOMHD
SOMED
2

CLMV Initiative
for ASEAN integration strategic framework

4

[ 46 ] :

2555 [ 47 ]

Summary
ASEAN is a region characterised by diversity, including public health
challenges.
The region is highly susceptible to natural disasters and other Emerging
Diseases
An inter governmental mechanism benefit for regional cooperation in
health development
Multi sectoral coordination is vital
Prioritization of key regional health issues and capacity building of
needed AMSs (CLMV) need to be intensified
Harmonization of efforts between key development partners need to be
highlighted
Capacity of ASEAN Secretariat as a nerved function should be
strengthened

[ 48 ] :


Crisis Management
Centre WHO Collaborating Centre for Disaster Management ASEAN Coordinating Centre for Humanitarian Assistance on Disaster Management (AHA Centre)

4
CLMV

2555 [ 49 ]

ASEAN
(ASCC,
AEC,
ASPC)

COORDINATION

National
Health
Priorities

PRIORITIZATION

Global Health Agendas

Globalization

Regional
Health
Threats

3
3

.. 2015
One Vision One Identity One Community
1 1 1 ?
[ 50 ] :

2555 [ 51 ]


Dr. Khanchit Limpakarnjanarat
:




2514 2515
.
2515 2519
.. ()
2523 2525



2525 2527
Epidemic Intelligence Service

(EIS) Program, US Centers for Disease

Control (CDC)
2527
Master in Public Health (MPH),

Emory University, Atlanta
2528

.. 2554
.. 2549 2553
Regional Advisor, Communicable Disease

Surveillance and Response (CSR),

Department of Communicable Diseases,

Southeast Asia Regional Office (SEARO),

World Health Organization
2549 Medical Officer (Epidemiologist),

World Health Organization, South-east Asia

Regional Office, New Delhi, India
[ 52 ] :

.. 2546 2549

.. 2544 2546

.. 2533 2544


.. 2528 - 2533




.. 2527- 2529

.. 2523 2525

.. 2521 -2523

.. 2520 2521

-
-

(
)

(Field Epidemiology
Training Program FETP)

.
.

2555 [ 53 ]