Sub-regional Coordination is the Cure for ASEAN’s Health Divide

Defense Minister Datuk Seri Hishammuddin Hussein (second from right) at the ASEAN Defense Minister Meeting in Manila in October 2017 | New Straits Times

In an article for East Asia Forum, Ronald Tundang discusses gaps in ASEAN's health systems, which leave millions without reliable access to essential medicines. Tundang proposes that, to bridge regional gaps, ASEAN's least developed countries could follow the “ASEAN Minus X” model to establish a sub-regional facility, combining a patent-licensing hub with pooled procurement, which would facilitate WTO-compliant licensing, aggregate demand, and uphold quality benchmarks.

ASEAN’s membership ranges from advanced economies to least-developed countries, resulting in stark disparities in healthcare access — a ‘two-speed’ health challenge for the region. Access to essential medicines remains a significant issue in Southeast Asia, where progress towards achieving universal health coverage has slowed since 2019, leaving millions without adequate medical support.

In countries like Cambodia, Laos and Myanmar, fragile health infrastructure and limited purchasing power mean life-saving drugs and vaccines often arrive late or at prohibitive cost. ASEAN’s common pledge of ‘health for all’ is strained by uneven levels of development and priorities.

Vast differences in healthcare realities make it difficult to champion regional health policies. ASEAN’s more affluent states often prioritise pharmaceutical innovation and industrial policy, while lower-income countries are primarily concerned with affordable access and basic coverage.

These diverging interests have at times hampered unified action on access to medicines. In trade negotiations, such as those for the Regional Comprehensive Economic Partnership, middle-income ASEAN members like Indonesia and the Philippines have pushed back against stringent intellectual property rules that others were willing to adopt. The result is a regional policy gap. Despite all ASEAN members agreeing to equitable healthcare in principle, divergent capacities and interests have delayed concrete collective measures to ensure medicines reach those who need them most.