The Role of Private Sector in Mainstreaming Right-based ASEAN AIDS Policies Tivana Arbiani Candini, SH., LL.M (Main author) Faculty of Law, Atma Jaya Catholic University of Indonesia
[email protected] Siradj Okta, SH., LL.M Faculty of Law, Atma Jaya Catholic University of Indonesia
[email protected] Abstract ASEAN has the Public-Private Engagement (PPE) in its integration framework that has been running and will continue to be adhered in the time of ASEAN Economic Community. The existence of PPE among other integration agenda is a clear indication that public policies, at some extent, rely on private sector’s involvement. It is important to acknowledge that at least 1.5 million people are living with HIV in ASEAN states, therefore, a regional response in care, support, and treatment is inevitable. ASEAN member states have been committed to address HIV-AIDS in the three main areas of AIDS response including prevention; care, support, and treatment; impact mitigation. This paper will examine the impact of ASEAN regionalism to the AIDS epidemic; the impact of HIV to private sector activities; costs and benefit of private sector’s investment on HIV programs; regional business coalition. Further on the role of private sector, this paper will elaborate the role of private sector in HIV programs; the role of private sector in occupational safety and health; private health care providers; private sector as patent holders. Private sector’s role is increasingly recognized in national AIDS strategies in ASEAN. As the main player related to mobile population, it is clear that their investment on coordinated AIDS program is significantly influential. Private companies should look AIDS programs implementation as their contribution to national and regional combat against the epidemic. Affordable access to ARV treatment, regionally, will ensure a healthy mobile worker population to take part in the regional growth.
Keywords: private sector, HIV/AIDS, public health law, intellectual property law, patent law, mobile population, migrant workers A. Introduction The Association of Southeast Asian Nations (ASEAN) is characterized by much diversity in terms of geography, society, economic development, and health outcomes. Those factors, if strongly supporting each other, will undeniably plays significant roles in creating the successful multilateral collaboration between countries in the ASEAN region (that has led to the ambition to create the ASEAN Economic Community (AEC) by 2015). This regional economic integration aims to achieve a single market and production base, which is competitive, equitable, and integrated into global economy. 1
In econonomic development area, ASEAN has an optimistic estimation of private consumption increase of close to 10% by 2025. Considering its 600 million population, this increase will enormously boost the purchasing power, especially during the commencement of the Asean Economic Community as the initial economic intergration by early 2016. 1 Despite the challenge of poverty remains, the region has attracted increasingly foreign investments and no less than 300 million workforce. 2 ASEAN has the Public-Private Engagement (PPE) in its integration framework that has been running and will continue to be adhered in the time of ASEAN Economic Community. PPE is the main initiative that ASEAN members’ believed to be the foundation of effective public policies.3 The existence of PPE among other integration agenda is a clear indication that public policies, at some extent, rely on private sector’s involvement. In health area, the health systems of those ASEAN countries , as well as healthcare structure and provisions vary considerably. Consequently, the progress toward Universal Health Coverage (UHC) in these countries also varies. The ASEAN Economic Community's (AEC) goal of regional economic integration and a single market presents both opportunities and challenges for UHC. Healthcare services have become more available but health and healthcare inequities will likely worsen as better-off citizens of member states might receive more benefits from the liberalization of trade policy in health, either via regional outmigration of health workers or intra-country health worker movement toward private hospitals, which tend to be located in urban areas. 4 The ASEAN Task Force on HIV and AIDS (ATFOA) was established in 1993 as a coperation coordinating body to address the epidemic in this emerging economy. It is important to acknowledge that at least 1.5 million people are living with HIV in ASEAN states, therefore, a regional response in care, support, and treatment is inevitable. This task force had been successful in making several amalgamated commitment among high-level officials: 1. ASEAN Declaration on HIV/AIDS signed at the 7th ASEAN Summit in Brunei Darussalam in 20015 2. Recommendations on Building HIV Resilience along the ASEAN Highway” (Bangkok Recommendations) in 2003 3. ASEAN Commitment on HIV/AIDS signed at the 12th ASEAN Summit in Cebu, Philippines in 2006. The main purpose of these instruments is utilize the leveraging potential of the relationships among ASEAN member states to increase the access to better HIV care and prevention. As such, HIV and AIDS had clearly claimed as the potential interest among ASEAN member states. This, in a certain political understanding, means the obligation to 1
ASEAN Community 2015, International Labor Organization and Asian Development Bank, 2014 Ibid. 3 ASEAN Official Website, Public-Private Engagement, http://www.asean.org/asean-economiccommunity/sectoral-bodies-under-the-purview-of-aem/public-private-sector-engagement-ppe/ visited 20 January 2016 4 Global Health Action. 2015; 8: 10.3402/gha.v8.27368. 5 ASEAN Member Governments pledged to “Lead and guidethe national responses to the HIV and AIDS epidemic as a national priority to prevent the spread of HIV infection and reduce the impact of the epidemic by integrating HIV and AIDS prevention, care, treatment and support and impact mitigation priorities into the mainstream of national development planning, including poverty eradication strategies and sectoraldevelopment plans” 2
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share required resources to respond HIV in the region. As proclaimed in the ASEAN Declaration on HIV/AIDS during the 7th ASEAN Summit, ASEAN member states have been committed to address HIV-AIDS in the three main areas of AIDS response: 1. prevention; 2. care, support, and treatment; 3. impact mitigation. These three areas has been the focus of many national AIDS program. Thailand, as an ASEAN example, is committed to obligate HIV program integration to the main health system as a condition for construction construct bidding and approval. Similarly, the National AIDS Authority of Cambodia has been committed to participate in infrastructure project process by obliging all infrastructure project plan to be endorsed by them in cooperation with the Ministry of Public Works and Transport.6 This paper is intended to describe the role of private sector in the effort of mainstreaming AIDS policy in ASEAN. There has been a strong right-based feature of AIDS response in the region that requires a convincing level of affirmative action. This is to take into account the diversed socio-political environment of ASEAN Member Countries. This paper will examine the impact of ASEAN regionalism to the AIDS epidemic; the impact of HIV to private sector activities; costs and benefit of private sector’s investment on HIV programs; regional business coalition. Further on the role of private sector, this paper will elaborate the role of private sector in HIV programs; the role of private sector in occupational safety and health; private health care providers; private sector as patent holders. A.1. The Impact of Regionalism on the Spread of HIV According to ASEAN key findings, migration patterns in South-East Asia are the result of complex push and pull factors. Certain developing economies as Thailand, Malaysia, Singapore and Brunei Darussalam have attracted in cumulative numbers an estimated 7.6 million migrants, off which more than 3.8 million were undocumented. Moreover, there has been an an estimated 12.6 million workers left Cambodia, Indonesia, Lao PDR, Myanmar, the Philippines and Vietnam for better economic opportunities abroad with a range of HIV prevalence:7 Tabel 1. Estimated HIV Prevalence and Mobility Pattern in Southeast Asia8 Country Source Countries Cambodia Indonesia Lao PDR Myanmar The Philippines
HIV Prevalence (Age 1549)
Estimated Total Migrant Workers
0.9% 0.16% >0.1% 0.7%
