Southeast Asia’s Ebola Response: Ready at Home but Reluctant Abroad

By Nigel Cory

Medical staff undergoing Ebola decontamination in Guinea. Source: EU Humanitarian Aid and Civil Protection's flickr photostream, used under a creative commons license.

Medical staff undergoing Ebola decontamination in Guinea. Source: EU Humanitarian Aid and Civil Protection’s flickr photostream, used under a creative commons license.

Thankfully there have been no confirmed cases of Ebola in Southeast Asia, with a few people testing negative after reporting symptoms common to the disease. Nine people arriving in Malaysia from West Africa with fevers tested negative on October 17. So did three men that arrived in Vietnam from Liberia on September 12.

A key part of the region’s risk from an Ebola outbreak comes from its role as a global transport and trading hub, including for its many migrant workers employed in affected areas. The Philippines has some 8,000 workers in Ebola-affected countries in West Africa. The ease of global travel means these risks are serious enough to raise concerns and prompt governments in the region to launch preparedness measures.

Southeast Asia has extensive, if tragic, experience dealing with highly infectious disease outbreaks over the last decade, which should put it in a relatively strong position to respond to any threat of an Ebola outbreak. The sudden appearance of severe acute respiratory syndrome (SARS) in 2002-2003 infected over 8,000 people and killed nearly 800, mainly in southern China, but resulted in smaller outbreaks and widespread fear in Southeast Asia. Southeast Asia has been the epicenter of the fight to contain a virulent strain of H5N1 avian influenza that emerged in 2003. And in 2009, a new strain of influenza called H1N1, or swine flu, killed up to 18,500 people worldwide, with outbreaks especially severe in Africa and Southeast Asia.

The World Health Organization (WHO) credits Southeast Asian nations with learning the lessons from these outbreaks. Political leaders, health care workers, bureaucrats and others are much better prepared to respond as regional cooperation has improved and countries have developed coordinated responses to outbreaks.

Despite the geographic distance between the two regions, Southeast Asia’s ties with Africa have grown in recent years as companies have sought to expand trade and investment opportunities. Former Thai prime minister Yingluck Shinawatra and Malaysian prime minister Najib Razak have both led delegations of business leaders and government officials on trade missions to Africa in search of trade, investment, and other commercial opportunities. The value of these economic ties has grown quickly. In 2012 two-way trade between Africa and Southeast Asia was worth $42.5 billion, up from $2.8 billion in 1990, making Africa the second-fastest growing continent for ASEAN trade.

Southeast Asia’s commercial ties have only been marginally affected by the Ebola outbreak so far. Thailand’s rice industry has perhaps been hardest hit as the bulk carrier vessels that deliver its rice to West Africa have had difficulty finding crews to man the ships due to fears among sailors of contracting Ebola.

Ebola’s main impact on travelers has been on outbound Asian tourists who are cancelling their trips to Africa, even to countries such as South Africa that are far from any cases of Ebola. Asian tourists seem especially wary given their experience with SARS and H1N1.

Southeast Asia’s contributions to fighting Ebola have been limited to indirect support. Malaysia, Thailand, and others are donating food, financial support, and medical equipment such as rubber gloves. ASEAN countries have refused to send medical staff to Africa, despite insistence by the WHO and international health groups that such assistance is the best way to prevent Ebola from spreading. But each ASEAN member has reportedly setup emergency operations centers for Ebola which are in contact with the WHO’s regional office in Manila and its headquarters in Geneva.

The Philippine government rebuffed a U.S. request to dispatch medical workers to Ebola-hit areas, saying its priority is boosting domestic defenses against any local outbreak. The Philippines Red Cross criticized this decision while preparing to send its own volunteers. Manila has also decided to pull its contingent of soldiers out of peacekeeping operations in Ebola-affected Liberia.

Southeast Asia’s current response downplays the region’s potential to make a direct contribution to the international community’s effort to fight Ebola at its source. The United States and many international organizations would welcome a greater role and have been urging Southeast Asia to make a more active contribution.

The United States has long worked with Southeast Asian nations to bolster their preparedness measures. The U.S. Centers for Disease Control and Prevention’s regional office in Thailand works with ASEAN countries on infectious disease preparedness, detection, and response capabilities. The U.S. Agency for International Development has invested a $1 billion since 2005, including $72.5 million in 2014, in helping countries, including in Southeast Asia, prepare to handle emerging and pandemic threats.

U.S. president Barack Obama hosted officials from Malaysia, Thailand, Vietnam, and 41 other nations at the White House on September 26 to talk about the Global Health Security Agenda and the international response to the Ebola outbreak, but failed to convince any Southeast Asian nation to change their stance on sending medical staff to Africa.

Southeast Asia’s concerns with domestic preparedness are understandable, but given the risks posed by Ebola and the region’s capabilities, it is in a position to make a bigger contribution to the international community’s response effort.

Mr. Nigel Cory is a researcher with the Sumitro Chair for Southeast Asia Studies at CSIS. He previously served as an Australian diplomat in Malaysia and the Philippines.


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