August 22, 2024
JAKARTA, CANBERRA – On Aug. 13, the Africa Centres for Disease Control and Prevention (CDC) declared mpox a public health emergency of continental security. Three days later, the World Health Organization (WHO) swiftly declared mpox a public health emergency of international concern, meaning it could be the next global pandemic after COVID-19.
Mpox transmission is currently known to occur through close intimate contact with a sick person, but its one- to two-week incubation period means a sick person could be unaware of their infection. A rash on the hands, feet, chest, face or mouth, or near the genitals, is a sign of mpox.
Mpox poses significant material consequences, with Clade I (endemic to Central Africa) killing more patients than Clade II (endemic to West Africa and causing a global outbreak in 2022). As of Jan.11, 2023, reports indicated a cumulative total of 84,400 laboratory-confirmed mpox cases, including 76 deaths. In the meantime, Singapore reported a total of 21 confirmed cases of mpox, with the exception of an isolated case in 2019. By February 2023, 110 countries worldwide had reported mpox cases.
It is crucial for Southeast Asian authorities to remain vigilant without succumbing to panic. Southeast Asia’s proximity to regions like South Asia and interconnectivity with the Middle East, Europe and Africa increase the risk of mpox transmission to its population.
Yet the region strategically provides multiple entry points for cross-border movement of people and goods, and it is also one of the fastest-growing regions in terms of economy and population, creating tension for its policymakers to respond to the recurring virus outbreaks. Can the region learn its lesson from COVID-19 to tackle the mpox outbreaks?
Southeast Asia faced several challenges in addressing the COVID-19 pandemic, both as a region and as individual countries, revealing both strengths and weaknesses. One significant issue was the uneven capacity for surveillance, monitoring and data sharing of virus outbreaks across the region.
While some countries had more robust systems in place, others struggled with limited capabilities. This disparity highlighted the urgent need to expand public health infrastructure and invest in regional response capacity to ensure a more cohesive and effective approach to future pandemics.
Another challenge was the availability and production of vaccines, which are crucial for sustaining economic activities during a pandemic. Southeast Asia, like many regions in the Global South, was heavily reliant on vaccine imports during COVID-19. This dependency on vaccine-exporting and producing countries created vulnerabilities and delayed access to COVID-19 vaccines at the beginning of the pandemic.
The current mpox situation highlights this issue, as the disease has received little attention outside of Africa, resulting in limited international production of vaccines and treatments. As a result, mpox vaccines remain out of reach for most African countries, and Southeast Asia could face similar challenges if regional production and access are not addressed.
Furthermore, regional cooperation in Southeast Asia, based on the principles of solidarity and strong political commitment, was critical during the COVID-19 pandemic. While these principles enabled member states to respond collectively through various regional initiatives, maintaining this level of political commitment and solidarity for a seamless, coordinated response requires sustained effort. Enhancing cross-sectoral communication and collaboration, including among political, security, economic, and health-related ministries, is crucial for achieving this goal.
The experiences of Indonesia, Malaysia and Singapore in handling the COVID-19 pandemic offer valuable lessons for the region. These countries, with their significant collective economies and population sizes, provide practical examples of how to move forward in addressing virus outbreaks like mpox.
Not only do their successes and challenges resonate with the majority of ASEAN countries, they also provide valuable insights for other nations confronting similar threats.
Singapore, a high-income country with a small population, boasts robust healthcare infrastructure, efficient vaccine procurement, and effective contact tracing and quarantine measures. Its government’s strong communication strategy, which ensured high public compliance, has been pivotal to the nation’s preparedness.
A centralized task force, involving various departments such as health, transportation and economics, provided clear, science-based messaging, helping to maintain public trust and compliance.
Malaysia, as an upper-middle-income country with a medium population size, demonstrated remarkable success in managing the COVID-19 pandemic, with relatively low infection and death rates compared to neighboring countries. The proactive preparation of the Malaysian Health Ministry, even prior to the registration of the first case, significantly contributed to the country’s readiness. Lessons from previous epidemics, such as Nipah, SARS, MERS and H1N1, contributed to Malaysia’s swift and effective response.
Indonesia, as an upper-middle-income country with a large population, faced early challenges with large-scale case detection, but eventually mounted a commendable response through extensive vaccination campaigns, community engagement, and the utilization of its vast network of local health workers.
These efforts reflect a strong public health commitment that can serve as a model for other nations. However, issues such as healthcare accessibility in rural areas and limited testing facilities remain significant obstacles.
To effectively address the threat of mpox, ASEAN must implement a unified strategy that encompasses several critical areas, despite the fact that member states have differences in economic and population size.
First, enhanced data sharing and joint research initiatives are essential for improving regional surveillance systems, enabling timely detection of and responses to mpox cases. ASEAN’s facilitation of these efforts will be crucial for a coordinated regional response. Second, capacity-building for widespread testing and vaccination is critical, with a focus on ensuring equitable access to vaccines to prevent health disparities and strengthen regional preparedness.
Third, it is imperative to protect vulnerable populations and maintain economic stability by establishing robust social support systems and implementing policies that support businesses during potential disruptions.
Lastly, ongoing public health education is key, with a need to engage community leaders and influencers in promoting preventive measures to secure widespread public compliance and support.
As Singapore, Indonesia and Malaysia all have their respective anniversaries in August, this month symbolizes their mutual interest in freedom from any threats to their sovereignty, including health security threats.
Mpox is testing Southeast Asia’s ability to remain vigilant and maintain political commitment to protect their citizens and economic growth in the face of uncertainty. The complex landscape of pandemic preparedness and response can only be solved through solidarity, intersectoral collaboration and transparency, which are critical to effective regional responses and strengthening regional positions for current and future health security threats.