Academic journal article Contemporary Southeast Asia

Regionalizing Health Security: Thailand's Leadership Ambitions in Mainland Southeast Asian Disease Control

Academic journal article Contemporary Southeast Asia

Regionalizing Health Security: Thailand's Leadership Ambitions in Mainland Southeast Asian Disease Control

Article excerpt

Southeast Asia, and Thailand in particular, has often been referred to as a potential "hot zone" or hub of emerging infectious diseases. (1) This has been attributed to a multiplicity of factors including: a greater concentration and connectivity of livestock, persons and products with unsafe animal husbandry practices; (2) a lack of development coupled with population growth and urbanization; (3) problems with effective governance of infectious disease; (4) and increasing interconnectivity in the region due to improved transportation links.

Pandemic potential in Southeast Asia has been framed as a security threat, (5) and Thailand has also recognized the implications of disease for transnational security. Most evident has been the impact of "crisis" events which have changed Thai policy in this area to reflect shifting understandings of disease and security. The first of these was the impact of human immunodeficiency virus infection and HIV/AIDS. Thailand recognized the implications of the virus for the country's national security through its impact on travel and trade. (6) This framing promoted a proactive policy pathway to limit the disease's spread through a series of campaigns such as the 100 per cent condom campaign, (7) scaling up access to antiretroviral drugs, (8) and normalizing discussions of family planning through initiatives like the Cabbages and Condoms restaurant. (9) Accordingly, Thailand has been touted as one of the "success stories" of state responses to HIV/AIDS. (10) However, taking into account the pivotal role of tourism in Thailand's economy, a critical view could consider such efforts in HIV/AIDS control as having been undertaken to protect the country's economic security."

In 2002-03, the spread of severe acute respiratory syndrome (SARS) represented a further key moment for understanding Thailand's infectious disease policy, similar to the "tipping point" it proved to be for regional activity in disease control. (12) Although Thailand only reported a few cases (resulting in two deaths), (13) the government made every effort to promote Thailand as a zero-transmission SARS country. (14) Despite the low impact SARS had on Thailand, it was Bangkok's leadership that was instrumental in summoning the involvement of its regional counterparts in a series of special Association of South East Asian Nations (ASEAN) + 3 meetings culminating in the region being declared SARS free by June 2003. This activity was undertaken in an attempt to limit the damage to the tourism industry and the wider economy, which occurred elsewhere in Asia such as Hong Kong and mainland China.

This focus on economic and national security was further evident in the outbreak of the H5N1 influenza virus in 2004-05. Despite having laboratory confirmation of the circulating virus, the Thai government tried to cover this outbreak up for over three months in order to protect its poultry and tourism industries. (15) This approach was exemplified by Deputy Agriculture Minister Newin Chidchob when he stated: "the chicken industry would have collapsed immediately and the economy would have lost more than 100 billion baht". (16) However, simultaneous to rejecting emerging global health norms of prompt reporting and outbreak transparency, Thailand took to regional activity, seizing a leadership position for disease control, notably by hosting a meeting of ASEAN+3 on how best to control the outbreak, culminating in the production of a Joint Ministerial Statement on Prevention and Control of Avian Influenza. (17)

By regionalizing the risk of disease, Thailand demonstrated that only a collective response would combat its spread. In taking the agency to establish such regional activity, Thailand placed itself at the centre of discussions on how to respond to the threat posed by the disease. Such action is indicative of Thailand's efforts for regional and subregional preponderance in disease control, which have visibly increased in the last 15 years through a range of formal and informal mechanisms, to the extent that Thailand can now be considered a subregional disease governor, arguably extending its own sovereign power in this arena beyond its borders. …

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