The proposed technical assistance (TA) addresses the need for improved Greater Mekong Subregion (GMS) regional health cooperation. The TA will provide a platform for a more coherent policy environment at both national and regional levels, which is supportive of cross-border collaboration and targeting vulnerable populations. The TA will also produce innovative ideas for a regional portfolio.
|Project Name||Strengthening Regional Health Cooperation in the Greater Mekong Subregion|
Lao People's Democratic Republic
China, People's Republic of
|Project Type / Modality of Assistance||Technical Assistance
|Source of Funding / Amount||
|Strategic Agendas||Inclusive economic growth
|Drivers of Change||Gender Equity and Mainstreaming
Governance and capacity development
|Sector / Subsector||
Health / Health system development
|Gender Equity and Mainstreaming||Effective gender mainstreaming|
|Description||The proposed technical assistance (TA) addresses the need for improved Greater Mekong Subregion (GMS) regional health cooperation. The TA will provide a platform for a more coherent policy environment at both national and regional levels, which is supportive of cross-border collaboration and targeting vulnerable populations. The TA will also produce innovative ideas for a regional portfolio.|
|Project Rationale and Linkage to Country/Regional Strategy||
All countries in the GMS are committed to achieving the Sustainable Development Goals for health. While health indicators have generally improved in recent years, communicable diseases remain a constant problem, reflected in rapid transmission rates and high case fatality. Outbreaks in the past decade have had severe economic consequences, (i) severe acute respiratory syndrome (SARS) is estimated to have cost Asian countries $30 billion, (ii) avian influenza A (H5N1) caused $120 million in losses for Viet Nam, and (iii) avian flu-related diseases in Thailand resulted in 1.5% GDP growth loss during 2003 -2004.
Challenging disease control environment. The GMS countries are characterized by increasing populations, dense and highly mobile labor force and inter-connected economies, which make disease control evermore challenging. Poor and marginalized people, including undocumented migrants, indigenous people, youth, and women in border zones disproportionately carry the burden of disease, especially infections such as HIV/AIDS, tuberculosis, malaria, dengue, and neglected tropical diseases. These groups are often excluded from communicable disease control (CDC) programs for a variety of reasons, including economic conditions, cultural beliefs, social acceptability, and perceived affordability. Another major concern in the region is the spread of hospital-acquired infections and drug resistance, particularly of tuberculosis and malaria.
Investing in emerging disease control has a strong public goods rationale. CDC is classed as a regional or global public good, characterized by its non-excludability and non-rivalry. Non-excludability means that once provided, no country can be excluded from consumption and is thus available to all, while non-rivalry suggests that one country's consumption does not impede or limit consumption for another country. These characteristics give rise to free-riding effects, where countries do not want to invest individually and bear the cost while others reap free' benefits. Consequently, the provision of public goods such as CDC is not guaranteed by any one country, and often requires an intervening force to bring relevant stakeholders to invest together. In this sense, global or regional cooperation provides one solution to a collective action problem and is especially important where inter-connected economies allow for movement of people and similarly, diseases. For example, migrants returning with HIV, malaria, or tuberculosis need continuity of treatment to avoid complications and drug resistance. In turn, this requires regional health financing systems and a network of facilities for migrants. Similarly, control of emerging infectious diseases requires both proactive and reactive rapid response, involving multiple actors and cooperation. Regional collaboration also has other benefits such as technology transfer and human resource development, economies of scale, and increased leverage for fund-raising.
|Impact||Healthy lives ensured and well-being promoted for all at all ages (Sustainable Development Goal 3)|
|Description of Outcome||Regional health cooperation in GMS strengthened|
|Progress Toward Outcome|
|Description of Project Outputs||
GMS Working Group on Health Cooperation (WGHC) established
GMS Health Cooperation Strategy developed and implemented
Knowledge development and exchange promoted
|Status of Implementation Progress (Outputs, Activities, and Issues)|
|Geographical Location||Cambodia - Nation-wide; China - Nation-wide; Lao People's Democratic Republic - Nation-wide; Myanmar - Nation-wide; Thailand - Nation-wide; Viet Nam - Nation-wide|
|Summary of Environmental and Social Aspects|
|Stakeholder Communication, Participation, and Consultation|
|During Project Design|
|During Project Implementation|
|Consulting Services||The proposed TA will hire three individual consultants to support overall TA coordination. Flexibility to mobilize expertise will be provided by determining the terms of reference and selection method during TA implementation and as the WGHC is set up. Possible areas of expertise include national planning, regional cooperation, migration, gender, zoonosis, laboratories, surveillance, drug resistance, financing, and knowledge management.|
|Responsible ADB Officer||Sato, Azusa|
|Responsible ADB Department||Southeast Asia Department|
|Responsible ADB Division||Human and Social Development Division, SERD|
Asian Development Bank
6 ADB Avenue,
Mandaluyong City 1550, Philippines
|Concept Clearance||21 Jun 2017|
|Fact Finding||03 Jul 2017 to 07 Jul 2017|
|Approval||22 Aug 2018|
|Last Review Mission||-|
|Last PDS Update||20 Sep 2018|
|Approval||Signing Date||Effectivity Date||Closing|
|22 Aug 2018||-||22 Aug 2018||30 Sep 2020||-||-|
|Financing Plan/TA Utilization||Cumulative Disbursements|
|1,000,000.00||0.00||0.00||0.00||0.00||0.00||1,000,000.00||22 Aug 2018||20,728.00|
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|Title||Document Type||Document Date|
|Strengthening Regional Health Cooperation in the Greater Mekong Subregion: Technical Assistance Report||Technical Assistance Reports||Aug 2018|
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