COVID-19 has brought the world to its knees as it massively impacts economies, big or small, with the deadly virus claiming millions of lives. As of May 20, 2021, COVID-19 has accounted for 166 million cases and 3.5 million deaths worldwide1. In the past months, following the steady drop of cases, Southeast Asia and many countries experienced a resurgence, putting significant pressure from different parts of the world to double efforts to control the virus. Governments enforced heightened surveillance measures as new COVID-19 variants from the UK, the US, and other countries emerged2. Experts say that it will take years to end the pandemic.
Following these developments, various health systems are already changing gears in their countries’ COVID-19 response. Amidst this, the necessity to build testing facilities at the height of succeeding waves of COVID-19, the urgency to supply tons of personal protective equipment, and the challenge to augment the availability of medicines to treat the disease continues.
Whether the country is rich or poor, governments struggle to return to normal amid socio-economic pressures. As stringent lockdowns and quarantine protocols across nations resulting in economic disruptions continue, many pre-existing health and social issues have been amplified. These include the glaring lack of access to primary care facilities and halted provision of health services due to transportation restrictions. Many vulnerable sectors, such as migrants and refugees, people living in poverty, people with disabilities, and people in detention have been affected. The pandemic, along with gaps in the delivery of services, hampered humanitarian efforts3. New challenges also rose with the rising number of mental health concerns and domestic violence among women and children as they stay at home with their families. The rate of joblessness has increased, and companies enforced reduced workhours. Access to information among men and women and the growing digital divide have hampered people from empowered decisions in the crisis. These, all together, have taken a toll not only on people’s health but also on the countries’ gross domestic products.
For several months, countries have waited to develop vaccines to stop the virus around the world. However, vaccine availability will notably not solve the problem, as concerns on access, reliability, and efficacy are other issues to consider. With the World Health Organization (WHO) efforts, through the Access to COVID-19 Tools (ACT)Accelerator and development partners worldwide, a facility was launched to ensure equitable development and distribution of vaccines across countries. Tagged as COVAX, this global partnership guarantees that countries that can pay will not disadvantage other poorer countries to secure their vaccine supply. On top of this, COVAX also ensures that health workers and people with comorbidities are prioritized. Coordinated with GAVI, the Vaccine Alliance, the Coalition of Epidemic Preparedness Innovation (CEPI), and the WHO, COVAX will supply the world’s 2 billion vaccine doses by the end of 2021. As of April 2021, there have already been 40 million doses made available to more than a hundred countries through this facility4.
In Southeast Asia, many countries in the ASEAN region are taking advantage of the COVAX to make vaccines available to them. Singapore is the first country to commence vaccination of its citizens in December 2020, followed by Indonesia in January 2021. Succeeding countries like Malaysia, Thailand, Laos, Myanmar, Cambodia, and Vietnam followed. Despite GAVI’s efforts, reports show that high-income countries with only 16% of the world’s population have already had access to 60% of the vaccines5. In the midst of this, challenges persist on vaccine distribution and logistics management as the rate at which countries do the vaccination depends on vaccines’ arrival, pushing several countries to rely on other sources of vaccines6. Countries like China, India, and Russia respond to this with the rise of vaccine diplomacy that paved the way for vaccine supply to other countries that cannot produce their vaccines. It is evident that, given these circumstances, Southeast Asian nations would need to revisit or monitor their economic relationship with these countries. Countries in this region also thought of ways to enable travel, with digital vaccine certificates as part of vaccine rollout proposals7. Southeast Asian leaders contemplate bilateral and multilateral agreements regarding travel restrictions and vaccine passports, among others.
In the Philippines, lockdowns have resulted in a projected 214,000 babies born in 2021 as access to reproductive health services, especially the poor, has been interrupted8. The country’s Population Commission regarded this unprecedented event as a “national social emergency.” Furthermore, the disruption of services has caused the decline in ante-natal check-ups and delivery due to most mothers’ fear of contracting the virus in health facilities. Before the pandemic, around 2,600 mothers died every year in the country. However, in 2020, an additional 670 mothers or a 26% increase in maternal deaths have been recorded due to the pandemic9. There was also an observed rise in psychiatric symptoms during the early phase of the pandemic10. To curb these effects and return to normal, the Philippines targets 70 out of 108 million Filipinos for vaccination in the next three to five years.
Following the Food and Drug Administration’s recommendation, there are eight (8) vaccines for use nationwide. Being the country with the second-highest COVID-19 cases, more than 30 companies signed an agreement to purchase an additional 2.6 million vaccine doses. Private companies intervened to fast-track inoculation activities in the country11. In January 2021, the Philippines released its national deployment and vaccination plan, which outlines the vaccination roadmap from evaluation, access, procurement, and distribution up to implementation and assessment. It also has special chapters on governance, risk communication and community engagement, and registry and data management12.
Singapore, on the other hand, has responded uniquely to the pandemic. Amidst the crisis, the government empowered small and medium enterprises (SMEs), especially in electronic commerce and digitization, to recover. However, as the country strives to adapt to the pandemic, several challenges persist, such as domestic violence and unfavorable living conditions among migrants. Singapore’s Association of Women for Action and Research (AWARE) reports a 33% increase in helpline calls related to family violence in February at the onset of the pandemic13. Migrant workers are also a particular concern as more than 150,000 dormitory residents contracted COVID-19. This event has brought the government’s attention to mainstream conversations on living conditions, mental health, and pay among the vastly migrant-habited Singapore14. Furthermore, prejudice and racism increased due to differences in language and culture15. In terms of vaccination, Singapore is a model across the ASEAN as it leads with the highest vaccination rate, and 30% of its people vaccinated at least with the first dose16.
Meanwhile, Malaysia exhibited solidarity actions as non-profit organizations launched a COVID-19 pandemic fund to support the medical needs of marginalized groups in the country. The government has also relaxed the payment of loans through relief policies. Similar to Singapore, underlying socio-economic impacts have been prevalent, such as the rising healthcare costs among foreigners and migrant workers. Many, especially the undocumented, have struggled to access health care due to fear of being put under detention during COVID-19. To ease these burdens, the government has developed the Employee Provident Fund (EPF), Private Retirement Scheme (PRS), and Employment Retention Programme (ERP) to assist workers in these situations. However, these are limited to formal workers only17. Despite these challenges, the country also proved instrumental in becoming the Association of Southeast Asian Nations(ASEAN)’s leader of the Public Health Emergency Operations Center Network (PHEOC), ASEAN Plus Three Field Epidemiology Training Network (ASEAN+3 FETN), and the ASEAN Risk Assessment and Risk Communication Centre (ARARC) as part of the ASEAN’s COVID-19 response18.
With these in mind, it is evident that more vital regional collaboration is necessary to combat the adverse effects of the pandemic as countries move towards a holistic overview of COVID-19 response following the testing, tracing, and treatment strategies.