Why Asia Should Unite Against SARS

Brad Glosserman (Director of Research, Pacific Forum CSIS)

This article originally appeared in the April 17, 2003 issue of South China Morning Post in Hong Kong and is reproduced here with permission from the publisher.

The rapid spread of severe acute respiratory syndrome (Sars) is a compelling demonstration of the need for a truly global health network to fight future epidemics.

The particulars of this outbreak also highlight the role that the Asia-Pacific region will have to play in this effort. Its population density, income and development disparities, and economic dynamism create an environment that breeds and facilitates the spread of these diseases.

The problem has existed for some time; Sars has underscored the need for a more creative response to such outbreaks. One avenue, relatively unexplored, is the Asia-Pacific Economic Co-operation (Apec) forum. Sars is an opportunity to invigorate this sometimes moribund institution.

The Sars casualty count keeps growing. Although the disease has a fatality rate of about 4 per cent - the same as flu - it is spreading exponentially. The economic toll is mounting with the human one.

Sars is the most serious incident to hit Southeast Asia since the 1997-98 financial crisis. It has had a far worse impact than the war on Iraq. Morgan Stanley has cut its forecast for growth in Asia, excluding Japan, from 5 per cent to 4.6 per cent, and that may be optimistic. Several countries will be pushed into recession as a result of Sars.

Sars is the ugly side of globalisation. Its transmission has been facilitated by the international mobility that most of us take for granted. The interconnectedness of the global economy ensures that its economic effects will be transmitted with similar ease. Tourism and tourist-related industries have been hit hardest, but no sector is immune. Retail sales in Hong Kong fell 50 per cent last month. Restaurants are empty. Schools have been closed.

China continues to be the great unknown. It is generally believed that the disease originated in Guangdong province. The Chinese government's response to the outbreak has badly damaged its credibility. There are still no reliable Chinese statistics and co-operation with international health authorities has been grudging at best. Forecasters believe that Sars could cut China's growth by between 0.2 per cent and 1 per cent, but those estimates do not take into account the potential drop in foreign investment that would follow if businesses continue to worry about the disease in China.

Keep an eye on the China Export Commodity Fair, under way in Guangzhou. Last year, more than 120,000 people attended, closing deals worth nearly US$17 billion (HK$132 billion). The figures this year are likely to be much lower and will serve as a bellwether on the impact of Sars.

Given the global impact of the disease, the World Health Organisation (working closely with the US Centres for Disease Control and Prevention) has been leading the response to Sars. But while the WHO leads, Asia-Pacific institutions can and should make important contributions. After all, Sars originated here and this region has been hit hardest. And most important, there is a channel - Apec - through which governments can work.

Infectious diseases were on the agenda at the first science and technology ministerial meeting in 1995, and became the focus of the group's first health initiative. Prevention and control of infectious diseases was explicitly identified as a key concern in Apec's industrial science and technology working group medium-term work plan. Apec has established an emerging infectious diseases network, Apec EINet, which provides internet-based information sharing throughout the region.

At the 2001 summit, Apec leaders endorsed a strategy to combat infectious diseases, and senior officials have been monitoring progress ever since.

The Apec action framework on emerging infectious diseases covers systems development, disease surveillance, outbreak response, prevention and control, and research. It stresses self-action and co-operation, primarily through sharing guidelines, assessing capabilities and collaborating to maximise resources.

The framework is comprehensive, but the Sars outbreak shows it is not enough. More aggressive action is required. Apec leaders should convene a health summit to show that Sars is a priority issue. Ideally, China would call the meeting: It would give the new leadership a chance to demonstrate its commitment to finding a solution and ending the bureaucratic practices that obscure more than they reveal. The call for a summit would also show China's readiness to take a leading role in regional affairs. If a leaders' summit is too ambitious, a meeting of senior health officials is not. Chinese officials need to take charge and reassure the public that checking the spread of Sars is a top priority.

An Apec summit would help invigorate an institution that is often derided for being ineffectual and a mere talking shop. Apec should work with the WHO to set standards that ensure disease outbreaks trigger reporting under the Global Outbreak Alert and Response Network. Apec could help develop guidelines for monitoring and quarantine procedures for travellers during outbreaks.

Apec has one other important advantage when it comes to fighting Sars and other infectious diseases: it includes Taiwan. The island has, thus far, recorded 23 cases of the disease, but collaboration with the WHO is restricted because Taiwan is not a member or an observer of the organisation. Sars underscores the importance of including all nations in the fight against these epidemics. A single sanctuary is one too many.