Recovery – António Guterres has released his latest policy brief on the crisis, which examines impacts on the 11 countries in the subregion and recommendations for the way forward that put gender equality at the centre of response efforts.

“As in other parts of the world, the health, economic and political impact of COVID-19 has been significant across Southeast Asia – hitting the most vulnerable the hardest”, he said in a video accompanying the launch.

Sustainable development off track

Southeast Asia comprises Brunei, Cambodia, Laos, Indonesia, Malaysia, Myanmar, the Philippines, Singapore, Thailand, Timor Leste and Viet Nam.

Prior to the pandemic, countries were lagging behind in achieving the Sustainable Development Goals (SDGs) by the 2030 deadline.

Despite strong economic growth, the policy brief reveals that the subregion was beset by numerous challenges including high inequality, low social protection, a large informal sector, and a regression in peace, justice and robust institutions.

Furthermore, ecosystem damage, biodiversity loss, greenhouse gas emissions and air quality were at “worrying” levels.

Inequalities revealed, tensions surfacing

“The pandemic has highlighted deep inequalities, shortfalls in governance and the imperative for a sustainable development pathway. And it has revealed new challenges, including to peace and security”, the Secretary-General said.

The current situation is leading to recession and social tensions, while several long-running conflicts have stagnated due to stalled political processes.

“All governments in the subregion have supported my appeal for a global ceasefire – and I count on all countries in Southeast Asia to translate that commitment into meaningful change on the ground”, he added.

Regional cooperation praised

The new coronavirus that causes COVID-19 first emerged in Wuhan, China, in late 2019, and the pandemic was declared in March. Globally, there have been more than 16.5 million cases, with nearly 657,000 deaths, the World Health Organization (WHO) reported on Wednesday.

While the disease arrived in Southeast Asia earlier than in the rest of the globe, the UN chief commended governments for acting swiftly to battle the pandemic.

On average, they took 17 days to declare a state of emergency or lockdown after 50 cases of COVID-19 were confirmed, according to the policy brief.

“Containment measures have spared Southeast Asia the degree of suffering and upheaval seen elsewhere,” said Mr. Guterres, who also praised cooperation among the countries.

Four critical areas for response

The Secretary-General underlined four areas that will be critical to ensuring recovery from the pandemic leads to a more sustainable, resilient and inclusive future for Southeast Asia.

The first – tackling inequality in income, health care and social protection – will require short-term stimulus measures as well as long-term policy changes, he said.

Mr. Guterres also advised countries to bridge the digital divide so that no one is left behind in an ever-more-connected world.

ILO/Marcel Crozet

Factory workers in an assembly line in Cambodia.

Due to the over dependence on coal and other industries of the past, he encouraged “greening” the economy, including to create future jobs.

Upholding human rights, protecting civic space and promoting transparency are all intrinsic to an effective response, he concluded.

Advance gender equality

“Central to these efforts is the need to advance gender equality, address upsurges in gender-based violence, and target women in all aspects of economic recovery and stimulus plans,” the UN chief said.

“This will mitigate the disproportionate impacts of the pandemic on women, and is also one of the surest avenues to sustainable, rapid, and inclusive recovery for all.”

Though the challenge is formidable, the Secretary-General underlined the UN’s strong commitment to helping Southeast Asian countries achieve the SDGs and a peaceful future for all.

Creating greater understanding of the importance of these workers in ensuring regional food security is the goal of a new FAO-backed campaign launched on Wednesday.

Described as “a call to action that everyone needs to hear”, it also aims to give voice to family farmers’ organizations and reach out to rural communities through the use of community radio across 15 countries in the region.

“The campaign is calling on all people to value the role of family farmers to achieve food security in this region, especially during the pandemic. Family farmers are the frontline to provide nutritious food for us all. We believe a more resilient family farmer is representing a more resilient world”, said Maria Stella Tirol of ComDev Asia, a communication for development initiative supported by FAO.

Other partners include the Asian Farmers’ Association, the UPLB College of Development Communication, the Association of Community Radio Broadcasters, Digital Green, and the Self-Employed Women’s Association.

Pandemic exposing fragilities

Globally, there are some 500 million family farmers who produce more than 80 per cent of the world’s food, thus contributing to national and even global food security.

In Asia-Pacific, smallholder farmers own and operate the majority of farmland, but they hold less than five hectares per farm. Most of what they produce, or 75 per cent, is sold on to markets, while the remainder is consumed by household members.

FAO explained that food, trade, health and climate are interdependent, and the pandemic has revealed the fragility of these linkages.

The crisis has threatened progress towards achieving the Sustainable Development Goals (SDGs), which promise to bring about a better world for all people by 2030.

Asia is home to some 350 million undernourished people, more than any other region, and FAO feared the pandemic could jeopardize decades of gains in reducing poverty and ending hunger.

Still feeding us all

Smallholder family farmers already earned low average incomes prior to the pandemic and are now enduring worsening conditions, such as a weakening in their purchasing power. Disruptions of food chains have also caused increasing food loss and falling prices.

Despite risks to their health, they continue to play a fundamental role in feeding people everywhere.

“This campaign to advocate for Asia-Pacific’s family farmers, fishers, herders and others is needed now more than ever”, said Allan Dow, FAO’s Asia-Pacific Communication Officer.

“Safeguarding the food security and livelihoods of the most vulnerable people in our vast region is an absolute priority – and with the added impact of this global pandemic a call to action must be loud and clear.”

FAO has created a family farming knowledge platform, with extensive information about COVID-19 impacts on food systems.

The partners in the campaign will also use the platform to reach out to various stakeholders and development partners.

The advance marks the achievement of a critical target in the Sustainable Development Goals (SDGs):  to reduce the transmission of hepatitis B in children under age five to under one per cent by this year.

The news coincides with World Hepatitis Day, commemorated annually on 28 July to raise awareness of the disease, a viral infection of the liver that causes a range of health problems, including liver cancer.  The theme for 2020 – “Hepatitis-free future” – has a strong focus on preventing the disease which attacks the liver, one of the five main strains, among mothers and newborns.

“No infant should grow up only to die of hepatitis B because they were not vaccinated”, said WHO Director-General Tedros Adhanom Ghebreyesus.  “Today’s milestone means that we have dramatically reduced the number of cases of liver damage and liver cancer in future generations.”

Preventing mother-to-child transmission essential

Preventing mother-to-child transmission of hepatitis B is the most important strategy for controlling the disease and saving lives, Dr. Tedros said.

WHO is calling for united and intensified efforts to test pregnant women, provide antiviral prophylaxis to women who need it, and expand access to hepatitis B immunization and its all-important birth dose vaccine.

Globally, more than 250 million people live with chronic hepatitis B infection, according to WHO.  Infants are especially vulnerable – and 90 per cent of children infected with hepatitis B in their first year of life become chronic carriers.  Each year, the disease claims nearly 900,000 lives.

Greater access to vaccine ‘birth dose’ needed

Infants can be protected from hepatitis B through a safe and effective vaccine that provides over 95 per cent protection.

WHO recommends that all infants receive a first dose of the hepatitis B vaccine as soon as possible after birth – preferably within 24 hours – followed by at least two additional doses.  Three-dose coverage during childhood, reached 85 per cent worldwide in 2019, up from 30 per cent in 2000.

However, access to the first critical dose within 24 hours of birth remains uneven.  Global coverage is 43 per cent.  Coverage drops to 34 per cent in the eastern Mediterranean region and only 6 per cent in Africa.

“Expanding access to a timely birth dose of the hepatitis B vaccine is the cornerstone of efforts to prevent mother-to-children transmission,” said Meg Doherty, WHO Director of Global HIV, Hepatitis and STI Programmes.  In sub-Saharan Africa, where the birth dose of hepatitis B vaccine has not yet been introduced, “it is a priority to assure that protection as early as possible”.

COVID-19 hampering progress

A new modelling study by Imperial College London and WHO found that disruptions caused by COVID-19 to WHO’s hepatitis B vaccination programme, could have a serious impact on efforts to reach targets in the global strategy.

Under a worst-case scenario, the study projects that 5.3 million additional chronic infections could be seen in children born between 2020 and 2030, and one million additional hepatitis B-related deaths among those children later on. 

Hepatitis C, once deadly, now highly curable

Speaking at a press conference from Geneva, Dr. Tedros said 325 million people live with hepatitis B or C.  Each year, 1.3 million people lose their lives to these diseases.

The first-ever global hepatitis strategy, adopted by countries at the 2016 World Health Assembly, calls for an end to viral hepatitis by 2030, reducing new infections by 90 per cent and mortality by 65 per cent.

“Even talking about hepatitis elimination would have once seemed a fantasy”, Tedros said, “but new drugs have transformed hepatitis C from a life-long deadly disease into one in most cases can be cured in 12 weeks.” 

While medicines remain too expensive for patients in many countries, the UN health chief pointed to cases of “incredible” progress, notably in Egypt, where 60 million people have been tested for Hepatitis C and linked to treatment, free of charge.  There has also been progress in eliminating hepatitis B in Asia, where childhood immunization coverage is high, including the all-important birth dose. 

Asked about the average cost of a 12-week treatment for hepatitis C in high, middle and low-income countries, Dr. Doherty said the price has fallen from $3,000 to $60 today. 

The price is right

“In many ways, we now have prices that will allow us to end hepatitis C,” she said.  “This is essentially a cure.”  The goal now is to find “the missing millions” of people who have not yet been identified as infected – and to test and treat them so they no longer pass on the virus.

COVID-19 has only made this goal more daunting.  With supply chains and services disrupted, resources diverted, and the political focus shifted to containing the pandemic, there is a real risk of losing gains made.

“Like so many diseases, hepatitis is not just a health problem, it is an enormous social and economic burden”, Tedros stressed.