Fourth Intellectual Dialogue on Building Asia's Tomorrow

Health and Human Security: Moving from Concept to Action

Summary of Discussions

Session 4

The final session discussed what needs to be done to operationalize the human security concept as a policy tool. Suggestions made during this session can be grouped into the following five categories:

1. to make the health human security everyone's business
2. to convince national governments of the importance of the concept
3. to convince and mobilize regional and global institutions
4. to rely on track 2
5. to use the market mechanism

(1) Making the Health and Human Security Everyone's Business

Quite a number of participants emphasized the importance of making the health and human security issue everyone's business, and they underscored the crucial importance of education and information in this process.

A Japanese participant pointed out that the health issue today is not only about the treatment of the sick, but it consists of the whole process of the health care system, i.e. (1) the first stage of health promotion for individuals based on individual responsibility; (2) preventative health care services, including health education; (3) early access to care; (4) early treatment and rehabilitation; (5) return to one's routine life or into terminal care. Human security is a key word to convince people that the health issue should be a core and common agenda for everyone.

A Southeast Asian intellectual observed that there are many people who are still very much unconvinced that information, education, and services could be acquired; issues of health could be treated; and information about health could be found. Therefore, he went on to underscore the primacy of education and information.

Another participant from Japan stressed that we need to put more efforts into developing a strategy to make human security a domestic issue in each country as well as a global issue. In his judgement, it is difficult for the general public to imagine what this concept is all about in concrete terms. Therefore, he concluded that there must be efforts to take action in all corners of society to make human security a domestic issue.

A medical doctor participant referred to the securitization of health (or human securitization); he believes that health has been under-prioritized in the political and public allocation process and that a demedicalization of health is very important to remedy this situation. According to this participant, it is not just that health has low priority, but that it is too important to be left in the hands of doctors alone. Human security can help make health everybody's business, which is an important part of the human securitization process.

(2) Convincing National Governments

While various actors are expected to play major roles in the promotion of health care as a human security issue, some believe that the role of national governments should not be underestimated. One Southeast Asian scholar believes that the government remains to be one of the most critical stakeholders. As such, we need to convince the government of the critical importance of human security, and the strategy is to link human security to values that appeal to power holders. They are interested in political stability and legitimacy, and human security can address these two things.

Another participant from ASEAN sees it as imperative to make the concept (and resultant actions) acceptable to Asian countries. He believes that we will have to start with bureaucrats and governments, because in the Asian context, agreement and acceptance by upper levels are indispensable. He cautioned that we must be careful to plan well the presentation of human security.

A third ASEAN participant stated the importance of persuading donor countries that investing in human security is in their own interests. When people in all societies have a level of human security, he claims that it will prevent the future recurrence of incidents like the 9-11 attacks.

Quite a number of participants referred to the special role of Japan in promoting human security. A Southeast Asian participant stated that if Japan thinks that human security is an important tool, then Japan's international cooperation community, including all the agencies involved, will have to adopt this idea as part of their operating procedure.

A Japanese participant also conceded that Japan should be more active in conveying the message that it is placing higher priority on human security through government-to-government dialogues on Japanese aid and ODA. It would also help the human security perspective gain more support from the Japanese public.

Another Japanese participant, in return, assured that the Japanese government is paying more attention to health issues as a common agenda for Asia.

(3) Mobilization of Regional and Global Institutions

Some participants stressed the utility of using regional and international organizations to promote human security. An ASEAN political leader believes that it will be necessary to make this concept known and to try to sell this idea to the ASEN+3 entities. He cautioned, however, that the introduction should be conducted carefully and tenderly to ASEAN+3.

Another participant advocated an ASEAN audit on human security. He argued for an audit of all ASEAN countries on human security, for tracking progress, and for the advocacy of specific policy and operational improvements to move countries from where they are to where they want to be. It would not mount to imposing an outside measuring stick, but rather have countries audit themselves as to where they are in terms of human security. This auditing could involve financing and tracking the resources in human security.

Institutions with more global scope should also be mobilized. Particularly on health, one participant argued that we must communicate to WHO, World Bank and ADB that health has been appropriated as a dimension of human security in our communities, and accordingly, they could consider their own projects with this conceptual tool in mind so the idea could gain currency. If these institutions are convinced and adopt this conceptual tool, he predicts that we can gain the necessary momentum.

(4) Promotion of Human Security through the Track 2

Voices were heard mainly from ASEAN participants on the effectiveness of the track 2 in promoting human security in Asia. One argued that track 2 institutions could be used as a platform to broadcast and develop the idea, which will develop constituencies in every country based on intellectual skills. For instance, the human rights colloquium in ASEAN/ISIS can serve as a forum to discuss human security. Other track 2 devices such as ASEAN People's Assembly and ASEAN Vision 2020 could also address human security themes. Through ASEAN/ISIS, linkages between government and civil society organizations could be facilitated. Thus, we must create a track 2 for human security

Another ASEAN participant called attention to the East Asian Development Network, which is a network of think tanks linked together with Global Development Network. Research could be done through these networks.

(5) Use of Market Mechanism: Pros and Cons

One factor over which participants did not quite agree among themselves was the wisdom of relying on the market mechanism. Some positively evaluated the potential role of the market, especially the corporate sector, in terms of building constituencies. He argues that there are aspects of health that are going to be marketized, beginning with the care of the elderly. He foresees increased opportunities for the corporate sector to work in the realm of health care, especially in China where one sees investment in old age homes by the private sector. He thus predicts that there is going to be a marketization of aspects of the health issue.

On the other hand, some were very cautious about an increased reliance on the market mechanism. One claimed that there are social and public responsibilities in health that must override market failures. His opinion was based on the past experiences of not being sufficiently successful in introducing universal access to health care with high quality and reasonable levels of efficiency, which in his judgment is an unfinished challenge for Asia.

Another participant from Southeast Asia also agreed that health must be taken out of the market system. For example, issues of drug production of, research, etc. must be not left to the market system.