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The ASEAN Leaders’ Declaration on Disaster Health Management (ALD on DHM) was adopted at the 31st Summit in Manila in 2017. The Plan of Action (POA) to implement the ALD on DHM was adopted by the ASEAN Health Ministers Meeting in 2019, with Regional Collaboration Committee on Disaster Health Management (RCCDHM) established as a primary implementing mechanism under the purview of ASEAN Health Cluster two and Senior Officials Meeting on Health Development (SOMHD) to operationalize the implementation of the POA with its priority areas and targets to be realized by 2025. The first RCCDHM Meeting was organized in-person in Bangkok in 2020. The RCCDHM is composed of two representatives from each ASEAN member state (AMS), one representative from the ASEAN Secretariat and one representative from AHA Centre, and the secretariat role for the RCCDHM is carried out by the Ministry of Public Health, Thailand. The RCCDHM Meeting decided to develop the Matrix of Detailed Activities (MDA) addressing the five priority areas of the POA-ALD on DHM.
The RCCDHM Meeting organized a core group consisting of the Philippines and Thailand to develop the MDA which identifies information on activities, expected outputs, indicators, lead country, source of support, and the timeline for achieving objectives of the POA. During the COVID-19 pandemic, online communication was applied to discuss and coordinate among the AMS.
The core group developed the draft MDA in consultation with the ASEAN Secretariat/Health Division. After a series of discussions, the RCCDHM endorsed the MDA which confirms necessary activities and commitment of AMS.
The review and endorsement process for the MDA will be elevated to the higher level meetings in the ASEAN Health sector for final approval. The RCCDHM also confirmed to strengthen collaboration with other ASEAN initiatives, non-health ASEAN sectors, UN, or other international partners, and the ARCH Project.
ASEAN Leaders’ Declaration on Disaster Health Management (ALD on DHM) (2019-2025) was adopted by the ASEAN Summit in November 2017 to strengthen the DHM system at national and regional levels, and the Plan of Action (POA) to implement the ALD on DHM was endorsed by the ASEAN Health Ministers Meeting in August 2019. Knowledge Management (KM) is one of the five priority areas in the POA with the relevant targets including the regional academic network establishment, organization of regional academic conferences, publication of the ASEAN academic journal on DHM, and so forth. The ARCH Project Phase2 (ARCH2), which started in January 2022, focuses on aiming to support implementation of this POA.
The ARCH2 will support the establishment of the ASEAN Academic Network on DHM (AAN-DHM) and the ASEAN Institute for DHM (AIDHM). In addition, the ARCH2 will support the promotion of academic activities on DHM which shall be conducted under the AAN-DHM in collaboration with the AAN member institutes and AIDHM.
Terms of Reference (TOR) of AAN-DHM was endorsed by the 15th ASEAN Health Ministers Meeting in May 2022. Afterward, the National Focal Point (NFP) institutes for the AAN were nominated among all ASEAN Member States (AMS). The first meeting of representatives of the NFP was held in September 2022 to discuss several areas such as governance of the AAN-DHM, the organization plan for the ASEAN Academic Conference (AAC), and the publication plan of the ASEAN Journal. Simultaneously, the TOR of the AIDHM was prepared for further discussion of its establishment.
The AAN has already been established to initiate the preparation of its academic activities. The AAC on DHM is scheduled to be held in November 2023 in Indonesia as the first regional event for accelerating academic activities toward enhancing KM on DHM in the region under the AAN-DHM.
Knowledge management on Disaster Health Management (DHM) is one of the priority areas in the Plan of Action to implement the ASEAN Leaders’ Declaration on DHM (POA/ ALD DHM) (2019-2025). The Japan International Cooperation Agency (JICA) has been implementing the Project for Strengthening the ASEAN Regional Capacity on Disaster Health Management (ARCH Project) since 2016 to assist the ASEAN region in strengthening coordination capacity on DHM. A regional training course on DHM for ASEAN member states (AMS) in Japan was proposed to be implemented in 2022 as a JICA’s Knowledge Co-creation Program (KCCP).
The training curriculum of the KCCP included emergency and disaster medicine in Japan, international trends on DHM, and underwent reviews by AMS representatives of the ARCH Project. Prior to the training, participants were required to prepare country reports (CRs) outlining information on legislation, system and structure related to emergency and disaster medicine, as well as systems to receive international emergency medical teams (I-EMTs).
The four-week KCCP course contained a trial implementation of a four-day training program for receiving I-EMTs and coordination among stakeholders in ASEAN disaster response, based on the regional standard curriculum developed by the ARCH Project, and invited experts in DHM not only from Japan but also from AMS as instructors. Participants analyzed and identified challenges on DHM in their countries, and developed draft action plans (APs) to improve the situation through the knowledge obtained from the program.
The draft APs, the training deliverables, will be shared with the ARCH Project, and used to build a support mechanism to achieve national level targets of the POA/ ALD DHM, and the progress will be reflected in the CR in the subsequent year. The KCCP on DHM is expected to facilitate knowledge sharing in AMS and Japan, and contribute to fostering the culture of mutual learning.
The Standard Operating Procedure for Coordination of Emergency Medical Teams in ASEAN (EMT SOP) was developed to facilitate the swift deployment of I-EMTs by ASEAN Member States (AMS) to disaster-affected countries in the ASEAN region and to effectively provide appropriate medical services to the affected population. It is one of the various products and activities by the ARCH Project, which was implemented in collaboration between ASEAN and Japan from 2016 through 2021. The EMT SOP was developed in line with the WHO EMT Initiative, and various WHO forms have been incorporated as ASEAN official forms for the management and coordination of I-EMT.
On the other hand, disaster management in ASEAN is conducted by National Disaster Management Organization (NDMO) of each AMS under the coordination of the ASEAN Coordinating Centre for Humanitarian Assistance on disaster management (AHA Centre) in accordance with the Standard Operating Procedure for Regional Standby Arrangements and Coordination of Joint Disaster Relief and Emergency Response Operations (SASOP), the sole official document for ASEAN regional collaboration in disasters, and AMS I-EMTs are required to follow the SASOP for their deployment to the affected AMS.
Discussions were held between the NDMOs and MOHs, and a table-top exercise to test the EMT SOP was conducted involving NDMOs and MOHs with the facilitation of the AHA Centre.
The EMT SOP has been incorporated as an additional chapter of the SASOP.
The institutionalization of the EMT SOP is an important milestone in strengthening the ASEAN regional cooperation mechanism on disaster management.
This report tries to capture the impact of the Project for Strengthening the ASEAN Regional Capacity on Disaster Health Management (ARCH Project) in each ASEAN Member State (AMS) and Japan as a result of the ARCH Project implementation since July 2016.
Impact on AMS: The analysis of the impact on AMS was based on a comparison of the impact of the project on management and coordination of Emergency Medical Teams (EMTs), and application of the project outcome in actual emergency operations compared to the previous status in each AMS.
Impact on Japan: The history of the development of disaster medicine in Japan was reviewed, with an aim to analyze the impact of supporting AMS through the ARCH Project on Japan, and the possibility of bi-directional cooperation in the future.
Impact on AMS: Since the initiation of the ARCH Project, AMS has made significant progress in WHO EMT accreditation, strengthening EMTCC capacity for receiving international assistance, as well as the development of legislation or strategic plans related to DHM, and application of the Project products such as standard operating procedures or regional tools in actual disasters/emergencies.
Impact on Japan: Disaster medicine in Japan originated from the Cambodian refugees’ relief mission in 1979. Since then, the management system has been strengthened including the foundation of the Japan Disaster Relief (JDR) Team, a structure with a legal foundation. The experience gained through international operations has contributed to the development of Japan’s domestic disaster response system. Japan learned the operational effectiveness of the post-disaster health surveillance system through the disaster response operation in 2013 Typhoon Yolanda Disaster in Philippines and introduced a modified system in Japan for domestic disaster response, which was later refined and proposed for an international standard.
ARCH Project is highly appreciated by AMS as the opportunity to share knowledge and experience among countries and thereby contributing to achieving the “One ASEAN, One Response” concept, as well as the driving force for each AMS to develop its capacity in DHM. While the ARCH Project started to support AMS to strengthen its regional capacity in disaster health management, it is important to build a bi-directional relationship between ASEAN and Japan in terms of mutual learning and support to tackle future disasters.
This paper aims to clarify how the Project for Strengthening the ASEAN Regional Capacity on Disaster Health Management (ARCH Project) strengthened regional collaboration mechanisms on disaster health management (DHM) in ASEAN.
The political process and the relevant documents of the ARCH Project were reviewed.
The ARCH Project established the Regional Coordination Committee as a coordination platform for providing strategic direction to the project and strengthening the regional coordination of DHM. Also, the Project Working Groups and Sub-Working Groups were set up as implementation bodies for the project activities with representatives of ASEAN Member States (AMS). With support from DHM experts of Japan and Thailand, a series of discussions were conducted for the development of a Standard Operating Procedure (SOP) for the Coordination of International Emergency Medical Teams (I-EMTs), regional tools, and collective measures supporting AMS to overcome challenges, and thereby meeting the minimum requirements set by the WHO EMT Initiative. The progress and outputs of the ARCH Project are subsequently elevated to the ASEAN Health Sector for endorsement, the updates are further shared to the Joint Task Force to Promote Synergy with Other Relevant ASEAN Bodies on Humanitarian Assistance and Disaster Relief (JTF-HADR) for the implementation of the ASEAN Declaration on One ASEAN One Response. The initiation of the ARCH Project in July 2016 has resulted in the development of the ASEAN regional collaboration framework, including the establishment of the Regional Coordination Committee on Disaster Health Management (RCCDHM), the SOP for ASEAN I-EMT coordination, and regional tools, such as forms for Medical Record for Emergency and Disaster and Health Needs Assessment. Moreover, further discussions on ASEAN Collective Measures that aim to support AMS to meet the WHO EMT minimum standards and strengthening I-EMT coordination capacity were also conducted. As adopted by the ASEAN Health Ministers Meeting (AHMM) in 2019, the RCCDHM was established as one of the mechanisms to operationalize the Plan of Action to implement the ASEAN Leaders’ Declaration on DHM.
The contribution of the ARCH Project to strengthen the ASEAN regional capacity in DHM has enhanced the regional coordination platform, with a formalization of RCCDHM as ASEAN’s official regional mechanism, and of the on-going integration process of the SOP for EMT coordination into the ASEAN SASOP.
Differences in individual eating habits may be influenced by genetic factors, in addition to cultural, social or environmental factors. Previous studies suggested that genetic variants within sweet taste receptor genes family were associated with sweet taste perception and the intake of sweet foods. The aim of this study was to conduct a genome-wide association study (GWAS) to find genetic variations that affect confection consumption in a Japanese population. We analysed GWAS data on confection consumption using 14 073 participants from the Japan Multi-Institutional Collaborative Cohort study. We used a semi-quantitative FFQ to estimate food intake that was validated previously. Association of the imputed variants with confection consumption was performed by linear regression analysis with adjustments for age, sex, total energy intake and principal component analysis components 1–3. Furthermore, the analysis was repeated adjusting for alcohol intake (g/d) in addition to the above-described variables. We found 418 SNP located in 12q24 that were associated with confection consumption. SNP with the ten lowest P-values were located on nine genes including at the BRAP, ACAD10 and aldehyde dehydrogenase 2 regions on 12q24.12-13. After adjustment for alcohol intake, no variant was associated with confections intake with genome-wide significance. In conclusion, we found a significant number of SNP located on 12q24 genes that were associated with confections intake before adjustment for alcohol intake. However, all of them lost statistical significance after adjustment for alcohol intake.
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