"The challenge for ASEAN collaboration in health matters is to evolve a distinctly ASEAN agenda for issues which require international cooperation such as emerging and re-emerging infections, the spread of HIV/AIDS, tobacco addiction and pharmaceuticals," stressed Dr. Susan Pineda Mercado, Undersecretary of the Department of Health in her keynote address during the opening of the 17^th Meeting of the ASEAN Sub-Committee on Health and Nutrition (ASCH & N) held in Mactan, Cebu from 20 to 23 October 1999. She urged delegates to recognize diversity in ASEAN and to create ways of integrating regional work with local priorities.

In the area of emerging and re-emerging diseases, an important milestone was achieved by the ASCH & N with the convening of an annual Experts Group Meeting on Disease Surveillance which brought together experts from the ASEAN Member Countries to operationalize the ASEAN Plan of Action on Strengthening Disease Surveillance. This will include health manpower development in epidemiology and establish regional surveillance networking, strengthening laboratory capacity and advocacy.

To address the increasing threat of tuberculosis in the region, projects under the ASEAN Medium Term Program on Tuberculosis Control will be implemented on a cost sharing basis. The use of Directly Observed Treatment Shortcourse (DOTS) is considered by the WHO as the most effective treatment for TB. Migration between ASEAN countries is increasing which poses difficulty in identifying TB cases. The project will be implemented to facilitate TB case management using DOTS as model.

Under the ASEAN Medium Term Plan of Collaboration on Health and Nutrition as adopted by the ASCH & N in 1998, three projects are being planned. One is a regional seminar on health and nutrition to address the health problems arising from changing lifestyle; second, develop a plan of action to address the nutritional aspects of child development and consider the establishment of ASEAN based research centers on child nutrition; thirdly, the health impact of atmospheric pollution, malaria control, food and drug safety, water sanitation and tobacco free ASEAN.

To address the health care need of the elderly, the ASCH & N has implemented the program with a co-sharing basis by Member Countries. Health care providers and policy makers were informed on the clinical implications of health problems of older persons, how to maintain good health and improve their ability to stay independent in the community. The Meeting also recognized the assistance of the WHO in developing programs for regional cooperation in order to improve mechanisms for collaboration.

Philippine Department of Health Secretary Alberto G. Romualdez, Jr. pointed out that it is hightime for ASEAN member countries to do an honest to goodness diagnosis of our work processes and to weed out the kinks in our links through better and closer collaboration within the region.

With clear programs and plans and the commitment of the ASEAN member countries, important steps has been taken by the ASCH & N in order to realize ASEAN vision of caring society by the year 2020.

The output of this 17^th ASEAN Sub-Committee Meeting on Health and Nutrition will be provided to the ASEAN Health Ministers Meeting to be conducted on February 2000 in Yogyakarta, Indonesia and the next ASEAN Meeting will be chaired and hosted by Viet Nam in October 2000 in Ha Noi.