BÖLGESEL SAĞLIK YÖNETİŞİMİ: ASEAN VE GÜNEYDOĞU ASYA’DA SALGIN HASTALIKLARLA MÜCADELE

Bu çalışma, Güneydoğu Asya Uluslar Birliği (ASEAN) bünyesinde bölgesel sağlık yönetişimine yönelik eylemleri, yakın dönemde Güneydoğu Asya’yı etkileyen SARS (Şiddetli Akut Solunum Yolu Sendromu), Kuş Gribi olarak da bilinen H5N1, Domuz Gribi şeklinde de adlandırılan H1N1 ve COVID-19 salgınları kapsamında ele almaktadır. İnsanlık tarihinin çeşitli dönemlerinde toplumlar, salgın hastalıklarla karşı karşıya kalmıştır. 20. yüzyılda tıp alanındaki ilerlemelerin ve aşılamanın yaygınlaşmasının sonuçlardan biri olarak bulaşıcı hastalıkların etkisi büyük ölçüde azaltılmakla birlikte, yakın tarihlerde gözlemlenen salgınlar, modern toplumun salgınlara karşı kırılganlığını göstermektedir. Bu bakımdan sağlık, siyasal aktörlerin dikkate alması gereken politika alanlarından biridir. Toplum sağlığının korunmasında, geleneksel olarak ulusal hükümetler birincil derecede sorumludur. Bununla birlikte devletler, artan oranda sağlık alanında çok taraflı iş birlikleri geliştirmekte ve bu hususta uluslararası kurumsal yapılanmalar oluşturmaktadır zira hareketliliklerin ve akışkanlıkların arttığı çağdaş dönemde bulaşıcı hastalıklar, sınırları aşabilmekte ve birden fazla devleti etkileyebilmektedir. Salgın hastalıkların belirli bir bölge boyunca toplumlar üzerinde olumsuz tesirler ortaya çıkarabilecek faktörlerden biri olması sebebiyle, bu durumla mücadele, devletlerin bölgesel düzeyde de ele aldığı konular arasında yer almaktadır. Bu hususta bölgesel örgütler, küresel ve bölgesel salgın hastalık risklerine karşı sağlık alanında bölgesel bir yaklaşım ve yönetişim yapısı geliştirmeye çalışmaktadır. Bu durum, sağlık sektörünün bölgeselciliğin gündemine dâhil olmasını beraberinde getirmektedir. Bu bağlamda çalışmada, gelişmekte olan coğrafyalarda bulunan devletler arasında kurulmuş bölgesel bütünleşme merkezli en eski örgütlerden biri olan ASEAN bünyesinde bölgesel sağlık yönetişimine ilişkin faaliyetler, Birliğin temel hedeflerini, sağlık sektörüne yönelik yaklaşımını ve kurumsal işleyişini de dikkate alarak, belirtilen salgın hastalıklar çerçevesinde ortaya konulmakta ve ASEAN’ın bölgesel sağlık yönetişimi içerisindeki konumu analiz edilmektedir.

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