Special Meeting on SARS, 2003

1. The Special ASEAN + 3 Health Ministers Meeting on Severe Acute Respiratory Syndrome (SARS) was convened from 10 to 11 June 2003 in Siem Reap, Cambodia, to follow-up on the operationalisation of the decisions of the ASEAN + 3 Ministers of Health Special Meeting on SARS held in Kuala Lumpur on 26 April 2003, the Special ASEAN Leaders Meeting and the Special ASEAN-China Leaders Meeting on SARS held in Bangkok on 29 April 2003. The Special ASEAN + 3 Health Ministers Meeting on SARS was preceded by the Special ASEAN + 3 Senior Health Officials Meeting on SARS held from 8 to 9 June 2003.
2. The Meeting was attended by the Health Ministers or their Representatives from ASEAN Member Countries, the People’s Republic of China, Japan and the Republic of Korea. The ASEAN Secretariat and Observers from Canada, Mongolia and the World Health Organisation (WHO) were also in attendance (See attached list of ASEAN + 3 Health Ministers or their Representatives).
3. His Excellency Dr. Hong Sun Huot, Senior Minister and Minister of Health of Cambodia, in his Opening Remarks, welcomed the ASEAN + 3 Health Ministers to the Meeting and expressed his hope that ASEAN+3 collaboration will be further strengthened and intensified in combating SARS. Noting that much progress has been made in stopping SARS, H.E. Dr. Hong Sun Huot emphasized that the SARS threat is not yet over and that ASEAN+3 countries should use their experience in responding to SARS to strengthen regional capacity to effectively meet the challenge of the next SARS or the next new and emerging infectious diseases.
4. Dr. Shigeru Omi, Regional Director of the WHO Western Pacific Region, in his Keynote Address noted that the SARS situation today is very different from six weeks ago when the ASEAN Health Ministers met in Kuala Lumpur on 26 April 2003.  Thanks to the commitment of the governments of the region to fight SARS and the implementation of aggresive and prompt control measures, the SARS epidemic appears to be under control.  The number of new cases has been dropped very significantly and there is a clear and consistent downward trend in both cases and deaths.  However, as the WHO Director General has pointed out, this was not the time to sit back.  We should use this breathing space to really build up national disease surveillance and outbreak response systems to better respond to any disease outbreak in the future.
5. His Excellency Sar Kheng, the Deputy Prime Minister and co-Minister of Interior of Cambodia, in his Closing Remarks highlighted Cambodia’s efforts in the fight against SARS.  The Deputy Prime Minister noted the serious impact of SARS on public health, the economy, trade, tourism and social stability as well as poverty eradication efforts. H.E. Sar Kheng also emphasized that regional cooperation on SARS control and prevention has helped Member Countries gain a better understand of the serious threat of SARS. He therefore stressed the need for strengthening international and regional solidarity in the face of SARS and future threats. 

Update on the SARS Situation

6. Recognizing the challenges posed by the SARS epidemic and fully aware of its potential impact on the well-being and livelihood of the people, the health systems and the economy, the Ministers acknowledged the great efforts, individually and collectively, made by countries with affected areas to implement effective measures to contain the spread of SARS. The collective efforts by all ASEAN Countries have borne fruit as evidenced by the last case being isolated in the region on 11 May 2003 which is 30 days ago. The region is now free of local transmission and ASEAN is a SARS free region. The Ministers therefore urged countries which have issued travel advisories to ASEAN countries to withdraw such advisories.
7. The Ministers congratulated the government of China for its very strong political commitment in containing SARS and its utmost efforts to improve the quality and timeliness of surveillance. The Ministers also added that China can make further improvement in obtaining information such as: a) the date when cases were isolated; and b) how the patients have become infected (either through community-based or hospital-based transmission). By doing so, the Ministers believe that China can make further contributions to the global containment of SARS.

Update on the Implementation of the Summit and Ministerial Directives on SARS

8. The Ministers noted the progress made in the implementation of the directives contained in the Joint Statement of the ASEAN + 3 Ministers of Health Special Meeting on SARS held on 26 April 2003 in Kuala Lumpur, the Joint Declaration of the Special ASEAN Leaders Meeting on SARS held on 29 May 2003 in Bangkok, and the Joint Statement of the Special ASEAN-China Leaders Meeting on SARS also held on 29 April 2003 in Bangkok. Notwithstanding the progress made in curbing the spread of SARS, the Ministers noted that ASEAN + 3 countries need to remain vigilant and committed to ensure that there is no let up in implementing the preventive and control measures that have been put in place.
9. The Ministers noted that several important initiatives have been implemented. Member Countries have established their respective national multi-sectoral task forces and that the Ministries of Health of Member Countries have appointed their contact points for the routine exchange of information on SARS. A “hotline” has been set up among the Health Ministers and their senior officials to facilitate communication in an emergency.
10. The Ministers noted with satisfaction that a number of high-level ASEAN and ASEAN+3 meetings on labour, transport, tourism, information and health have addressed the SARS issue following the Special ASEAN Leaders Summit on SARS and the Special ASEAN-China Leaders Meeting on SARS held on 29 April 2003 in Bangkok. The Ministers reaffirmed that a multi-sectoral response was the only effective way to deal with SARS since its impact went beyond the health sector. They expressed their commitment to further work with relevant sectors in continuing efforts to prevent the spread of SARS and other infectious diseases.
11. The Ministers noted that the ASEAN+3 Labour Ministers Meeting held on 9 May 2003 in Indonesia had agreed to convene an ASEAN+3 Special Senior Labour Officials Meeting on SARS in early July 2003 in the Philippines. The Meeting will address the impact of SARS on labour, employment , human resources and occupational safety and health, including the role of the social partners in easing the impact on retrenchments, unemployment and worker protection.
12. The Ministers noted with appreciation that the Philippines has successfully organised the “Aviation Forum on the Prevention and Containment of SARS” from 15 to 16 May 2003 in Clark Special Economic Zone, Pampanga, Philippines. Forum participants stated their intention to take measures to prevent and contain the spread of SARS, including standardized airport procedures for passenger screening.
13. The Ministers also noted with appreciation that China has completed two activities, namely: the “China-ASEAN Entry-Exit Quarantine Meeting on SARS” held from 1 to 2 June in Beijing, during which the Entry  – Exit Quarantine Action Plan for Controlling the Spread of SARS by Governments of the People’s Republic of China and ASEAN was adopted, and the “ASEAN, China, Japan and the ROK (10+3) High-Level Symposium on SARS held from 3 to 4 June in Beijing.
14. The Ministers recognised the solidarity of ASEAN + 3 and other partners when they cooperatively and successfully worked out the Resolution on SARS which was adopted by the 56^th World Health Assembly held from 19 to 28 May 2003 in Geneva.
15. The Ministers also noted that Malaysia will host the WHO Global Conference on SARS from 17 to 18 June 2003 in Kuala Lumpur to review the epidemiological, clinical management and laboratory findings on SARS, and discuss global control strategies. The Ministers encouraged ASEAN + 3 countries to attend the Conference. 
16. As for the efforts currently underway to strengthen the region’s capacity to prevent and control SARS and other new and emerging infectious diseases, the Ministers noted with satisfaction the progress made in implementing the following:
    1. Thailand’s proposal to organise a consultative meeting to strengthen the capacity of ASEAN+3 countries in epidemiological surveillance from 24 to 26 June 2003 in Bangkok;
    2. Malaysia’s work plan on the project proposal to strengthen capacity and quality assurance of diagnostic laboratories to support infectious disease surveillance in the ASEAN+3 countries and the convening of its first meeting from 7 to 8 July 2003 in Kuala Lumpur;
    3. Indonesia’s initiative to improve the ASEAN-disease-surveillance.net website and to set up an ASEAN+3 SARS homepage to disseminate information on SARS epidemiology, prevention and control, with links to the SARS websites of ASEAN+3 Countries, the ASEAN Secretariat and WHO. The work plan for strengthening the SARS website would be prepared by Indonesia and circulated to Member Countries for review by 30 June; and
    4. Formulation of a longer-term ASEAN+3 work plan for strengthening surveillance of new and emerging diseases. The ASEAN Secretariat will prepare a terms of reference for the project and circulate it to Member Countries for review by 30 June 2003.
17. The Ministers reaffirmed their commitment to implement fully the decisions as contained in the Special ASEAN Leaders Meeting on SARS held on 29 April 2003 in Bangkok and the ASEAN+3 Health Ministers Special Meeting on SARS held on 26 April 2003 in Kuala Lumpur.

ASEAN+3 Action Plan on Prevention and Control of SARS and Other Infectious Diseases

18. To further operationalise the Summit and Ministerial directives on SARS, the Ministers adopted the framework ASEAN+3 Action Plan on Prevention and Control of SARS and other Infectious Diseases with the following priority areas:
    1. a.      Guidelines for International Travel;
    2. b.      ASEAN SARS Containment Information Network;
    3. c.      Capacity Building for Outbreak Alert and Response (e.g. Early Warning System/ASEAN Centre of Excellence for Disease Control); and
    1. d.      Public Education and Information.
19. The Ministers requested the ASEAN Secretariat to prepare, in consultation with the ASEAN+3 Senior Health Officials, a detailed Action Plan which would include institutional mechanisms for coordination, strategies for resource mobilisation, timelines for implementation, and include a consolidated list of meetings and activeities proposed by the plan. The detailed Action Plan would be circulated to Member Countries for comment by August 2003.
20. The Ministers agreed that follow-up action on the implementation of the Action Plan should be in conformity with relevant international rules and regulations and should not discriminate against any nation or individual. With regard to measures for international travel, the Ministers emphasized that all countries with recent local transmission must continue to carry out stringent pre-departure screening. In addition they urged countries without local transmission to continue arrival screening, including the use of health declaration forms, to improve early detection of imported cases. The implementation of such measures should take into consideration the domestic situation, the laws and the health systems of individual member countries as well as the global SARS situation as advised by the WHO.
21. The Ministers thanked their Senior Health Officials for preparing the Action Plan and requested them to work with the ASEAN Secretariat and the WHO to fully operationalise it. They expressed confidence that the Action Plan would strengthen the region’s efforts not only in the fight against SARS but also contribute towards building the longer-term capacity of the region to respond to new and emerging diseases.
22. The Ministers expressed satisfaction with the efforts made so far and pledged to implement the Action Plan. In this regard, the Ministers expressed appreciation to Member Countries who, in the spirit of solidarity, have offered to coordinate and implement priority projects under the Action Plan on a cost-sharing basis. The Ministers also requested the ASEAN Dialogue Partners, the WHO and other international and regional organisations to mobilise financial and human resources and technical support in order to implement the Action Plan. The Ministers also encouraged Canada and Mongolia to support and participate in the activities under the Action Plan, as and when appropriate.

Acknowledgements

23. The delegations of Brunei Darussalam, China, Indonesia, Japan, Republic of Korea, Lao PDR, Malaysia, Philippines, Singapore, Thailand and Viet Nam expressed their deep appreciation to the government and people of Cambodia for the generous hospitality extended to the delegates and the excellent arrangements made for the meeting. The Ministers also registered their appreciation to the ASEAN Secretariat for its valuable contributions to the meeting.  

List of Health Ministers or Their Representatives attending the Special ASEAN+3 Health Ministers Meeting on Severe Acute Respiratory Syndrome (SARS), Siem Reap, 10 – 11 June 2003

1. Honourable Pehin Dato Abu Bakar Apong
   Minister of Health Brunei Darussalam
2. H.E. Dr. Hong Sun Huot
   Senior Minister and Minister of Health Cambodia
3. H.E. Dr. Huang Jiefu
   Vice Minister of Health People’s Republic of China
4. Prof. Dr. Umar Fah mi Achmadi, Ph.D
   Director General of Communicable Disease Control and Environmental Health Ministry of Health Indonesia
5. Mr. Takashi  Minagawa
   Assistant Director General, International Affairs Division Minister’s Secretariat Ministry of Health, Labour and Welfare Japan
6. Dr. Dae  Kyu  OH
   Director General of Health Promotion Bureau Ministry of Health and Welfare Republic of Korea
7. H.E. Dr. Ponmek Dalaloy
   Minister of Health Lao PDR
8. H.E. Dato’ Chua Jui Meng
   Minister of Health Malaysia
9. H.E. Dr. Manuel M. Dayrit
   Secretary of Health Department of Health, Philippines
10. H.E. Dr. Balaji Sadasivan
    Minister of State for Health and Transport Singapore
11. H.E.Mrs. Sudarat Keyuraphan
    Minister of Public Health Thailand
12. H.E. Dr. Tran Chi Liem
    Vice Minister of Health Viet Nam
13. Dr. Azmi Mat Akhir
    Director of Bureau of Functional Cooperation
    ASEAN Secretariat

Observers

13. Mrs. Stefanie Beck
    Ambassador of Canada in Cambodia
14. Dr. Ts. Sodnompil, MD, MPH, PhD
    State Secretary, Ministry of Health Mongolia
15. Dr. Shigeru Omi
    Regional Director ofthe Western Pacific Regional Office
    World Health Organization

---