Advancing Equitable Access to Medicines in Southeast Asia: A Comprehensive Policy Analysis of the 2025 Regional Position Paper
Abstract
The Southeast Asia region faces persistent challenges in ensuring equitable access to affordable, quality medicines despite decades of economic growth and health system advancements. This article provides a comprehensive policy analysis of the "Advancing Equitable Access to Medicines in Southeast Asia" position paper released by the Southeast Asia Access to Medicine Working Group following the February 2025 Bangkok Summit and April 2025 New Delhi consultations. The analysis examines the paper's conceptual framework that redefines access as a patient-centered continuum, evaluates its recommendations across five core pillars; governance, digital health, health technology assessment, innovative financing, and public-private partnerships and assesses implementation feasibility within ASEAN's diverse contexts. Findings reveal that while the position paper offers transformative strategies emphasizing regional harmonization and community engagement, successful implementation requires navigating significant challenges including regulatory fragmentation, varying institutional capacities, sustainable financing mechanisms, and political economy constraints. The analysis employs health systems frameworks and political economy analysis to identify critical success factors for translating policy recommendations into measurable improvements. The article concludes that realizing equitable access demands sustained political commitment, institutionalized cross-sector collaboration, adaptive governance frameworks, and robust monitoring systems. The study contributes to policy discourse by identifying critical research gaps including the need for context-specific implementation metrics, longitudinal impact assessment frameworks, and participatory governance evaluation tools.
References
Bazzano, A. N., Martin, J., Hicks, E., Faughnan, M., & Murphy, L. (2017). Human-centred design in global health: a scoping review of applications and contexts. PloS One, 12(11), e0186744.
Bigdeli, M., Jacobs, B., Tomson, G., Laing, R., Ghaffar, A., Dujardin, B., & Van Damme, W. (2013). Access to medicines from a health system perspective. Health Policy and Planning, 28(7), 692–704.
Buse, K., Mays, N., Colombini, M., Fraser, A., Khan, M., & Walls, H. (2023). Making health policy, 3e. McGraw Hill.
Citaristi, I. (2022). International telecommunication union—itu. In The Europa directory of international organizations 2022 (pp. 365–369). Routledge.
Dartanto, T., Halimatussadiah, A., Rezki, J. F., Nurhasana, R., Siregar, C. H., Bintara, H., Usman, Pramono, W., Sholihah, N. K., & Yuan, E. Z. W. (2020). Why do informal sector workers not pay the premium regularly? Evidence from the National Health Insurance System in Indonesia. Applied Health Economics and Health Policy, 18(1), 81–96.
Florence, A. (2025). Innovative and Evidence-Based Financing Mechanisms for Supporting the Growth of Health-Oriented Social Enterprises in LMICs. Available at SSRN 5496878.
Freedman, L. P. (2005). Achieving the MDGs: health systems as core social institutions. Development, 48(1), 19–24.
Gustafsson-Wright, E., Boggild-Jones, I., Segell, D., & Durland, J. (2017). Impact bonds in developing countries: early learning from the field. Global Economy and Development at Brookings.
Kickbusch, I., & Gleicher, D. E. (2012). Governance for health in the 21st century.
Lim, M. Y., Kamaruzaman, H. F., Wu, O., & Geue, C. (2023). Health financing challenges in Southeast Asian countries for universal health coverage: a systematic review. Archives of Public Health, 81(1), 148.
Organization, W. H. (2007). Everybody’s business: strengthening health systems to improve health outcomes: WHO’s framework for action.
Organization, W. H. (2024). Community engagement for quality health services. https://www.who.int/teams/integrated-health-services/quality-of-care/community-engagement
Otte, M., Dauben, H. P., Ahn, J., Gutierrez Ibarluzea, I., Drummond, M., Simoens, S., Kaló, Z., & Suh, D.-C. (2024). Value based healthcare and Health Technology Assessment for emerging market countries: joint efforts to overcome barriers. Expert Review of Pharmacoeconomics & Outcomes Research, 24(9), 1061–1066.
Penchansky, R., & Thomas, J. W. (1981). The concept of access: definition and relationship to consumer satisfaction. Medical Care, 19(2), 127–140.
Rahman, M. M., Khanam, R., & Rahman, M. (2018). Health care expenditure and health outcome nexus: new evidence from the SAARC-ASEAN region. Globalization and Health, 14(1), 113.
Reich, M. R. (2019). Political economy analysis for health. Bulletin of the World Health Organization, 97(8), 514.
Ritchie, J., & Spencer, L. (2002). Qualitative data analysis for applied policy research. In Analyzing qualitative data (pp. 173–194). routledge.
Scott, C. (2001). Analysing regulatory space: fragmented resources and institutional design.
Secretariat, A. (2024). Old age poverty and active ageing in ASEAN.
Silalahi, V. (2024). Ten year evaluation of JKN: strengthening primary health care for national resilience. Indonesian Journal of Economic & Management Sciences, 2(4), 651–670.
Sparkes, S. P., Bump, J. B., Özçelik, E. A., Kutzin, J., & Reich, M. R. (2019). Political economy analysis for health financing reform. Health Systems & Reform, 5(3), 183–194.
Tangcharoensathien, V., Witthayapipopsakul, W., Panichkriangkrai, W., Patcharanarumol, W., & Mills, A. (2018). Health systems development in Thailand: a solid platform for successful implementation of universal health coverage. The Lancet, 391(10126), 1205–1223.
Tantivess, S., Chalkidou, K., Tritasavit, N., & Teerawattananon, Y. (2017). Health Technology Assessment capacity development in low-and middle-income countries: Experiences from the international units of HITAP and NICE. F1000Research, 6, 2119.
Topp, S. M., Abimbola, S., Joshi, R., & Negin, J. (2018). How to assess and prepare health systems in low-and middle-income countries for integration of services—a systematic review. Health Policy and Planning, 33(2), 298–312.
Ulep, V. G. T., & Casas, L. D. D. (2021). Regional health integration and cooperation in the Philippines. PIDS Discussion Paper Series.
Veinot, T. C., Ancker, J. S., & Bakken, S. (2019). Health informatics and health equity: improving our reach and impact. Journal of the American Medical Informatics Association, 26(8–9), 689–695.
Veinot, T. C., Mitchell, H., & Ancker, J. S. (2018). Good intentions are not enough: how informatics interventions can worsen inequality. Journal of the American Medical Informatics Association, 25(8), 1080–1088.
Walt, G., & Gilson, L. (1994). Reforming the health sector in developing countries: the central role of policy analysis. Health Policy and Planning, 9(4), 353–370.
Wan, K. B. (2010). All Can Afford Healthcare. A Singapore Government Agency Website. https://www.moh.gov.sg/newsroom/all-can-afford-healthcare/
