Around the world climate change is already impacting on health,
via more frequent and intense extreme weather events, as well as
by altering the prevalence and distributions of vector- and
water-borne diseases. The high and rapidly growing population in
Southeast Asia is heavily reliant on agriculture for livelihoods,
which makes it vulnerable to climate change impacts such as sea
level rise and typhoons. In this context, regional organisations
are playing an increasingly important role in climate change
adaptation and health. For example, the Asian Development Bank
and the Asia-Pacific Regional Forum on Health and Environment are
both involved in adaptation and health initiatives. Despite this,
however, there is a lack of empirical research on the value added
by regional organisations to adaptation and health actions and
initiatives.
Prepared as a thesis by compilation, this research helps fill
this gap by examining the effectiveness of regional organisations
supporting national level adaptation and health in Southeast
Asia. A three-step process was used for this examination.
Firstly, three national case studies were conducted in Southeast
Asia, focussing on adaptation and health. These individual pieces
of research used an open-ended research methodology to limit
researcher bias, with the goal of identifying similarities and
differences in governance-related adaptation and health
challenges across the case-study countries. Secondly, a
systematic framework was developed for assessing regional
organisations supporting climate change adaptation. So as to be
applicable across sectors and geographies, the framework was
developed outside of Southeast Asia and outside the health
sector. Thirdly, the resultant framework was used to guide the
research examining regional organisations supporting adaptation
and health initiatives in Southeast Asia, to both determine their
strengths and weaknesses, and to identify pathways to improve
their effectiveness.
The main findings of this research were that, first, coordination
challenges exist between organisations, sectors and scales, as
well as across sub-national boundaries. In all cases, poor
coordination is limiting and constraining adaptation and health.
Further, coordination challenges are limiting adaptation and
health in all three case study countries, despite different
levels of development and different governance arrangements.
Second, regional organisations are not necessarily well-placed
for direct project implementation, but maymore effectively
support adaptation through creating enabling environments at the
national level. This may be done through supporting national
level capacity building, and acting as specialised knowledge
banks, such as for climate-modelling data. Third, where there is
a lack of coordination, mandate overlaps for regional
organisations working in the same region have negative impacts on
climate change adaptation, including adaptation and health. A
final finding is that institutionalised and incentivised
coordination between such regional organisations would benefit
adaptation and health initiatives in two key ways. Firstly, both
the administrative workload on developing country government
agencies and redundancies in the work of regional organisations
would be reduced. Secondly, better inter-organisation
coordination would provide regional organisations with a stronger
foundation for supporting countries to coordinate across scales,
sectors and boundaries.
The findings outlined in the paragraph above are the basis for
the five primary contributions to the academic literature that
this thesis makes. Firstly, coordination is a major adaptation
and health constraint, regardless of governance arrangements,
ideologies or scales. Secondly, a framework for assessing
regional organisations coordinating climate change adaptation was
developed. Thirdly, the utility of the developed framework was
demonstrated across three regions, as well as across sectors.
Fourth, integrating the strengths of project and governance
approaches provides an avenue for improving adaptation and health
results. The final theoretical contribution of this thesis is
that integrating the strengths of these two approaches, by
coordinating collaboratively, will enable better regional
organisation support for coordination within countries. This body
of work will provide insights for national governments as well as
regional and international organisations on how they can improve
their interactions to better support adaptation and health
outcomes
