Greater Mekong Subregion Countries Research Articles

Integrating transportation and economic information for the African Swine Fever Virus (ASFV) risk modelling purposes in the Greater Mekong Sub-region (GMS) using online data and grey literature

Integrating transportation and economic information for the African Swine Fever Virus (ASFV) risk modelling purposes in the Greater Mekong Sub-region (GMS) using online data and grey literature

Access to health care for migrants in the Greater Mekong Subregion: policies and legal frameworks and their impact on malaria control in the context of malaria elimination.

The launch of the Global compact for safe, orderly and regular migration in December 2018 marked the first-ever United Nations global agreement on a common approach to international migration in all its dimensions. The global compact aims to reduce the risks and vulnerabilities migrants face at different stages of migration, by respecting, protecting and fulfilling their human rights and providing them with care and assistance. A key example of the intersection of the right to health and migration is seen in the Greater Mekong Subregion (GMS) - comprising Cambodia, Lao People's Democratic Republic, Myanmar, the People's Republic of China (Yunnan Province and Guangxi Zhuang Autonomous Region), Thailand and Viet Nam. The GMS has a highly dynamic and complex pattern of fluctuating migration, and population mobility has been identified as an important concern in the GMS, since five of the six GMS countries are endemic for malaria. Based on the concept of universal health coverage, and as endorsed by the 61st World Health Assembly in 2008, migrants, independently of their legal status, should be included in national health schemes. This paper summarizes work done to understand and address the legal obstacles that migrants face in accessing health services in the GMS countries, and the impact that these obstacles have in relation to elimination of malaria and containment of artemisinin resistance. Despite efforts being made towards achieving universal health coverage in all the GMS countries, no country has current health and social protection regulations to ensure migrants' access to health services, although in Thailand documented and undocumented migrants can opt for acquiring health insurance. Additionally, there is a lack of migrant-inclusive legislation in GMS countries, since barriers to accessing health services for migrants - such as language and/or socioeconomic factors - have been scarcely considered. Advocacy to promote legislative approaches that include migrants' health needs has been made at global and regional levels, to overcome these barriers. Assistance is available to Member States for reviewing and adopting migrant-friendly policies and legal frameworks that promote rather than hinder migrants' and mobile populations' access to health services.

Effectiveness of repellent delivered through village health volunteers on malaria incidence in villages in South-East Myanmar: a stepped-wedge cluster-randomised controlled trial protocol

BackgroundTo combat emerging drug resistance in the Greater Mekong Sub-region (GMS) the World Health Organization and GMS countries have committed to eliminating malaria in the region by 2030. The overall approach includes providing universal access to diagnosis and treatment of malaria, and sustainable preventive measures, including vector control. Topical repellents are an intervention that can be used to target residual malaria transmission not covered by long lasting insecticide nets and indoor residual spraying. Although there is strong evidence that topical repellents protect against mosquito bites, evidence is not well established for the effectiveness of repellents distributed as part of malaria control activities in protecting against episodes of malaria. A common approach to deliver malaria services is to assign Village Health Volunteers (VHVs) to villages, particularly where limited or no services exist. The proposed trial aims to provide evidence for the effectiveness of repellent distributed through VHVs in reducing malaria.MethodsThe study is an open stepped-wedge cluster-randomised controlled trial randomised at the village level. Using this approach, repellent (N,N-diethyl-benzamide – 12% w/w, cream) is distributed by VHVs in villages sequentially throughout the malaria transmission season. Villages will be grouped into blocks, with blocks transitioned monthly from control (no repellent) to intervention states (to receive repellent) across 14 monthly intervals in random order). This follows a 4-week baseline period where all villages do not receive repellent. The primary endpoint is defined as the number of individuals positive for Plasmodium falciparum and Plasmodium vivax infections diagnosed by a rapid diagnostic test. Secondary endpoints include symptomatic malaria, Polymerase Chain Reaction (PCR)-detectable Plasmodium spp. infections, molecular markers of drug resistance and antibodies specific for Plasmodium spp. parasites.DiscussionThis study has been approved by relevant institutional ethics committees in Myanmar and Australia. Results will be disseminated through workshops, conferences and peer-reviewed publications. Findings will contribute to a better understanding of the optimal distribution mechanisms of repellent, context specific effectiveness and inform policy makers and implementers of malaria elimination programs in the GMS.Trial registrationAustralian and New Zealand Clinical Trials Registry (ACTRN12616001434482). Retrospectively registered 14th October 2016.

Weed biological control in the Greater Mekong Subregion: status and opportunities for the future.

Abstract The status of weed biological control in the six Greater Mekong Subregion (GMS) countries was assessed, and opportunities to develop biological control in the region are proposed. Twenty biological control agents targeting nine weed species have been introduced into GMS countries, with 13 agents establishing on seven weed species. Another nine biological control agents have spread unintentionally into the region. These agents are having a slight to high impact on their target weeds. However, the number of weeds in the region that have been targeted for biological control is only a fraction of the number of weeds (45) in the region that have been targeted for biological control elsewhere. This presents a tremendous opportunity to expand weed biological control in the region and reduce the dependency on herbicides while increasing productivity. There are numerous highly effective biological control agents present elsewhere that could be introduced to assist with the management of the region's most important weeds, such as Pistia stratiotes , Salvinia molesta , Chromolaena odorata and Mikania micrantha . Along with the introduction of biological control agents, there is also a scope to increase the capacity and training in biological control within GMS countries to develop effective weed control and management.

Opisthorchiasis-Induced Cholangiocarcinoma: How Innate Immunity May Cause Cancer.

Innate, inflammatory responses towards persistent Opisthorchis viverrini (OV) infection are likely to contribute to the development of cholangiocarcinoma (CCA), a liver cancer that is rare in the West but prevalent in Greater Mekong Subregion countries in Southeast Asia. Infection results in the infiltration of innate immune cells into the bile ducts and subsequent activation of inflammatory immune responses that fail to clear OV but instead may damage local tissues within the bile ducts. Not all patients infected with OV develop CCA, and so tumourigenesis may be dependent on multiple factors including the magnitude of the inflammatory response that is activated in infected individuals. The purpose of this review is to summarize how innate immune responses may promote tumourigenesis following OV infection and if such responses can be used to predict CCA onset in OV-infected individuals. It also hypothesizes on the role that Helicobacterspp., which are associated with liver fluke infections, may play in activation of the innate the immune system to promote tissue damage and persistent inflammation leading to CCA.

Comparison of the Determinants of the Health Service System and the Health Status of the People in the Greater Mekong Subregion (GMS).

Background: Health is influenced by numerous factors that affect the health service system and health status of the people in every country. This article aims to compare the determinants of the health service system and the health status of the people in Thailand, the Lao PDR, Vietnam, and Cambodia; and to recommend policies that impact the population’s health and the country’s development. Methods: A comprehensive search of the literature from a variety of online search and aca-demic databases, and synthesis of previous study was used in this paper. Data on country indicators were taken from publis-hed online databases of the Ministry of Public Health of Cambodia, Lao PDR, Thailand,and Vietnam; the World Health Or-ganization, and the World Bank.Results: In Thailand, the determinants of the health service system and health status of the people are medical information and technology because of the government initiatives to improve the quality of healthcare services through the use of modern technology. In Vietnam, the society and culture, and the strengths and weaknesses of the hospital significantly affect the health status and health service system there because of the religious beliefs of the people. However, in Cambodia, the strengths and weaknesses of the hospital are the primary determinant of the health service system and health status of the people due to the condition of the hospitals, the availability of new medical devices, and the number of healthcare professio-nals. In the Lao PDR, trade and investment, and medical information and technology, significantly influence the health servi-ce system and health status of the people because of the government efforts to outsource capital expenditures and medical te-chnology.Conclusion: The strengths and weaknesses of the hospital are the key determinants of the health service system and health status of the people in all GMS countries. Understanding the determinants of health is essential in order to develop policies and programs that impact the population's health and the country's development.

Regionalism, Identity, and Hydropower Dams: The Chinese-Built Lower Sesan 2 Dam in Cambodia

The Greater Mekong Subregion (GMS) has been styled as a natural region drawn together by the Mekong River. However, the literature on regional identity has argued that regions are socially constructed phenomena. River basins in particular are historically evolved constructs of specific political and social relations. Drawing on concepts of regional identity and on the literature examining the links between culture and water, the article argues that the actors driving the GMS have exacerbated social tensions through hydropower programmes, thus failing to establish social coherence. These programmes focus on energy production for national economic growth and economic integration between GMS countries, but they ignore the need to govern water resources for the benefit of local communities, many of which are made up of ethnic minorities with specific cultural attachments to the river. This produces tensions around the type of development that takes place in the GMS, leading to value fragmentation rather than value convergence. The article explores these issues by focusing on the Chinese-built Lower Sesan 2 Dam in Cambodia.

A Review of the Relationships among the Key Determinants Affecting the Mental Health Disorders of the People in Greater Mekong Subregion Countries.

Background: ASEAN integration aims to transform the GMS into a single market with free flows of products, services, and skilled labor, as well as investment openness, which will ultimately force regional economic growth. Therefore, this integration is likely to bring about a big change to this area in the new era; it can subsequently cause many problems as well, including mental health issues of the people in this region. The characteristic differences among the GMS member countries in terms of trade and investment, social and cultural values, medical information and technology, and the living and working environment have become major problems affecting mental health disorders, which are usually identified as depression, stress, and substance abuse.Methods: This review paper is a literature review of the relationship of the determinants affecting GMS mental disorders conducted using the following strategies: 1) collecting data from previous qualitative and quantitative research studies, comparatively analyzing the literature, articles, published papers, and reports relevant to the existing policies on economic, environmental, and healthcare issues obtained from the GMS; and 2) exchanging information from the institutions involved, including reports and papers regarding the determinants affecting mental health disorders of the people in the GMS, which were used to generate the synthesis of the existing knowledge of the mental health and to provide recommendation programs for the GMS people.Results: Based on the reviewed literature there are four key factors affecting mental health, especially mental health in GMS populations: 1) the living and work environments; 2) trade and investment; 3) technology and medical information; and 4) social and cultural values. The study found that the increasing number of mental health disorders is a big burden for national healthcare spending. Financial issues have become a major key to the wide prevalence of mental disorders in the GMS. Health issues related to mental health disorders are also caused by the environment and other related factors and therefore a stable and a well-balanced environment is an indicator of healthy mental status. In addition, the environment is a way to pursue both physical and mental health because green spaces serve as a mood freshener and can alleviate anxiety, stress, and depression.Conclusion: Globalization and urbanization should follow sustainable development instructions and concerns about the population’s health, especially regarding mental health. These key determinants affect the people’s life, especially in terms of mental health thus leading to mental health disorders.

The Relationship between Tourism and Economic Development in the Greater Mekong Sub-Region: Panel Cointegration and Granger Causality

This paper examines the causal relationship between tourism and economic development. Tourism is considered in two ways; number of international tourist arrivals and tourism receipts. The data are collected from the five Greater Mekong Sub-region (GMS) countries i.e. Myanmar, Cambodia, Lao PDR, Thailand and Vietnam; and the Yunnan and Guangxi provinces of China. The sample period is semi annual data from 2000 to 2012 and is also estimated by a panel data approach. This study finds a long-run relationship is unidirectional running from the number of international tourist arrivals to economic development; and from economic development to tourism receipts. The short-run causality is unidirectional running from the international tourist arrivals to economic development only. This study suggests that the GMS countries should concentrate on tourism marketing promotion and expand economic development, especially in tourism investment such as enhancing the tourism and hotel industry to meet international standard for tourism sustainability as an entire region.

Molecular surveillance of artemisinin resistance falciparum malaria among migrant goldmine workers in Myanmar

BackgroundArtemisinin resistance has been reported in Greater Mekong Sub-region countries, including Myanmar. After discovery of artemisinin resistance marker (K13), molecular surveillance on artemisinin resistance in endemic regions have been conducted. As the migrant population represents a high percentage of malaria cases, molecular surveillance of artemisinin resistance among migrant workers is of great concern.MethodsA cross-sectional survey was conducted in Shwegyin Township, where migrants work in the goldmines. Blood samples were collected from uncomplicated Plasmodium falciparum-infected migrant workers by active and passive cases screening with rapid diagnostic testing (RDT) and microscopy. Amplification and sequence analysis of artemisinin resistance molecular markers, such as k13, pfarps10, pffd, pfmdr2, pfmrp1, pfrad5, and pfcnbp, were carried out and pfmdr1 copy number analysis was conducted by real-time PCR.ResultsAmong the 100 falciparum-infected patients, most were male (90%), of working age (20–40 years) with median parasite density of 11,166 parasites/µL (range 270–110,472 parasites/µL). Artemisinin resistance molecular marker, k13 mutations were detected in (21/100, 21.0%) in which composed of a validated marker, C580Y (9/21, 42.9%) and candidate markers such as P574L (5/21, 23.8%), P667T (5/21, 23.8%) and M476I (2/21, 9.5%). Underlying genetic markers predisposing to become k13 mutants were found as V127M of pfarps10 (41/100, 41.0%), D153Y of pffd (64/100, 64.0%), T484I of pfmdr2 (58/100, 58.0%) and F1390I of pfmrp1 (24/100, 24.0%). The pfmdr1 copy number analysis revealed six copy numbers (1/100, 1.0%), three (2/100, 2.0%), two (8/100, 8.0%) and only one copy number (89/100, 89.0%). Only one sample showed both k13 mutation (P667T) and multiple copy number of pfmdr1.ConclusionsHigh mutant rate of artemisinin resistance markers and relatively high pfmdr1 copy number among isolates collected from migrant goldmine workers alert the importance of containment measures among this target population. Clinical and molecular surveillance of artemisinin resistance among migrants should be scaled up.

Paradiplomacy as a Provincial State-Building Project: The Case of Yunnan’s Relations With the Greater Mekong Subregion

This article examines Yunnan’s relations with the Greater Mekong Subregion (GMS) countries grouped in the Asian Development Bank’s (ADB) GMS Program. While locating the analysis in the context of paradiplomacy, this article makes two claims. First, it argues that—unlike subnational governments in federal states—Yunnanese authorities do not use domestic opportunity structures to develop the province’s international agency. Instead, they pursue paradiplomacy as a subnational state-building project, designed to extract economic assistance from the central state. Second, it asserts that—unlike other Westphalian states—the Chinese government has recognized the benefits of paradiplomacy as a way to enhance the structural competitiveness of its borderland provinces in the regional economy. In doing so, it has proactively deployed provincial authorities in the multilevel governance of the GMS Program. At the same time, the central government has remained at the center of Yunnan’s external relations through providing funding and preferential policies for Yunnan’s internal and external economic projects and defining the parameters of Yunnan’s cooperation with the GMS countries and the ADB.

An Examination of Determinants That Affect the Health-Service Systems and Health Status of People in the Greater Mekong Subregion

Background: One means of better understanding the variations in health systems among the four greater Mekong subregion (GMS) countries is to determine how the overall health environment influences the area’s health-service systems and health status. Objectives: The study examined the determinants that affect the health-service systems and health status of the Thai, Lao, Vietnamese, and Cambodian people in the GMS countries, as well as the determinants that best predict health-service-system quality and health status. Patients and Methods: The sample groups consisted of 320 - 402 clients and 30 - 69 healthcare providers recruited from three hospitals with similar topographies to those in the respective countries. The sample sizes depended on the number of hospital beds and people in the study areas. The questionnaires included assessments of the perceptions of health-service-system quality and health status, as well as the affecting determinants; the analyses included descriptive statistics, Pearson product-moment correlation, and stepwise multiple regression. Results: The major findings included the following: first, for the clients’ perceptions, only the internal determinant that reflected the strengths and weaknesses of the hospital environment was shown to be a strong predictor of health-service-system quality of the GMS countries. Second, for both the clients’ and providers’ perceptions, we found no common determinant that could predict the health status of GMS people, although we did find a few similar and different determinants. Societal and cultural values affected health-service-system quality and the health status of Vietnamese people, as well the health status of the Lao people, while trade and investment only had an impact on the health-status perception of Lao clients. In addition, medical information and technology affected the health-service systems of Thailand and Vietnam, as well as the health status of the people of Thailand and Laos; the living and working environment influenced the health status of the people of Thailand and Vietnam. The strengths and weaknesses of the hospital also affected the health status of the people of Vietnam and Cambodia. Conclusions: These findings may be used for further knowledge development and for various practical applications. Our findings recommend that a comprehensive and system-wide review of health-policy planning and strategic settings should be conducted in accordance with those particular factors to improve the health-service systems and health status of the GMS countries.

A Study of the Holistic-Health Status of the Peoples in the Greater Mekong Subregion Countries

A Study of the Holistic-Health Status of the Peoples in the Greater Mekong Subregion Countries

Creating a Network of Youth in Sustainable Tourism Development in the Greater Mekong Sub-region Case study: Nakhon Phanom,Thailand and Khammouan, Laos PDR

The tourism industry has become significantly important sector in economic cooperation between the countries in the Greater Mekong Sub-region (GMS). A focus on the development of young people as a major force in the development of sustainable tourism would be developed to benefit the economic, social, cultural and environmental needs continuing development together with the GMS countries by creating a network for knowledge sharing. First, the study of attitude of the local youth towards sustainable tourism in the GMS at Nakhon Phanom and Khammouan was revealed that the group of youth had been developed by plans of participating in five aspects of the development of sustainable tourism: the problem searching, the planning, the operation, the benefit and the evaluation. Secondly, the results from this study were taken and integrating into the project of creating a sustainable tourism industry in the GMS network of youth in Nakhon Phanom and Laos PDR. The purpose of this qualitative study was to investigate how to build a network of youth in order to increase their awareness of sustainable tourism in the GMS by using the action research with the application of A-I-C for participatory planning as a tool. Thirdly, this study also analyzes and synthesizes the results of the previous quantitative study along with findings from interview, group discussion and direct observation from qualitative study for searching a guideline of sustainable tourism by youth. The results from a model of the guideline in sustainable tourism by youth using the English letters form “TEAM” showed that participants have exchanged the knowledge and the operational experience from the sustainable tourism community which guided them to understand problems of tourism in the community. Participants have also participated in tourism plans, implemented in the sustainable tourism, received mutual benefits and evaluations in order to develop the community together effectively.

An analysis of macroeconomic interdependence between Greater Mekong Sub-region countries

An analysis of macroeconomic interdependence between Greater Mekong Sub-region countries

Integrated Resource Planning for Long-term Electricity Supply in Selected GMS Countries, Part 2: Environmental and Economic Impacts

This research article presents the potential of integrated resource planning (IRP) options for long term electricity supply in selected Greater Mekong Subregion (GMS) countries, namely Cambodia, Laos, Thailand, and Vietnam. Results from Part 1 show the achievement of the IRP context in GMS. The mitigation scenario would improve the quality of electricity supply and mitigate CO2 emissions from the power sector. At the same time, the renewable energy (RE) scenario has the highest total generation cost. However, to make the renewable energy technologies competitive with fossil fuels, incentives in terms of carbon credit are taken into account. Results of this study were analyzed by using the Long-range Energy Alternative Planning system model. Results reveal that under the IRP concept, the selected GMS countries could mitigate CO2 emissions by about 61.16 million tonnes when compared to the business as usual (BAU) scenario by 2030. In the meantime, under incentive cost in the RE scenario, the total generation would be reduced by 2.3% when compared to the BAU scenario.

The relationship between Japan and the Greater Mekong subregion in terms of trade and economy in the Cold War

After World War II ended, Japan set the background for the implementation of policies on economy and diplomacy to the Greater Mekong Subregion (GMS) through the signing of the reparations agreements with the subregion’s countries. At the same time, Japan consolidated and promoted tradeeconomy relationship with the GMS countries with the goal of turning those countries into resource providers and wide salers of Japanese goods. The purpose of this study is to analyze the trade relationship between Japan and Mekong Subregion countries from 1945 to the early 1990s, which contributed to the clarification of the change in Japan’s policies on foreign relations towards this subregion within the international and regional contexts.

Integrated Resource Planning for Long-term Electricity Supply in Selected GMS Countries, Part 1:Energy Efficiency and Renewable Energy

The scarcity of fossil fuel to supply the high growth in energy demand in the selected Greater Mekong Subregion (GMS) is leading to the concern about future electricity supply. The effect of the high fossil fuel price on the global market would lead to limitation in economic development in this region. In 2007, most countries in the selected GMS, namely Cambodia, Laos, Thailand, and Vietnam, used abundant fossil fuels in electricity generation. Fossil fuels used in power generation accounted for 90%, 85%, 60%, and 1.5% in Cambodia, Thailand, Vietnam, and Laos, respectively. This study includes the integrated resource planning (IRP) concept into the long-term power planning. IRP is the most appropriate approach that applied to both demand and supply sides. To curb the high growth in electricity demand, the demand-side management options are taken into account. To reduce the high dependency on imported fossil fuel, the domestic renewable energy resources and reduction in transmission and distribution losses are introduced. Results of this study were analyzed by using the Long-range Energy Alternatives Planning system model. Results reveal that under the IRP concept, the selected GMS countries could save the installed power capacity of 5,780 MW by 2030.

The Location Substitution Effect: Does it Apply for China?

The notion that China is the factory of the world is now changing. Factories in China are shifting their production base to neighbouring Asia, primarily because of higher input costs in China, a volatile Chinese exchange rate and protectionist measures targeted against Chinese exports. In this article, we examine the location substitution effect for China: Chinese firms are exporting primary, intermediate and machinery items, meant for producing final output in the Greater Mekong Subregion (GMS), which include Laos, Thailand, Vietnam, Cambodia and Myanmar. Results suggest that GMS countries are exporting finished items to China, that are increasingly getting manufactured using primary and intermediate inputs imported from China.

Ecotope-based entomological surveillance and molecular xenomonitoring of multidrug resistant malaria parasites in anopheles vectors.

The emergence and spread of multidrug resistant (MDR) malaria caused by Plasmodium falciparum or Plasmodium vivax have become increasingly important in the Greater Mekong Subregion (GMS). MDR malaria is the heritable and hypermutable property of human malarial parasite populations that can decrease in vitro and in vivo susceptibility to proven antimalarial drugs as they exhibit dose-dependent drug resistance and delayed parasite clearance time in treated patients. MDR malaria risk situations reflect consequences of the national policy and strategy as this influences the ongoing national-level or subnational-level implementation of malaria control strategies in endemic GMS countries. Based on our experience along with current literature review, the design of ecotope-based entomological surveillance (EES) and molecular xenomonitoring of MDR falciparum and vivax malaria parasites in Anopheles vectors is proposed to monitor infection pockets in transmission control areas of forest and forest fringe-related malaria, so as to bridge malaria landscape ecology (ecotope and ecotone) and epidemiology. Malaria ecotope and ecotone are confined to a malaria transmission area geographically associated with the infestation of Anopheles vectors and particular environments to which human activities are related. This enables the EES to encompass mosquito collection and identification, salivary gland DNA extraction, Plasmodium- and species-specific identification, molecular marker-based PCR detection methods for putative drug resistance genes, and data management. The EES establishes strong evidence of Anopheles vectors carrying MDR P. vivax in infection pockets epidemiologically linked with other data obtained during which a course of follow-up treatment of the notified P. vivax patients receiving the first-line treatment was conducted. For regional and global perspectives, the EES would augment the epidemiological surveillance and monitoring of MDR falciparum and vivax malaria parasites in hotspots or suspected areas established in most endemic GMS countries implementing the National Malaria Control Programs, in addition to what is guided by the World Health Organization.