Climate change adaptation and health in Southeast Asia: What do regional organisations contribute?

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