The Economic Research Institute for ASEAN and East Asia or ERIA is an international organization established in Jakarta, Indonesia in 2008 by a formal agreement among Leaders of 16 countries in the East Asian region to conduct research activities and make policy recommendations for further economic integration in the East Asia. ERIA works very closely with both the ASEAN Secretariat and 16 Research Institutes to undertake and disseminate policy research under the three pillars, namely “Deepening Economic Integration”, ”Narrowing Development Gaps”, and “Sustainable Development” and provide analytical policy recommendations to Leaders and Ministers at their regional meetings. ERIA provides intellectual contributions to East Asian Community building and serves as a Sherpa international organization. ERIA ranks 32nd among the world's "Top 85 International Economics Think Tanks" according to the 2016 Global Go To Think Tanks Index Report conducted by University of Pennsylvania.
Access to essential diagnostic services is a key component of effective primary health care and universal health coverage. In the Philippines, the Philippine Health Insurance Corporation (PhilHealth) has introduced a primary care benefit package, the Yaman ng Kalusugan Program (YAKAP), which provides capitation-based payments to accredited providers to deliver a defined set of primary care services. Under this scheme, providers are required to offer a set of 15 laboratory and diagnostic tests. However, many primary care facilities, particularly rural health units (RHUs) managed by local government units (LGUs), operate with limited laboratory infrastructure and human resources. This correspondence describes a case from an RHU in the Cordillera Administrative Region (CAR) serving approximately 16,000 people. Of the 15 diagnostic tests required under the YAKAP package, nine are provided through memoranda of agreement with external laboratories located in other municipalities rather than being performed on-site. Patients referred for these diagnostic tests are required to travel approximately one to two and a half hours and incur out-of-pocket transportation costs of about 700 Philippine pesos (US12) per round trip. While such arrangements allow facilities to meet accreditation requirements, they may not ensure timely and affordable access to diagnostics for patients. Strengthening diagnostic capacity within primary care facilities is, therefore, critical. Increasing awareness among LGUs of the importance of diagnostics in PHC may encourage greater investment in laboratory services. In addition, the development of a National Essential Diagnostics List could help clarify which tests should be available at primary care facilities and guide prioritized resource allocation.
BACKGROUND:Access to essential in vitro diagnostics (IVDs) remains limited in many low- and middle-income countries, where persistent challenges exist in financing, human resources, infrastructure, procurement, supply chain management, and health insurance arrangements. Despite growing regional initiatives, such as the Association of Southeast Asian Nations (ASEAN) Essential Diagnostics List Initiative, country-specific evidence on barriers to IVD access remains limited. This article summarizes barriers to accessing IVDs and related lessons identified from field missions conducted as part of a technical cooperation project supporting the development of the National Essential Diagnostics Lists (NEDLs) in Cambodia, Indonesia, Lao PDR, and the Philippines. METHODS:Field missions were conducted in the four countries between December 2024 and May 2025. Mission reports and interview records derived from key informant interviews with government officials and health workers from ministries of health, health facilities, local health offices, and health insurance agencies were examined. Statements related to potential barriers to accessing IVDs were coded, and emergent concepts were organized into a thematic framework consisting of domains and key access barriers. RESULTS:Seventeen barriers to IVD access were identified across six domains (resources; procurement and supply chain; equipment maintenance; documented rules and standards; health insurance coverage; and attitudes of service recipients). Resource constraints, including limited budgets, workforce shortages, and inadequate laboratory infrastructure, were widespread. Procurement and supply chain challenges-such as weak demand forecasting, limited supplier availability, and logistical constraints-frequently resulted in stockouts. An important operational insight was that delays in health insurance reimbursement disrupted supplier payments and contributed to stockouts. Additional barriers included limited equipment maintenance capacity, gaps in guidelines and regulations, insufficient insurance coverage, and demand-side constraints such as low awareness and trust in diagnostic tests. CONCLUSIONS:Access to IVDs in the four ASEAN countries is constrained by multifaceted health system barriers. This study highlights an underrecognized mechanism-insurance reimbursement delays leading to stockouts-that warrants policy attention in the Asian context. As countries progress from the NEDL development to implementation, the six-domain, 17-barrier framework offers a practical tool for identifying system bottlenecks and guiding targeted interventions to ensure equitable access to essential IVDs.
This article examines the relationship between commodity booms and the incidence of group conflict and criminality in the context of Indonesia's expanding oil palm sector. Informed by original fieldwork, the article theorizes that violence will occur where there are choke points in a commodity's production supply chain. Such choke points create the opportunity and incentive for armed groups-including "mafias," youth gangs, landholders, and state security services-to compete for control of an industry's rents. Analyses of multiple sources of violent conflict data at the individual, village, and subdistrict levels support our main hypothesis that violence has a nonlinear relationship with the extent of oil palm production. We also find that the effect of oil palm cultivation on conflict changes over time with prevailing commodity prices. Our results are robust to the use of reduced form analysis to account for the potential endogeneity of plantation expansion.
Macro marine debris, which is marine debris of 2.5–100 cm in size composed of different materials including plastics (‘macrodebris’), has become a widespread issue across the Southeast Asia and Pacific regions, causing disproportionate impacts on small island communities dependent on ocean economy. This article reviews the distribution of macrodebris abundance along the shorelines of these regions, highlighting the comparison between small islands and mainlands. The composition of macrodebris varies across locations, but plastics emerge as the dominating material in most shorelines. Research efforts in quantifying macrodebris on small islands and mainland are relatively equal, and that there is no significant difference between macrodebris abundance on small islands and mainlands (t-test, p = 0.403), despite the former’s smaller areas, less populations, and remote locations. Factors affecting macrodebris distribution include ecosystem types, wind and oceanographic transport and nearby anthropogenic activities. One of the primary drivers of macrodebris prevalence in the coastal and marine environment is land-based sources of mismanaged waste, positioning solid waste management improvement as one of the priority actions to combat macrodebris. Several shortcomings were noted in the policy, technical, financial, institutional, and social aspects of solid waste management, some of which stem from the remote nature and small scale of small islands. Nevertheless, exemplary solid waste management practices have emerged from small islands across the two regions, underlining that a holistic strategy that integrates coherent policies, strengthened local financial and technical capacities has the potential for overcoming the unique challenges of solid waste management improvement on small islands.
