Rising geopolitical tensions, cascading climate crises and post-pandemic setbacks have exposed serious gaps in global health preparedness. In Asia and the Pacific, systemic vulnerabilities and deepening inequalities require a reimagined model of multilateral cooperation conflict. The number of geopolitical disturbances is at an all-time high, displacing over 122 million people and eroding access to essential health services. In 2023, false health claims amassed over 4 billion views across digital platforms, compromising vaccine uptake and fuelling health-related conspiracy theories. Exponential technological advances in artificial intelligence outpace public health governance systems, creating new ethical and equity dilemmas. Health is no longer a downstream consideration; it is the front line of our security. ASIA AND THE PACIFIC HEALTH AT A CROSSROADS The Asia Pacific region faces a convergence of structural vulnerabilities that threaten its health gains, adding pressure on its economic growth and developmental future. The most disaster-prone region in the world, Asia and the Pacific accounted for over 40% of global climate-related disasters over the past two decades. In 2022, the region experienced over 140 disasters that affected more than 64 million people and resulted in approximately $57 billion in economic damage. With rising sea levels in the Pacific, heatwaves in South Asia and typhoons in Southeast Asia, climate shocks drive unprecedented internal displacement, food insecurity and disease burdens. The triple burden of disease – the unfinished agenda of maternal
From crisis to cohesion: A new mandate for health and multilateralism T he Covid-19 pandemic brought health systems to a standstill. Its aftershocks still reverberate around the world. Routine immunisation, non-communicable disease screening and per capita health spending remain below pre-pandemic levels. In 2024 alone, the world experienced 17 significant disease outbreaks including H5N1, Marburg virus and hMPV. New biological threats and the resurgence of communicable diseases expose persistent gaps in global pandemic preparedness. Climate change, a defining issue of our times, is a threat multiplier for health systems. It rapidly accelerates disease transmission, increases disaster risks, intensifies nutritional challenges and displaces populations in low-resource settings. Over the next 25 years, climate change could cause over 15 million excess deaths in low- and middle-income countries. Economic losses due to climatic risks associated with health could exceed $20.8 trillion in LMICs. Deepening political polarisation weakens the global cooperation essential for scientific progress and amplifies
Dinesh Arora, principal health specialist, Asian Development Bank
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Health: A Political Choice – The Future of Health in a Fractured World
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