Authors
Jie Wang, Yikai Feng, Yihong Liu, Minmin Wang, Teck Chuan Voo, Tran Diep Tuan, Emmanuel S Baja, Sok King Ong, Victor Chee Wai Hoe, Sarawut Thepanondh, Chhea Chhorvann, Andreasta Meliala, Hla Hla Win, Mayfong Mayxay, Minghui Ren, Yinzi Jin
Published in
The Lancet. Global health. Pages 104014. Jul 24, 2026. Epub Jul 24, 2026.
Abstract
Southeast Asia's regional health governance has evolved into a dense but weakly integrated system of overlapping institutions. This Health Policy paper maps the regional health governance of the Association of Southeast Asian Nations (ASEAN) as an evolving health regime complex, tracing the historical origins of regional health governance to the early 20th century and examining developments from 1980 to 2024. The study also identifies two structural features: functional specialisation along with persistent fragmentation and structural asymmetry, in which external actors dominate technical and agenda-setting roles while ASEAN retains coordination authority. Although recent reforms under the ASEAN Post-2015 Health Development Agenda have improved institutional alignment, system-wide coherence remains poor. Strengthening regional health governance will require institutional rationalisation to reduce duplication and strengthen underdeveloped functions, alongside a rebalancing of external engagement to restore regional ownership of policy priorities. The analytical approach developed in this Health Policy paper offers a transferable framework for other regions facing institutional proliferation. Policy efforts should shift from expanding arrangements towards managing complexity through coordination, functional differentiation, and clearer authority structures.
PMID:
42497876
Bibliographic data and abstract were imported from PubMed on 25 Jul 2026.
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