The Intel

Australia’s regional efforts should focus less on episodic emergency response and more on the foundations of resilience: primary care, surveillance, workforce capacity, supply chains and financing. The challenge is not whether these areas receive attention, but whether investments are sufficiently long-term and integrated.

The Indo-Pacific faces a double threat. Acute infectious disease risks remain real, but a slower-moving pandemic is already here: the rise of non-communicable diseases. Diabetes, cardiovascular disease, cancer, eye disease and mental illness are increasingly dominating mortality, disability, and spending across the region. They can weaken populations before infectious outbreaks arrive, crowd out essential services during crises, and impose long-run economic costs through lost productivity, household impoverishment and fiscal pressure.

Australia’s comparative advantage lies in helping countries build systems that can manage both shocks and chronic burdens. That means investing in prevention, early diagnosis, affordable medicines and assistive technologies, health information systems, a trained workforce and sustainable financing. It also means integrating pandemic preparedness with routine care, rather than treating them as separate agendas. A clinic that can detect hypertension, manage diabetes and maintain vaccination coverage is also better placed to identify outbreaks, communicate risk and keep essential services running.

The region needs more than emergency preparedness. It needs durable health infrastructure. Australia should direct its efforts toward strengthening long-term investment in everyday health systems - the institutions, workers and services that determine whether both fast pandemics and slow ones become human and economic crises.

The last 5 years have seen Australia play a significant role in the progress of pandemic preparedness across the region. The recent Hanta virus and Ebola outbreaks have shown we cannot afford to stop investing in prevention and preparedness. This is particularly true as other agencies and donors reduce support globally.

Australia should continue to support health system approaches to preparedness and response – by strengthening surveillance, laboratory systems, risk communication and health workforce and emergency operations. This inter-pandemic period provides a unique opportunity to address diseases of current significance which are placing pressure on countries in the region. For example, measles across Southeast Asia and Dengue in the Pacific Island Countries are both testing country capacities to respond. Taking an all-hazards approach and promoting multi-sectoral collaborations can also help extend the preparedness capacities.

Australia has played a leading role in negotiations of the pandemic agreement. Australia should continue advocating for equitable outcomes in the final stages of the Pathogen Access and Benefits Sharing negotiations. Failure to achieve this negotiating position will signal a step backwards for equity. The New International Health Regulations (IHR) amendments came into effect this year, with many countries, including Australia, having established IHR Authorities. National Public Health Institutes play a critical role in maintaining and delivering on core capacities under the IHR. Australia can work with countries in the region to learn and share lessons with other Member States.

The magnitude of technical health capacities across our region are expanding but are not equally distributed or represented. Australia should focus on identifying key areas in which technical capabilities can be developed further, especially to support evidence-informed, time-sensitive decision-making during pandemics and emergency response.

Preparing for the next pandemic requires broadening how we see health. Health systems are essential and incredible for detecting and treating disease once it is already there. But that's response, not prevention. Effective prevention starts much earlier by asking why some people, communities and countries are more vulnerable before a pathogen even arrives. Those vulnerabilities are created by the conditions people live in– not the pathogen itself.

Gender, socioeconomic status, ethnicity, conflict exposure and access to care don't sit alongside each other as separate risk factors; they compound. Together they shape who is exposed, who bears the greatest burden, and how well societies absorb future shocks. A health program focused only on hospitals, surveillance and outbreak response risks overlooking the very conditions that determine population vulnerability. As our General Manager often says, 'it's hard to measure success through what hasn't happened.’

In a system that rewards what's countable, the visible emergency response can easily be favoured over the less visible foundational capacity, even though investments in the social determinants of health can save lives and improve health outcomes, while reducing healthcare costs of treating preventable illness and productivity losses over the long term.

Australia can do more than fund stronger health systems. It can take a whole-of-portfolio view of prevention, recognising that governance, civil society and social protection are not adjacent to health; they are part of how health is created. Australia's challenge is to design country programs around reducing vulnerability, rather than around sectoral boundaries. The next pandemic will not be prevented by health spending alone, but by the policies that shape vulnerability long before disease arrives.