As the world navigates a pivotal moment in global health and development, one of the most critical pathways to sustainable development is through regional public health. Investing in regional health systems and production capacity of public health goods isn’t just a moral responsibility; it is an economic imperative. 

A 2020 McKinsey & Company report revealed that every $1 spent on health in developing countries can yield a return of $2 to $4, underlining the impact of strategic investments in health. 

When the COVID-19 pandemic brought the world to a standstill, it not only revealed critical failures and fragilities in the global response to public health crises but also highlighted the inextricable link between health and development. 

It caused the first rise in global poverty in a generation, triggered the deepest global recession since the end of World War II, and widened inequalities within and across countries, particularly for the most vulnerable. 

The unequal access and distribution of medical countermeasures between wealthy nations and low- and middle-income countries left millions around the world without life-saving vaccines, overwhelmed healthcare systems, and led to the loss of lives. 

Over-centralized, top-down response

Beyond the human and economic costs, the pandemic exposed a troubling reality: An overly centralized, top-down global response is inadequate when crises arise. The failure of initiatives like the COVID-19 Vaccines Global Access (COVAX) to ensure equitable vaccine access for poorer nations exemplified these weaknesses. 

In response, regional institutions stepped up. The Caribbean Public Health Agency (CARPHA) mobilized resources to support member states in their COVAX participation. Similarly, the Association of Southeast Asian Nations (ASEAN) launched the Vaccine Security and Self-Reliance initiative to boost regional procurement and stockpiling. 

In Africa, the African Union (AU) and the Africa Centres for Disease Control and Prevention (Africa CDC) created the African Vaccine Acquisition Task Team, securing enough doses to cover a third of the continent’s population. 

Historically, public health outbreaks like HIV, TB, malaria, Ebola, SARS, dengue, Zika, mpox, and COVID-19 have demonstrated that public health threats do not respect borders. When a nation or region cannot adequately prepare for, prevent, or respond to these threats, it poses significant risks for the rest of the global community. 

Around the world, regional agencies like the Africa CDC, CARPHA, the European Centre for Disease Prevention and Control (ECDC), the Gulf CDC and the, yet to be established, ASEAN Centre for Public Health Emergencies and Emerging Diseases (ACPHEED), are emerging as powerful models for tackling cross-border health challenges and fostering regional countries’ cooperation and a platform for future south-south collaboration – through shared responsibilities, knowledge exchange, data-sharing, and pooled resources. 

In the face of recent disruptions, regional bodies continue to show their indispensable role in shaping a more resilient and coordinated global response. 

The Africa CDC’s declaration of the 2024 mpox outbreak as a Public Health Emergency of Continental Security before the World Health Organisation (WHO) – making it the first of its kind in the agency’s history – illustrates the power of regional leadership. 

This catalyzed the rapid mobilization of resources, collective will, and interventions to contain the outbreak and protect vulnerable populations.

 Likewise, ASEAN convened and activated regional action quickly during its 2024 mpox outbreak, while in 2021, the European Union (EU) established the Health Emergency Preparedness and Response Authority, bolstering regional capacity to respond to health emergencies and ensuring access to vaccines, diagnostics, and therapeutics. 

Together, these highlight the transformative potential of regionally anchored strategies, and the crucial need for them as central players – not just in crisis response, but in ongoing efforts to coordinate, respond, and sustain recovery – not as mere beneficiaries but as essential actors. 

Equity and resilience

Strong regional public health mechanisms should be the key engines for equity and resilience. Although the world has taken a significant step forward with the adoption of the Pandemic Agreement to improve coordination, transparency, and equity, it is not enough. 

Challenges persist, especially the power dynamics that favor wealthier countries in decision-making and in controlling vaccine rights and distribution. By contrast, empowering regional health systems to produce vaccines, therapeutics, and diagnostics locally can help address these inequities. Such efforts can create ripple effects – enhancing human capital, creating jobs, and stimulating economic growth.

The African Vaccine Manufacturing Accelerator (AVMA) financing initiative, designed to unlock up to $1.2 billion over the next decade, reinforces this shift toward self-reliance. 

Moreover, regional institutions are vital for advancing equity by increasing the negotiating leverage of marginalized or less powerful states in global health governance. 

For instance, the Pandemic Agreement’s provision and voting rights for regional organisations such as ASEAN, the AU and the EU illustrate the importance of regional voices. 

The Africa CDC’s role in galvanizing a unified African position during the negotiations emphasizes how regional bodies strengthen collective influence. 

The lesson is clear: Robust regional public health systems not only promote equitable representation on the global stage but also serve as mediums for self-sufficiency and health sovereignty. 

These qualities are key to building resilient health systems capable of weathering overlapping global shocks and shifting geopolitical priorities. Given these promising developments, there is a compelling argument for establishing a Latin American CDC to enhance the region’s capacity to coordinate and respond to outbreaks effectively – a proposal worth exploring. 

Public health is a public good, and it must be viewed not as charity but as a strategic investment in our shared future. Building resilient, equitable, and well-resourced regional health systems, backed by strong political will, is essential for stability and shared prosperity. 

By prioritizing this approach, we take a step toward transforming the global health architecture and creating a more equitable and healthier future.  

Michael Weinstein is the president and co-founder of the AIDS Healthcare Foundation (AHF), the largest AIDS health organization in the world, whose mission is to provide cutting-edge medicine and advocacy regardless of ability to pay.

Mehdi Jomaa is the former Prime Minister of Tunisia (2014-2015) and a member of Club de Madrid, a forum of former democratic presidents and prime ministers who leverage their experience and global reach to strengthen inclusive democratic practice and improve the well-being of people around the world.

Image Credits: Kerry Cullinan.