East Asia’s Health Wake-Up Call: World Bank Urges PHC Reform as NCDs Surge

“Strong primary health care systems do more than safeguard well-being,” said Carlos Felipe Jaramillo, World Bank Vice President for East Asia and the Pacific.

East Asia and the Pacific (EAP) is approaching a critical inflection point. A rapid rise in chronic, noncommunicable diseases (NCDs) now threatens to overwhelm health systems, weaken productivity, and slow long-term income growth across one of the world’s most dynamic regions.

A new World Bank report, A Healthy Future: Primary Health Care and the Chronic Disease Epidemic in EAP, argues that urgent reform of primary health care (PHC) is the region’s strongest—and most cost-effective—defense. The stakes are high: evidence shows that every US$1 invested in strong PHC can generate up to US$16 in economic returns, through improved health, higher productivity, and job creation.

From Health Gains to Health Risks

Over the past 30 years, EAP countries have delivered extraordinary health improvements. Under-five mortality has fallen sharply—from 57 deaths per 1,000 live births to just 15—while life expectancy has climbed from 68 to 77 years. But longevity has come with a catch.

People across the region now spend nearly a decade of their lives in poor health, largely due to preventable chronic conditions such as cardiovascular disease, diabetes, and cancer. Rapid urbanisation, ageing populations, and unhealthy lifestyles are driving NCDs among adults in their most productive years—undermining economic growth and pushing health-care costs higher.

“Strong primary health care systems do more than safeguard well-being,” said Carlos Felipe Jaramillo, World Bank Vice President for East Asia and the Pacific. “Healthier people learn more, work more productively, and invest more. These benefits expand opportunity, build human capital, and drive inclusive prosperity.”

Prevention Over Cure—But Systems Lag Behind

The report makes a clear case: prevention is the first line of defense against NCDs. Screening, early detection, and ongoing management through PHC can keep people healthier—and out of costly hospitals.

Yet in many EAP countries, health systems remain heavily oriented toward treatment rather than prevention. Public awareness of NCD risks is low, trust in PHC services is limited, and patients often bypass community clinics altogether, seeking care only when illnesses worsen. The result is delayed treatment, overcrowded hospitals, and widespread underuse of preventive services.

“Improved primary health care is critical for sustained growth in East Asia and the Pacific,” said Aaditya Mattoo, the World Bank’s EAP Chief Economist. “By investing in prevention, embracing innovation, and strengthening community-level health services, countries can unlock new economic opportunities and improve quality of life at scale.”

A Reform Blueprint for the Region

Recognising the diversity of health systems across EAP, the report stresses that reforms must be tailored to each country’s financial capacity, technical readiness, and political context. It outlines four priority actions:

1. Upgrade PHC capabilities with the infrastructure, tools, and skills needed to manage NCDs.

2. Improve quality of care by monitoring outcomes and rewarding providers for strong performance.

3. Make PHC affordable—or free—for low-income populations, reducing barriers to early care.

4. Use information, nudges, and incentives to promote healthier lifestyles and encourage preventive care.

Call to Action: Innovate Early, Scale Fast

With EAP representing a major share of the World Bank’s ambition to deliver quality, affordable health services to 1.5 billion people by 2030, the report sends a clear signal to policymakers, health-tech innovators, and investors alike.

Countries that move early to modernise primary health care—leveraging digital tools, data-driven incentives, and community-based models—stand to gain not only healthier populations, but stronger, more resilient economies.