Highlights

• Total DALYs increased across all five Asian societies between 2000 and 2019.
• Population aging was identified as the primary driver of total DALY increases.
• However, substantial decreases in DALYs per disease case were observed.
• These trends were especially pronounced for non-communicable diseases.

The COVID-19 crisis was a profound stress test for health, economic, and governance systems worldwide, and its lessons remain urgent. The pandemic revealed that unpreparedness carries cascading consequences, including the collapse of health services, the reversal of development gains, and the destabilization of economies. The magnitude of global losses, measured in trillions of dollars and millions of lives, demonstrated that preparedness is not a discretionary expense but a foundation of macroeconomic stability. Countries that invested early in surveillance, resilient systems, and inclusive access managed to contain shocks and recover faster, proving that health security and economic security are inseparable.

For the Asia-Pacific, the path forward lies in transforming vulnerability into long-term resilience. Building pandemic readiness requires embedding preparedness within fiscal and development planning, not as an emergency measure but as a permanent policy function. The region’s diverse economies can draw on collective strengths in manufacturing capacity, technological innovation, and strong regional cooperation to institutionalize the four pillars— globally networked surveillance and research, a resilient national system, an equitable supply of medical countermeasures and tools, and global governance and financing—thereby maximizing pandemic prevention, preparedness, and response. Achieving this will depend on sustained political will and predictable financing, supported by the catalytic role of multilateral development banks and international financial institutions that can align public investment with global standards and private capital.

The coming decade presents a narrow but decisive window to consolidate these gains. Climate change, urbanization, and ecological disruption are intensifying the probability of new zoonotic spillovers. Meeting this challenge demands a shift from episodic response to continuous readiness, from isolated health interventions to integrated systems that link health, the environment, and the economy. Strengthening regional solidarity, transparency, and mutual accountability will be vital in ensuring that no country is left exposed when the next threat emerges.

A pandemic-ready Asia-Pacific is not an aspiration but an imperative. The lessons of COVID-19 call for institutionalized preparedness that transcends political cycles and emergency budgets. By treating health resilience as a global public good, the region can turn its experience of crisis into a model of sustained, inclusive security for the world.

Abstract

 

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Introduction

Health care spending in South Korea is associated with improvements in health. However, it remains unclear whether the value of this spending is equally distributed across income groups.

 

Methods

We analyzed lifetime health care spending and quality-adjusted life expectancy (QALE) by income quintile among South Korean adults from 2010 to 2018. We then calculated the ratio of changes in health care spending to changes in QALE to estimate the value of health care spending across income groups. Additionally, we investigated mechanisms underlying income-related differences in the value of health care.

 

Results

Assuming 80% of QALE gains are attributable to health care, adults in the lowest income quintile received the least value, incurring $78,209 per QALE gained. However, middle- and higher-income quintiles achieved greater value ($47,831, $46,905, $31,757, and $53,889 from the second to highest quintile), although the highest value did not occur in the highest-income quintile. The higher spending per QALE gained in the lowest income quintile reflects smaller improvements in QALE, likely driven by poorer baseline health and greater unmet needs.

 

Conclusion

These findings highlight structural inequities in the South Korea health system and emphasize the need for targeted policies to promote equitable health care value.

Shorenstein APARC's annual report for the academic year 2023-24 is now available.

Learn about the research, publications, and events produced by the Center and its programs over the last academic year. Read the feature sections, which look at the historic meeting at Stanford between the leaders of Korea and Japan and the launch of the Center's new Taiwan Program; learn about the research our faculty and postdoctoral fellows engaged in, including a study on China's integration of urban-rural health insurance and the policy work done by the Stanford Next Asia Policy Lab (SNAPL); and catch up on the Center's policy work, education initiatives, publications, and policy outreach. Download your copy or read it online below.