Last month, asthma cases in Malaysia rose by 259 per cent amid haze affecting several parts of the country, according to the country’s health minister, while hundreds of schools in its Sarawak state were forced to close as air quality reached unhealthy levels.
Meanwhile, Singapore’s environment agency warned that occasional haze may also affect the city-state, as forest fires fuelled by a strong El Niño have continued to burn across neighbouring Indonesia’s Sumatra and Kalimantan.
These episodes illustrate only one dimension of Asia’s growing climate-health challenge. Experts say extreme heat, flooding, shifting patterns of vector-borne disease and mounting pressure on healthcare systems are also placing communities across the region at greater risk.
“Understanding the influence of environmental factors on health outcomes is becoming increasingly urgent, both from a protection perspective and in helping people and communities build resilience,” Mitch New, Group General Counsel, AIA and Chairman of AIA’s ESG Committee, told Eco-Business.
“[Climate] risks interact with broader trends shaping Asia, including ageing populations, rapid urbanisation, pressure on healthcare systems and other key infrastructure,” he added, citing findings by Climate and Health in Asia, a report by Forum for the Future, commissioned by AIA, examining the health impacts of climate change across Asia and how insurers can strengthen resilience.
The report cited the World Health Organization (WHO) showing that 99 per cent of Southeast Asian cities are breathing air above safe levels. It said climate change, “once primarily an environmental concern,” is now recognised as a global health threat, with implications for how health and life insurers assess risk, design products and make investment decisions.
“Climate-health is becoming one of the defining development challenges for the region,” highlighted Dr Sally Uren, Executive Director and Chief Acceleration Officer at Forum for the Future.
Anil Soni, Chief Executive Officer of the WHO Foundation, shares a similar view.
“Climate change is no longer a distant environmental concern,” Soni wrote in the Climate and Health in Asia report foreword, adding that rising temperatures, extreme weather events, air pollution and changing patterns of disease are placing growing pressure on individuals, communities and health systems alike.
“As these impacts intensify, they are reshaping health outcomes across the world, affecting how people live, work and stay well.”
Stronger prevention, early-warning systems and resilient healthcare infrastructure will be critical as climate-related health risks place increasing demands on communities across Asia. Image: ILO Asia-Pacific, CC BY-SA 3.0, via Flickr.
Web of risks
For Adrita Bhattacharya-Craven, Director of Population Health Trends at the insurance think tank The Geneva Association, understanding those connections is more important than simply cataloguing individual hazards.
“Heat gets [the most] headlines because it’s visible and immediate,” said Bhattacharya-Craven, also one of the report’s foresight resource contributors, but the health risks extend far beyond heat.
The Asia-Pacific region is particularly exposed: around 75 per cent of its workers are already exposed to excessive heat, higher than the global average of 71 per cent, according to the International Labour Organization (ILO). The ILO also estimates that heat stress could result in the loss of the equivalent of 13 million jobs across Asean economies by 2030.
“It’s exactly why [the Climate and Health in Asia] report differentiated between acute and slow-changing effects, because if you focus only on the dramatic, sudden risks, you miss the long tail that climate change is quietly leaving behind,” Bhattacharya-Craven added.
She explained that one of those longer-term risks is the changing environment for vector-borne diseases.
“Vector-borne disease is becoming genuinely worrying,” said Bhattacharya-Craven. “A hotter climate and increasingly erratic rainfall are extending the breeding and transmission season for dengue-carrying mosquitoes, and we’re now seeing outbreaks land at times of year that are unexpected.”
The implications are particularly significant in Asia, which accounts for about 70 per cent of global dengue cases, according to WHO.
Dengue infections in Malaysia have surged 56.2 per cent this year, while key cities in the Philippines have declared dengue epidemics amid a sharp rise in cases this monsoon season.
“Flooding brings waterborne disease and displacement; rainfall deficits bring water scarcity, poor hygiene, diarrhoeal disease, dehydration and kidney disease,” said Bhattacharya-Craven.
An estimated 2.9 million additional people in Asian metropolitan areas could be exposed to dengue over the next decade as changing rainfall patterns expand the disease’s geographic range and transmission window.
“The effects of climate change will continue to appear over time, and many will emerge in parts of our lives not currently seen as directly connected,” the report highlighted.
Extreme heat adds another layer, exacerbating cardiovascular and respiratory illnesses, according to Bhattacharya-Craven, who said those effects can become more severe when extreme heat coincides with poor air quality.
From construction sites to farms and city streets, outdoor workers are among those most exposed as extreme heat becomes more frequent and intense across Asia. Image: Icaro Cooke Vieira / CIFOR, CC BY-SA 3.0, via Flickr.
Professor Steve Yim, Founding Director of the Centre for Climate Change and Environmental Health at Nanyang Technological University (NTU), said these compound hazards remain poorly captured because most warning systems continue to assess climate threats separately rather than integrating their health effects.
“Most existing warning systems evaluate hazards in isolation and seldom integrate health metrics, leaving the amplified risks of these combined events largely overlooked,” he told Eco-Business.
Yim noted that the health impacts can be particularly severe when hazards overlap.
“Asia is home to more than half of the global population and is highly exposed to climate-related risks, including extreme heat, flooding, air pollution and climate-sensitive infectious diseases, placing it at the frontline of this challenge,” said WHO Foundation’s Soni. “Rapid urbanisation, population ageing and existing health inequities further increase vulnerability. In many parts of Asia, the health impacts of climate change are already visible, even when they are not always recognised or recorded as climate-related.”
Around 2.2 billion people already live in Asian urban areas, and another 1.2 billion are expected to move to cities over the next 25 years. As cities grow denser, limited green space and the urban heat-island effect can increase exposure to heat and air pollution, while rapid urbanisation puts additional pressure on infrastructure and healthcare services.
“For Asia specifically, the physical signal is clear,” Bhattacharya-Craven said, as Asia is warming twice as fast as the rest of the world.
An ageing population adds another layer of vulnerability. One in four people in Asia will be over 60 by 2050, while 44.1 million people in the Asia-Pacific region live below one metre of elevation, leaving many communities exposed to rising seas and flooding.
Forum for the Future’s Uren underscored that those facing the greatest exposure are often those with the least capacity to adapt, including older people, residents of dense urban and delta communities, and outdoor and informal workers.
“There is a clear equity, or lack of it, issue associated with climate impacts on health,” she explained.
Outdoor workers face some of the most direct health risks from rising temperatures, with prolonged heat exposure increasing the threat of heat stress, dehydration and other illnesses. Image: ILO Asia-Pacific, CC BY-SA 3.0, via Flickr.
Building health systems that can withstand change
An assessment of 10,117 hospitals across Southeast Asia found rising risks of climate-related damage under a high-emissions scenario, with 696 hospitals in Indonesia and 550 in the Philippines classified as high risk to floods and other extreme weather events.
Public health spending in Asia’s lower-income countries averages just 4.5 per cent of GDP, compared with 9.7 per cent in OECD countries.
For AIA’s New, the ability of healthcare systems to keep operating as these pressures evolve is becoming increasingly important.
“A key priority must be ensuring healthcare systems remain resilient and are able to continue delivering accessible, affordable and quality care,” he said.
“Alleviating these systemic pressures will require greater emphasis on prevention, investment in resilient healthcare infrastructure and stronger collaboration across the healthcare ecosystem,” New continued.
“At the same time, reducing emissions and accelerating the transition to a lower-carbon future remain essential, as mitigation helps reduce the long-term health risks that healthcare systems and communities will increasingly face.”
Yim said the challenge becomes more acute when multiple hazards strike at once, exposing weaknesses in systems designed around individual threats.
“Most health and disaster risk management systems in Asia operate in linear, single-hazard silos,” he said.
“When a compound event occurs, such as a flood disrupting healthcare supply chains and power grids precisely during a severe heatwave and dengue surge, the result is system failure. Emergency rooms become overwhelmed while public health infrastructure loses cooling and clean water capacity,” Yim continued.
Uren similarly warned that the combination of ageing populations, rapid urbanisation and Asia’s large disaster protection gap could steadily weaken health-system capacity at a time when demand is increasing.
Preparedness, however, remains uneven. Bhattacharya-Craven said climate-related health risks are increasingly recognised by policymakers, but health systems still face constraints in turning that awareness into readiness.
A 2024 Geneva Association study found that insurers expect long-term effects on the insurability and affordability of health and life insurance to become more pronounced if global warming surpasses 1.5°C.
Health systems globally could face an additional US$1.1 trillion burden from climate change, driven by floods, droughts, heatwaves and infectious disease, according to the World Economic Forum. Existing pressures on healthcare demand and costs can make it harder for systems to adapt quickly.
That puts prevention and adaptation at the centre of the response. Bhattacharya-Craven identifies health-focused early-warning systems as one practical opportunity, particularly systems that can translate climate information into decisions about hospital capacity, medicine supplies and support for vulnerable groups.
The economic burden is also likely to fall disproportionately on people and systems least able to absorb it. Uren noted heat exposure caused an estimated US$1.09 trillion in lost labour income globally in 2024, while Asia’s disaster protection gap of 88 to 90 per cent means much of the cost of recovery falls on households and health systems.
Yim said such systems should move beyond basic weather alerts by combining meteorological monitoring with disease surveillance. This could allow cities to activate cooling centres, pre-position medical supplies and issue targeted warnings to vulnerable groups before compound hazards peak.
Healthcare systems across Asia are being tested by overlapping climate hazards, including heatwaves, toxic air, flooding and shifting patterns of infectious disease. Image: ILO Asia-Pacific, CC BY-SA 3.0, via Flickr.
Prevention before protection
Prevention can reduce pressure on healthcare systems before climate-related hazards translate into illness or disrupt services, according to New.
For communities, this can mean better access to primary care, the promotion of healthier lifestyles, timely warnings and targeted support for vulnerable groups. For healthcare providers, it may be in the form of stronger disease surveillance, resilient facilities, reliable energy and water supplies, emergency preparedness and digital tools that can keep care running when physical access is disrupted.
“Climate-health challenges highlight the importance of supporting people before adverse events occur,” New said. “As health risks evolve, there is an opportunity to complement protection with approaches that encourage prevention, preparedness and resilience. This aligns with AIA’s purpose of helping people live Healthier, Longer, Better Lives.”
New highlighted AIA Vitality, a health and wellbeing programme that uses education and behavioural incentives to encourage healthier lifestyles and preventive care. The Climate and Health in Asia report cited that among participating members at clinical risk thresholds, 23 per cent achieved healthier body mass index (BMI) ranges, 66 per cent reached healthy blood glucose levels and 35 per cent returned to healthy cholesterol levels, through incentivised physical exercise, sleep tracking and health assessments.
New also points to the role of awareness and earlier intervention in reducing vulnerability and improving long-term health outcomes.
“Insurers can contribute in several ways beyond traditional coverage,” said New. For AIA, that includes preventive health programmes like AIA Vitality, the AIA Healthiest Schools Programme, healthcare partnerships and research. The AIA Healthiest Schools Programme provides teachers across Asia-Pacific with educational resources on health and wellbeing.
Uren said the wider shift towards prevention could be critical to building resilience, as health systems increasingly need to reduce vulnerability before people require acute care.
People lie on the grass under trees during a sunny heatwave in Hong Kong. Image: Hong Kong Free Press, CC BY-SA 3.0, via Wikimedia.
“Across the world we are seeing health systems shift towards prevention rather than cure,” she said. “This broader reframe of how we view the function of our health systems is critical to building resilience.”
“One of the biggest barriers today is that climate change and health have often been treated as separate conversations,” New said. “While awareness is growing, important gaps remain in data, research and understanding, particularly around how climate-related risks affect different populations and healthcare systems across Asia.”
Those gaps matter beyond the insurance industry. Better evidence is needed by governments and healthcare providers to identify vulnerable populations, plan services and prepare for emerging risks. For insurers, it can also inform how new risks are assessed and products are developed.
Yim said the problem is particularly acute in Asia, where health data remains fragmented and there is no centralised regional system for coordinated collection and standardised quality control.
“Asia is not one climate risk profile, it’s dozens,” Uren said, adding that much of the available data does not capture variation at the district or city level. Fragmented health records between public and private providers also make it difficult to link illness to climate exposure, particularly for slower-onset impacts such as chronic disease.
That makes collaboration central to building resilience.
“Governments, healthcare providers, researchers, businesses, communities, and insurers all have important roles to play,” New said. “The greatest value will come from collaboration that helps reduce climate-related health risks and strengthen the resilience of communities and healthcare systems.”
Climate-related health impacts also include mental health. Around 67 per cent of people affected by floods experienced anxiety symptoms and 60 per cent experienced depression.
Yim said the mental health burden of climate change remains under-researched, with displacement, chronic environmental degradation and slow-onset hazards such as sea-level rise contributing to psychological stress and other longer-term impacts.
Digital healthcare and telemedicine could help maintain continuity of care when climate events disrupt physical infrastructure, Uren said.
In Singapore, AIA has partnered with digital health provider WhiteCoat on the Think Well programme, which aims to make mental health support more accessible by giving workers covered under participating corporate outpatient plans access to mental health self-assessments, text-based sessions with professionals and video and in-person consultations.
These initiatives form part of AIA One Billion, the company’s goal of reaching one billion people with health and wellbeing initiatives by 2030.
Preparing for what comes next
New believes that recognising the connection between climate change and health will be critical to strengthening resilience.
“The more effectively we connect climate and health, the better positioned we will be to strengthen prevention, improve preparedness, and build healthier, more resilient communities for the future,” New said.
The report similarly notes that climate risks require systems capable of anticipating and adapting to change: “Escalating climate risks will not resolve on their own and require coordinated interventions and systems that are prepared to respond. It will take time to build, but it is achievable.”
Uren said there are reasons for optimism as the response begins to move beyond individual projects towards more coordinated, system-level approaches. Asia also has significant strengths to build on, including high smartphone penetration, a young and increasingly health-literate population and a growing pool of climate-risk expertise, she said.
“The task now is coordination and collaboration rather than invention, and that’s a solvable problem,” Uren said.
For insurers, that means contributing to prevention, health engagement, access to care, research and partnerships alongside their traditional role in protection. More broadly, climate-health resilience cannot be achieved by any single actor. Governments, healthcare providers, researchers, investors, and civil society all have important roles in strengthening the resilience of healthcare systems across Asia.
Asia’s climate-health future will depend on how effectively those pieces come together, and how early the region acts.
