Pathogen genomics using Next Generation Sequencing (NGS), has emerged as an essential tool for supporting timely public health responses to outbreaks. NGS can rapidly and accurately identify which pathogens or variants are circulating and causing disease. In addition, pathogen sequence information is a foundational building block for the development of new outbreak response tools – such as rapid diagnostics and vaccines.

Despite its promise, not every country has the same access to this crucial technology. Disparities in access are more than just numbers. They represent lives and livelihoods that could have been preserved if the playing field were levelled. While wealthy countries have long used NGS for routine surveillance, many low- and middle-income countries (LMICs) only established this capability during COVID-19, with external support. Now, they struggle to sustain and expand this newfound capability, despite remaining the most vulnerable to emerging pathogens, where NGS could have the most transformative impact in providing early warning and curbing the outbreaks at source.

To understand the barriers faced by countries in the region, the Asia Pathogen Genomics Initiative (Asia PGI) conducted a comprehensive assessment of pathogen genomics capacity and challenges across 13 countries. This wasn’t just another survey; it was about actively listening to the voices on the ground—gathering the perspectives of public health officials, scientists and laboratory technicians at the heart of pathogen detection across Asia.

The findings were both encouraging and sobering. All the countries assessed had some level of NGS capacity, and many had begun to develop strategic plans to integrate genomics into their broader surveillance systems. But the challenges were significant. For many, NGS was used largely as a research tool or an add-on to outbreak investigation, rather than being fully integrated with national surveillance programmes. Moreover, it is evident that poor countries pay many times more than wealthy countries for NGS equipment and supplies. Furthermore, supply chain disruptions, a shortage of trained personnel, and quality assurance pose major hurdles.

Behind the data are real stories of people working tirelessly to protect their communities despite these obstacles:     

• Stakeholders from Pakistan noted that while donor funding quickly boosted capacity in pathogen genomics, long-term financing remains uncertain. Similarly, Sri Lanka's economic crisis has resulted in severe shortfalls of public sector funding, leading to a lack of domestic financial resources for pathogen genomics.
• In Bangladesh, sequencing activities are currently centralized in Dhaka, but it can take nearly two weeks for samples to reach the capital. Efforts are being made to decentralize sequencing capacity.
• In Laos, despite increasing interest in establishing pathogen genomic surveillance, a significant barrier is the shortage of trained laboratory staff, primarily due to limited training and funding opportunities.
• Prior to COVID, Indonesia had just one centre with the capacity to conduct pathogen genomics. Since the pandemic, all 34 provinces have recently built local genomics capacity, introducing a need for quality assurance and supervision.
• In Cambodia, NGS has transformed disease surveillance in high-risk wildlife markets, and was instrumental in detecting a bird-flu outbreak within 24-48 hours of receiving a sample.

These are not isolated examples. Across Asia, dedicated professionals are pushing the boundaries of what is possible with the tools they have. Countries with established systems, such as India, Indonesia, Malaysia, and Thailand, are well-positioned to take on leadership roles, sharing valuable lessons to foster cross-country learning.

Perhaps what is needed is a sense of solidarity. Pathogens do not recognize borders, and neither should our response. With this purpose in mind, the Asia PGI is dedicated to building a collaborative community that accelerates pathogen genomic sequencing across Asia, where early detection, control, and elimination of infectious diseases are urgent priorities.

By bringing together countries and individuals with a shared commitment to using genomics for public good, the Asia PGI network is shaping a future where Asia not only safeguards its own populations but also contributes as a collective to global health security.