The Ledger Asia | Health and Wellness
Asia, 2 December 2025 — Asia is living through a silent medical emergency. For every headline that focuses on the rise of AI-driven hospitals or billion-dollar healthcare investments, there is another crisis unfolding beneath the surface, one that receives less attention but threatens to define Asia’s demographic and economic future.
Across the region, hundreds of millions of people are living with chronic diseases they do not even know they have. The World Health Organization (WHO), national health ministries, and major regional studies repeatedly warn of a dramatic pattern: Asia has some of the world’s highest rates of undiagnosed conditions such as diabetes, hypertension, kidney disease, and cardiovascular disease.
So the question is no longer whether Asia has a chronic disease problem.
It is: How many millions are living with illnesses that remain completely unrecognised, untreated, and economically destabilising?
The Numbers: The Majority Are Undiagnosed
Across Asia, undiagnosed chronic diseases are not the exception, they are the norm.
Using the most widely cited health-survey estimates:
• Diabetes: 55% to 60% of Asians with diabetes are undiagnosed
In countries like Malaysia, Indonesia, and Thailand, studies show that more than half of all people with diabetes do not know they have it. In Bangladesh and India, this number rises to nearly 60%.
• Hypertension: 50% to 65% undiagnosed across major Asian economies
Hypertension, often called the “silent killer”, frequently presents no symptoms. In Indonesia, China, and the Philippines, over half of all adults with high blood pressure remain undiagnosed.
• Chronic Kidney Disease (CKD): Up to 90% undiagnosed in Asia
CKD is one of the region’s most under-detected illnesses. Singapore, Malaysia, China, and Vietnam all report staggering under-diagnosis rates, with 70% to 90% of sufferers unaware until late-stage decline.
• Cardiovascular risks: Millions unaware of early heart disease indicators
Coronary artery issues, arterial plaque buildup, high LDL cholesterol, and endothelial dysfunction often go untested in lower- and middle-income Asian communities, meaning millions of heart disease patients are invisible inside the system.
The estimate: Over 500 million Asians may be living with undiagnosed chronic diseases today
This is a conservative calculation when aggregated across 4.7 billion people in Asia and the rising prevalence rates of metabolic and circulatory illnesses. In effect, Asia is carrying an invisible disease burden that is larger than the population of the European Union.
Why Asia Has One of the Highest Undiagnosed Populations in the World
Three structural forces explain why undiagnosed disease rates in Asia are so high.
1. Rapid Urbanisation and Diet Shifts Outpace Healthcare Infrastructure
Asia’s consumption patterns have transformed faster than its healthcare systems.
Over the last 30 years:
- Diets have moved from plant- and fish-based meals to sugar-dense, high-calorie processed food.
- Urbanisation has increased sedentary lifestyles.
- Obesity and pre-diabetic markers have surged.
But screening programs, particularly for lower-income populations, have not scaled at the same speed. Millions of rural and migrant workers fall outside of routine annual checkups. Health systems designed for infectious diseases are now overwhelmed by metabolic ones.
2. Cultural Norms Discourage Early Screening
A pervasive cultural mindset exists in many Asian societies:
“If nothing hurts, I must be fine.”
Many chronic diseases show zero symptoms during their early progression. Diabetes, hypertension, and CKD often remain undetected for years.
In several markets:
- Men avoid screenings due to stigma.
- Women face barriers in accessing routine preventive care.
- Elders consider health complaints a sign of weakness.
- Younger people assume chronic diseases only affect “old people.”
This cultural inertia creates substantial diagnostic blind spots.
3. Healthcare Access Inequality Across Southeast Asia and South Asia
Healthcare in Asia is not evenly distributed:
- Urban hospitals are overcrowded.
- Rural clinics often lack diagnostic equipment.
- Millions remain uninsured or underinsured.
- Out-of-pocket spending is still the region’s dominant healthcare financing method.
Routine blood tests, screenings, and specialist consultations remain unaffordable for many. As a result, chronic diseases are typically discovered only during emergencies, stroke, kidney failure, diabetic crisis, or heart attacks.
The Economic Consequences: A Multi-Trillion Dollar Drag on Asia’s Future
Asia’s undiagnosed disease crisis is not just a health issue, it is an economic one. The region’s productivity, workforce stability, and healthcare budgets are all at risk.
1. Productivity Loss Across Asia’s Young and Middle-Aged Workforce
Chronic diseases do not only affect the elderly.
Undiagnosed diabetes or high blood pressure can silently damage:
- Eyesight
- Arteries
- Nerves
- Kidneys
- Cardiovascular systems
As these workers hit their 30s, 40s, and 50s, employers face rising absenteeism, early disability, and reduced productivity. The Asian Development Bank warns that chronic diseases could reduce labour productivity by up to 30% in some countries by 2040.
2. Rising National Healthcare Costs
Treating late-stage disease is dramatically more expensive than early detection.
A single dialysis patient costs governments and insurers 15 to 20 times more than preventive care screenings.
Undiagnosed patients enter care late, when:
- They require expensive medication
- They need long-term treatment
- They face higher hospital admission rates
This creates a tsunami of avoidable medical spending.
3. Economic Inequality Worsens as Poorer Populations Are Hit Hardest
Wealthy families screen earlier and manage disease earlier.
Low-income families do not.
This widens the socioeconomic gap and leads to long-term intergenerational disadvantage.
4. Pressure Builds on Asian Pension and Social-Protection Systems
As chronic diseases strike earlier in life:
- Early retirement increases
- Disability claims rise
- Long-term care systems face heavy stress
Governments from China to Malaysia must prepare for sharper and more costly demographic headwinds.
How Asia Can Reverse the Trend
To bend the curve, Asia must shift from reactive healthcare to proactive, preventive healthcare at scale.
A. Region-wide screening initiatives
Governments must expand mandatory annual screenings, especially for:
- Diabetes
- Blood pressure
- Kidney function
- Cholesterol
B. Affordable, accessible diagnostics
Portable test kits, mobile clinics, and community health programs can close major detection gaps.
C. Public campaigns that reshape cultural attitudes
Influencers, celebrities, and public icons must break the stigma around health checks.
D. Digital health technologies
AI diagnostics, telemedicine, and home test devices can bring preventive care directly to the population.
E. Employer-driven health programmes
Companies need structured annual health tests, not once every 5 years.
Asia’s economic future depends not only on innovation, infrastructure, and trade, but on the health of its people. And right now, that health is more fragile than most are willing to admit.
Conclusion: The Silent Epidemic Asia Can No Longer Ignore
Asia’s chronic disease crisis is already here.
Millions are sick but do not know it.
Millions more will become sick unless the region pivots swiftly.
Economists and health experts agree on one point:
The real cost of chronic disease is not measured in treatment bills, but in lost human potential.
To build a prosperous Asia for the next generation, the region must confront the uncomfortable truth that healthcare systems built for infectious disease must now transform to fight something even more dangerous, the illnesses that hide in the dark.
