Aceso Global developed a policy brief for the Asian Development Bank (ADB) examining the role of regional and sub-regional institutions in pandemic prevention, preparedness, and response (PPR) across Asia and the Pacific. Drawing on lessons from COVID-19, the brief highlights the urgent need for more coordinated regional action to confront cross-border health threats. It explores the potential design of new institutions that balance national sovereignty with the authority to act collectively, and reviews the mixed performance of existing regional bodies during the pandemic. With attention to political and economic realities, the brief outlines key considerations for building effective, trusted regional institutions that can drive collaborative PPR efforts and better protect populations and economies from future crises.