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In 2008, the World Health Assembly formally recognised the health threats of climate change. In the years that followed, the centre of gravity of sustainable healthcare hovered over the North Atlantic, driven first by health professionals and then by governments, predominantly in Europe, North America, and Australia. The implicit theory of change was that progress in high income health systems would drive action worldwide. Today, despite global headwinds, health systems across the Asia Pacific region are accelerating decarbonisation efforts most quickly.