From fragmented emergence to uneven scale-up: ASEAN's unfinished transition in AI-for-health research

ASEAN’s artificial-intelligence-for-health literature has grown rapidly, especially since 2020, but the region’s research system remains unevenly integrated. Bibliometric mapping suggests a three-phase transition from sparse, technically oriented research to regional network formation and thematic diversification, followed by rapid but hub-dominated expansion, with publication growth outpacing equitable regional collaboration and broader participation. Despite this momentum, ASEAN still accounts for only a small share of global AI-for-health output, suggesting that regional growth has not yet translated into a proportionate global footprint or shared scientific ownership. The key messages of this viewpoint are as follows: (1) ASEAN’s AI-for-health literature has undergone a structural transition rather than simple numerical growth, evolving from early technical emergence with weak regional ties to network formation and thematic diversification, and then to post-2020 hub-dominated expansion; (2) although intra-ASEAN collaboration has intensified, the regional system remains uneven, with Singapore, Malaysia, and Thailand functioning as dominant hubs while smaller national research systems remain peripheral; (3) some publications focus on ASEAN settings despite having no ASEAN-affiliated authors, indicating that the region is not only a producer of knowledge but also an object of externally led research, with important implications for representation, agenda setting, participation, and scientific ownership; (4) the principal policy challenge is no longer whether ASEAN participates in AI-for-health research, but whether it can translate rapid growth into a more equitable, integrated, inclusive, and scientifically sovereign regional knowledge system; and (5) despite rapid expansion, ASEAN still accounts for only a small fraction of global AI-for-health output, underscoring the need to strengthen regional research capacity, visibility, participation, and influence.