Southeast Asia is a region of enormous social, economic, and political diversity, both across and within countries, shaped by its history, geography, and position as a major crossroad of trade and the movement of goods and services. These factors have not only contributed to the disparate health status of the region's diverse populations, but also to the diverse nature of its health systems, which are at varying stages of evolution. Rapid but inequitable socioeconomic development, coupled with differing rates of demographic and epidemiological transitions, have accentuated health disparities and posed great public health challenges for national health systems, particularly the control of emerging infectious diseases and the rise of non-communicable diseases within ageing populations. While novel forms of health care are evolving in the region, such as corporatised public health-care systems (government owned, but operating according to corporate principles and with private-sector participation) and financing mechanisms to achieve universal coverage, there are key lessons for health reforms and decentralisation. New challenges have emerged with rising trade in health services, migration of the health workforce, and medical tourism. Juxtaposed between the emerging giant economies of China and India, countries of the region are attempting to forge a common regional identity, despite their diversity, to seek mutually acceptable and effective solutions to key regional health challenges. In this first paper in the Lancet Series on health in southeast Asia, we present an overview of key demographic and epidemiological changes in the region, explore challenges facing health systems, and draw attention to the potential for regional collaboration in health.

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The paper traces the development of Singapore as an 'intelligent' island through an identi cation of the various social policy arrangements which have harnessed new information technology modes in their delivery. At home, at work, on the road, in public service and in the court room, the emergence of new IT arrangements is a matter of fact in Singaporean lives. Attention is drawn to the 'unencumbered' character of IT policy-making in Singapore, a characteristic which is the outcome of little or no strong political opposition in parliament.

The trajectory of Singapore's population size and composition can be mapped out with its progression through the various phases of demographic transition from high birth and death rates in the post-war years to very low birth and death rates today, all within the context of rapid economic and social development that has taken place in the past 50 years. Population planning has been integral in Singapore's national development strategy, balancing the economy's needs for more and better qualified workers with social considerations such as the dependency burden and the integration of large numbers of foreigners in a global city-state. This paper considers Singapore's population and manpower planning policies, with an account of the country's passage through the various stages of its demographic transition, and how its working age population composition has evolved. Population and labor force policies are examined with specific consideration of the social, economic and political implications resulting from those policy choices. A final section considers the challenges for the future stemming from these demographic trends.

This introductory article provides background to an understanding of "Aging in Asia," focusing on the demographics of population aging in Asia. It discusses the differences in the magnitude of the aged population in different parts of Asia and highlights the perennial concerns of care and support facing the aged and their families as Asian societies grapple with the graying population. Globalization is one important factor presenting new challenges as well as opportunities to aging Asia. The introduction substantiates the discussions in this special issue, which range from an examination of broad issues of support for the aged and policy directions in East and Southeast Asia, to specific concerns relating to activity and elderly in Singapore, intergenerational relationships in Korea, and issues concerning caregiving of the old in Singapore.

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