Osteoporosis and fragility fracture burden in Asia Pacific: Key findings from the APCO-IOF Asia Pacific Regional Audit

Rapid population aging in the Asia Pacific region will significantly increase its burden of osteoporosis and fragility fractures. The Asia Pacific Consortium on Osteoporosis (APCO)-International Osteoporosis Foundation (IOF) Asia Pacific Regional Audit was developed through a coordinated effort of these two organizations. Spanning data from 22 countries and regions in the Asia Pacific, it comprehensively assembles the most current regionally relevant osteoporosis evidence available. The audit used a structured questionnaire covering 12 domains, supplemented by demographic projections, registry data, government statistics, and expert consensus estimates where formal data were unavailable. The audit revealed that osteoporosis is a national health priority in only six countries, limiting attention, funding, and coordinated service development. It also highlights glaring infrastructural gaps: insufficient fracture surveillance, uneven diagnostic access, misaligned reimbursement, and limited secondary fracture prevention. Collectively, these deficiencies point not to a lack of evidence, but to an implementation deficit in translating evidence into routine care. The audit proposes several key solutions including implementing fracture registries and post-fracture care pathways, developing coherent country-specific guidelines, aligning reimbursement with risk profile, and tracking quality outcomes. These findings provide a timely roadmap for governments and health care systems to reduce fracture burden and improve equitable osteoporosis care across the Asia Pacific region.