This report presents findings from the Living Evidence Architecture (LEA) project which set out to explore how living evidence systems can better support decision-making across diverse health contexts, with a particular focus on South-East Asia and the Western Pacific.

The primary purpose was to co-design a regional vision and practical roadmap for a more inclusive, accessible, and sustainable living evidence system. The project aims to identify system-level enablers, barriers, user needs, and design priorities to guide the development of a context-aware, AI-enabled, and equity-centred evidence platform to support the uptake, interpretation, and contextualisation of evidence across diverse healthcare systems.

The study revealed that while living evidence offers transformative opportunities, such as real-time updates, local empowerment, cross-border collaboration, stakeholder co-design, equity, and evolving evidence framings, it is constrained by critical challenges, including infrastructure gaps, platform fragmentation, trust, policy disconnects, and a lack of contextual relevance. The report highlights the need for centralised, personalised, AI-enabled, and locally adaptable design features for a future living evidence architecture.

The findings from the research paint a picture of living evidence as a catalyst for change technologically, politically and socially. Moreover, living evidence is envisioned as a new infrastructure for health knowledge that is flexible, inclusive, real-time, and rooted in the realities of its diverse users. To achieve this vision, participants called for sustained investment, regional coordination, and political will to reimagine how evidence is generated, shared, and used