Substantial health inequity exists in Asia Pacific and huge challenges remain, despite various actions that are addressing the structural drivers and conditions of daily living that affect health inequities in the Asia Pacific region. While gains have been made, they are not equally distributed and may be unsustainable as the world encounters new economic, social and environmental challenges. The article concludes that health inequities must be tackled as a political imperative and this will require leadership, political courage, social action, a sound evidence base and progressive public policy.