Before the outbreak of Coronavirus disease (COVID -19), Southeast Asia had already experienced a wave of emerging and endemic infectious disease outbreaks ranging from Nipah, SARS, and Avian Flu to Dengue and Japanese Encephalitis. For over a decade, Southeast Asian states showed their commitment to pursue a collective approach to the surveillance and communication of outbreaks. This commentary discusses can be learnt from previous experiences to assist with the COVID-19 response. The commentary explores how the region interpreted their obligation to the revised International Health Regulations (IHR) through the deliberate alignment of political interests and regional cooperation. It argues for continued regional investment in a cooperative health diplomacy relationship in the COVID-19 era.