Topic-based pub/sub is a widely used communication mechanism in distributed systems for targeted information dissemination between loosely coupled entities. To scale dynamically depending on the current communication demands, pub/services can be conveniently deployed in the cloud. To provide fast dissemination, the service can be distributed across multiple cloud regions. The architectural design and run-time deployment of such a middleware is tricky, though, as it can have a significant effect on communication latency and cloud-based cost. In this paper, we propose MultiPub, a flexible pub/sub middleware for latency-constrained, world-wide distributed applications that dynamically reconfigures the communication layer to ensure a predefined maximum latency for publication dissemination while minimizing cloud-based costs. This is achieved by routing publications either through a single or across multiple cloud regions. We demonstrate the effectiveness of MultiPub by presenting a set of experiments that report on the achieved communication latency and cost savings compared to traditional approaches, as well as a performance evaluation.