After COVID-19, there is a possibility of an 'epidemic' of non-communicable diseases

Former Health Minister Khairy Jamaluddin has warned that non-communicable diseases (NCDs) could pose a threat to the public health system in the wake of the Covid-19 pandemic.

He said the public healthcare system had nearly collapsed during the pandemic, but the impact of non-communicable diseases could be even worse.

“If you look at the behaviour of Malaysians, you will find that some of them are things we can change, some of them are things we cannot.”

“We always say that Malaysians lead unhealthy lifestyles, but some people have no choice,” he said at a conference organised by the National Cancer Society of Malaysia recently.

NCDs are defined as diseases caused by unhealthy behaviour, rather than those spread through infection. These include heart disease, cancer, lung disease and diabetes.

According to the National Health and Morbidity Survey 2023 released by the Health Ministry last month, more than five million or 2.5% of adults in Malaysia suffer from four major non-communicable diseases: diabetes, hypertension, high cholesterol and obesity.

The report said diabetes is one of the leading causes of death in Malaysia, where 15.6% or one in six adults suffer from the disease.

Khairy also discussed the dangers that come with an ageing population, saying that by 2040, 15% of Malaysians will be 65 years or older.

“The adjusted life years lost due to the NCD epidemic are worse than Covid.

“With COVID, we know where the danger is. With non-communicable diseases, it sneaks up on you unless you do something when there is no clear and present danger,” he said.

Politics is the worst thing for health care

Khairy was the Health Minister during the COVID-19 pandemic until the 15th general election in November 2022. During this time, he was also the Coordinating Minister for the National Vaccination Program.

He cited challenges such as budget constraints for the Ministry of Health as well as continuity of policies in the event of a change of government, and said this was the main reason for the Healthcare White Paper.

“Politics is the worst thing for healthcare. There is no continuity because the minister doesn’t like the previous minister, even if the policy is right.

Former Health Minister Khairy Jamaluddin.
Former Health Minister Khairy Jamaluddin.

He said, “That's why I was happy when Dr Zaliha Mustapha tabled the white paper on healthcare in Parliament. I was no longer an MP by then, but I led her to victory.”

Meanwhile, consultant hepatologist Dr Rosmawati Mohamed called for capacity building through decentralisation in terms of primary care in the community to help tackle non-communicable diseases.

“Yes, we have a shortage of specialists, and many people think we should bring in more specialists. But instead of doing that, we should empower primary care physicians in the clinics with the best knowledge or best practices,” Rosmawati, from Universiti Malaya Medical Centre's internal medicine department, said in a panel discussion later.

“They will know what to do and when to refer the patient to specialist centres.”

Meanwhile, Dr Hadi Mohammed Abu Rashid from Qatar Cancer Society stressed the role of non-governmental organisations in collaborating with the government to combat non-communicable diseases.

“NGOs have a vital role to play in building meaningful partnerships with patients and being part of policy making. Without this, policies will not meet the needs of patients.

“At the policy level, sometimes the government has a lot of red tape, so NGOs can bring in public-private partnerships in the healthcare ecosystem,” he said.

Khairy also said the budget for healthcare should be 5% of GDP, and called for the introduction of a co-payment system.

“You can't talk about a new payment system without getting there (5%). If you want people to pay for national health insurance, reduce waiting times,” he said.

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