After Covid-19, fears of 'creeping epidemic' of non-communicable diseases

Former health minister Khairy Jamaluddin has warned that non-communicable diseases (NCDs) could threaten the public healthcare system in the wake of the Covid-19 pandemic.

He said the public healthcare system had almost collapsed during the pandemic, but that the effect of NCDs could be worse.

"If you look at the kind of behaviour that Malaysians have, some of it are things that we can change, some of them we cannot change.

"We always say that Malaysians live an unhealthy lifestyle, but some people don't have a choice," he told a congress organised by the National Cancer Society of Malaysia recently.

NCDs are defined as diseases caused by unhealthy behaviour, as opposed to those spread through infection. They include heart disease, cancer, lung disease and diabetes.

According to the National Health and Morbidity Survey 2023 released by the health ministry last month, over half a million or 2.5% of adults in Malaysia live with four major NCDs: diabetes, hypertension, high cholesterol and obesity.

The report said that diabetes alone is one of the top causes of death in Malaysia, with 15.6% or one in six adults suffering from the disease.

Khairy also spoke of the risks accompanying an ageing population, saying that 15% of Malaysians would be 65 and above by 2040.

"The adjusted living year is poorer because of the NCD epidemic, which is worse than Covid.

"With Covid, we know where the threat is. With NCDs, it creeps up on you unless you do something when there is no clear and present danger," he said.

Politics the 'worst thing' for healthcare

Khairy was 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 immunisation programme.

He noted challenges for the health ministry in the form of budget constraints as well as the continuity of policies in the event of a change in government, saying this was the main reason for the healthcare white paper.

"Politics is the worst thing that could happen to healthcare. There is no continuity because the minister does not like the previous minister, even if the policy is right.

Former health minister Khairy Jamaluddin.

"So I was happy when Dr Zaliha Mustafa tabled the healthcare white paper in Parliament. By then I was no longer an MP, but I gave the victory to her," he said.

Consultant hepatologist Dr Rosmawati Mohamed meanwhile called for capacity-building through decentralisation in terms of primary care in the community in order to help tackle NCDs.

"Yes, we lack specialists, and many think that we should get more specialists. But instead of doing that, we should empower the primary care physicians at clinics with the best knowledge or the best practices," Rosmawati, from the department of internal medicine at the Universiti Malaya Medical Centre, said in a subsequent panel discussion.

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

Dr Hadi Mohamad Abu Rasheed of the Qatar Cancer Society meanwhile stressed the role of NGOs in collaborating with the government to deal with NCDs.

"NGOs need to be a critical player in having meaningful involvement with patients, to be part of the policymaking. Without this, policies will not meet patients' needs.

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

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

"Without getting there (5%), you can't talk about a new payment system. Cut down the waiting time if you want people to pay for national health insurance," he said.