Kuala Lumpur, 27 July 2023 — Prime Minister Anwar Ibrahim’s Ekonomi Madani: Memperkasa Rakyat (Madani Economy: Empowering the People) vision shared today is welcomed and vital to provide further clarity of the government’s policy direction and commitment to necessary structural reforms as well as its priorities in rebuilding and strengthening Malaysia’s economy. Therefore, it is disappointing that there is seemingly a lack of recognition and appreciation of the role of health and healthcare in this vision. Looking at the PM’s speech and accompanying slides, there are three critical areas where this could have been done: challenges to the economy, investment in increasing Malaysia’s competitiveness, and building the care economy.

“Health is a vital component of the economy. Unfortunately, Malaysia is amidst a non-communicable diseases (NCD) crisis. Malaysians are increasingly in ill health, living with and dying of chronic diseases,” emphasised Azrul Mohd Khalib, Chief Executive of the Galen Centre for Health and Social Policy. “The Ministry of Health 2019 findings indicated that 3.9 million adults lived with diabetes, 6.4 million had high blood pressure, and 8 million with high cholesterol. Around 1.7 million Malaysians had all three chronic conditions. About half of adults are overweight or obese. NCDs accounted for 67% of premature deaths, and 70% of diseases. Dealing with cancer, diabetes and cardiovascular disease alone is costing the country at least RM 22.5 billion annually.”

“More and more Malaysians are facing catastrophic health expenditure due to these diseases. Ill health will cause households to fall into poverty, degrade social mobility, cause disability, take away economic gains, reduce productivity, reduce educational opportunities, erode investment returns, and cause the premature death of workers. This was left out of the challenges identified. Not recognising and responding to this challenge will cause Malaysia to fail its United Nations Human Development Index target,” Azrul pointed out.

“Health is more than a line item in the federal budget and expenditure. This sector contributes billions to the economy and hires hundreds of thousands of workers. The pharmaceutical sector alone contributes at least RM 6 billion to Malaysia’s GDP annually. The public and private health sector combined employ more than 450,000 healthcare workers. Clinical trials conducted here bring in hundreds of millions in foreign investment. The surrounding countries such as Thailand, Singapore and Indonesia, are rapidly building new pockets of economic growth centred around innovative healthcare services.”

“The pandemic underlined the consequences of underinvestment, overdependence, complacency, disparities and outdated mindsets within Malaysia’s healthcare system. To ensure that we are able to gain from the benefits of a vibrant and progressive modern economy and compete with other economies, the people must have access to better health facilities, treatment and care services. This requires increased investment and emphasis on training and retaining healthcare workers. Building more hospitals, clinics or healthcare facilities is insufficient to build Malaysia’s resiliency against future pandemics and ongoing health crises.”

“It was surprising for the care economy to be placed within the context of improving women’s participation in the workforce and childcare centres. While this is certainly important, the area for Malaysia to invest, develop and expand urgently under this segment of the economy is elderly care. This country has been deemed to be ill-prepared and unable to support the needs of an ageing population,” said Azrul.

“The life expectancy of Malaysian men and women have risen to 72 and 77 years respectively. Malaysia is already facing many of the same challenges experienced by Japan, Hong Kong and Australia. The Department of Statistics estimated that 3.5 million people or 7% of Malaysians are above 65 years of age. It projects that by 2030, at least one in 10 people will be 65 or older or surpassing 15% of the total population.”

“The care economy which needs to be developed today involves providing essential support and specialised services for the aged such as disability and care, social and financial security systems, welfare services, and realistic retirement schemes. For at least the past two decades, expecting family members to take full care of their elderly parents and grandparents has been an unrealistic prospect for many who are struggling through the rising cost of living.”

“The government’s own Health White Paper points out the contribution of health from the economy to social well-being to national security, and the need to invest in a high-performing health system. Worryingly, the architects of the economic vision seem to lack awareness and recognition of the challenges and consequences posed by a population whose health is worsening and ageing,” said Azrul.

“People who are sick and infirm will be disadvantaged and unable to participate in the benefits of this economic vision. They may be left behind or seen as liabilities and a burden. As highlighted in the Health White Paper, the intersectionality of health needs to be recognised at the highest level, and not simply left for the Ministry of Health to address and elaborate.”

“Malaysia’s economic future depends on the health of its people.”