Kuala Lumpur, 03 October 2023 — The Galen Centre for Health & Social Policy calls upon the Madani Unity Government to make realistic, serious, and necessary commitments in the upcoming Federal Budget 2024 to boost efforts to build and future-proof the country’s healthcare infrastructure towards sustainability and resiliency.

The Galen Centre repeats its calls for increases in investments in five critical areas: healthcare financing; non-communicable diseases; aged care; reproductive health, and epidemic outbreak preparedness and response.

“Conversations regarding healthcare should be centred around meeting the current and future needs and challenges of the Malaysian people. Whether we recognise it or not, this country is transiting from a upper middle income to a high income economy, and is not dependent on overseas development assistance. There is no one to help us if we underinvest in health. We need to help ourselves to ensure that no one is left behind,” said Azrul Mohd Khalib, Chief Executive Officer of the Galen Centre for Health and Social Policy.

“We need to find out what we need, how much money is available, and find solutions to bridge those funding gaps, particularly in areas such as staff recruitment and retention, modernisation of medical infrastructure, and treatment of non-communicable diseases.”

“Yes, health needs more funding, but we must also look at where and how it is being spent. We must also treat health as a serious investment whose return comes in the form of healthy, productive citizens helping to build this country.”

“We recommend that the Government removes the RM 1 and RM 5 charges for outpatient and specialist care respectively in Ministry of Health (MOH) facilities. People should not need to pay anything at the point of registration for treatment at a public healthcare facility. These charges keep alive the fiction that the cost of healthcare in Malaysia is cheaper in government facilities, and mislead the public. They are also inadequate for meaningful cost recovery. We believe that removing these charges will open the way to meaningful discussion and facilitation of future reforms in healthcare financing,” Azrul emphasised.

“Malaysia is amidst a crisis of non-communicable diseases (NCDs) crisis, of which diabetes is one. There are now almost 5,5 million people living with diabetes in this country. A recent Ministry of Health – World Health Organisation report showed that 6 years ago, the annual direct healthcare spending for this disease was RM 4.38 billion, and is the highest compared to cardiovascular disease and cancer. For every ringgit spent on the three NCDs, 45 sen goes to diabetes, 41 sen goes to CVD, and 14 sen to cancer.  We propose introducing co-payments of up to 30 percent of actual cost for the treatment of diabetes. This will help people increase their adherence to treatment, reduce wastage of highly subsidised medication, and reduce the likelihood of developing further complications such as end stage renal disease or kidney failure. This move alone could save thousands of  lives,” Azrul pointed out.

“Malaysia has been deemed as being ill-prepared to deal with the needs and consequences of a growing aging population. Politicians often speak of this issue as if it was in the distant future to be addressed by somebody else. The reality is that the future is already upon us. Aged and long-term care facilities and relevant essential services remain limited, mostly confined to urban centres, and concentrated to private providers or dependent on already stretched families and households,” Azrul pointed out. “There continues to be a lack of clarity on which Ministry should take the lead on aged care, and the care economy. There is an unsustainable dependence on informal care, such as families. As a result, many older individuals among us are now vulnerable to or suffering from neglect, substandard care, and even abuse.”

“The government needs to immediately make improving aged and long term care a priority in Budget 2024. We recommend introducing a national scheme for those above the age of 40 to fund aged and long term care, similar to what is implemented in Japan.” he emphasised.

“Unintended pregnancy is not just a problem of teenagers, unmarried women, or poor women from disadvantaged backgrounds. Being able to plan or decide one’s pregnancy enables women to take control of their futures, so that they can finish their education, get better jobs, and not be trapped in a cycle of grinding poverty and deprivation. It affects everyone,” Azrul emphasised.

“Unintended pregnancies are a national concern. This Budget should have an increased allocation to strengthen essential reproductive health services in the Ministry of Health and National Population and Family Development Board (LPPKN) which include providing equal access to contraceptives for both married and unmarried individuals.”

“Finally, COVID-19 has demonstrated the value and merit of investing in public health systems which are effectively able to respond to emerging diseases, outbreaks and epidemics. The Disease Control Division of the Ministry of Health needs increased investments in capacity and expertise to prevent, detect and manage future epidemics. That means investing in training more epidemiologists, public health specialists, infectious disease experts, and increasing diagnostic laboratory capacity. Waiting for an outbreak to hit before doing so, would be too late and could cost the country billions. Previous budgets seem to not have recognised this urgent need or learnt from the COVID-19 emergency.”

The Madani Government must take health seriously as Malaysia’s future will continue to be vulnerable if the people are in poor health.