When Malaysians hear about armed conflict in the Strait of Hormuz, most think about oil prices, inflation, and the cost of living. However, it is not just an energy priority but also about national health security.

What is happening in Hormuz should concern and even alarm policymakers, hospital administrators, clinicians, and patient groups in Malaysia. When supply routes through one of the world’s most important maritime chokepoints are disrupted, the consequences do not end at the petrol or diesel pump. They travel through the petrochemical chain, into plastics manufacturing, and eventually into hospitals, operating theatres, pharmacies, treatment centres, and community clinics.

Malaysia’s healthcare system, like other modern healthcare systems in the 21st century, is deeply dependent on plastic-based medical devices, consumables, and disposables. These are not optional items. They are essential to modern medicine. Medical consumables are single-use, disposable items essential for patient care, infection control, and daily operations in healthcare settings.

Blood tubing sets, IV lines, catheters, sterile packaging, syringes, dialyser housings, nebulisers, specimen containers, drainage bags, valves, clamps and countless other components rely on petrochemical source material.

Naphtha, a vital petroleum derivative used in plastic manufacturing and petrochemicals, is essential for the production of these items. If the flow of naphtha is disrupted, particularly for naphtha-derived resins used in polyethene (PE), polypropylene (PP), and polystyrene (PS), the effects cascade downward. Prices rise. Production slows. Deliveries are delayed. Supplies tighten and lessen. Continuity of treatment will be threatened, and patient care will be compromised. Of particular concern is dialysis care.

Malaysia has one of the highest incidence rates of end-stage renal disease (ESRD) or Stage 5 of chronic kidney disease (CKD) in the Asia Pacific region and globally. The rising number of patients diagnosed with Type 2 diabetes is one of the main reasons for the increasing rates of CKD and the need for dialysis.

Patients with ESRD need dialysis or a kidney transplant. For Malaysia, the ongoing crisis in the Persian Gulf places many patients on haemodialysis at tremendous risk.

There are now an estimated 60,000 dialysis patients in Malaysia. 90 percent of them depend on haemodialysis, while the rest are on peritoneal dialysis.

Every single haemodialysis session requires a steady supply of plastic consumables, including tubing, dialysers, connectors, sterile packs, canisters, and components that must be used safely, and reliably.

These are not products that can simply be improvised or substituted. Most are single-use and cannot be recycled or reused. If supplies of these essentials are disrupted, treatment schedules will be strained, limited, or even collapse.

For patients with ESRD requiring treatment three times each week, dialysis is not an option that can be deferred, delayed or compromised. Lives are put at risk and could be lost. For them, it becomes a matter of life and death.

Although Malaysia has a growing domestic medical device sector, it remains heavily exposed to imported feedstocks and components, as well as disruptions to global shipping routes. Ongoing upstream dependency may still trace back to supplies originating from or passing through the Persian Gulf.

When armed conflict disrupted shipping through the Straits of Hormuz, the impact was immediate. Vessel traffic fell. Insurance premiums surged. Freight costs spiked. Delivery times lengthened or became indefinite. Low-margin and high-volume medical consumables became especially vulnerable.

Hospitals and healthcare providers may still be able to secure stock, but it could be at a higher cost and with greater uncertainty. Some may not be able to procure anything at all due to the financial burden and limited supplies.

The COVID-19 pandemic taught us what happens when global supply chains fail. A key lesson was that efficiency without resilience is a dangerous illusion. However, too many modern health systems still assume that critical supplies will somehow continue to flow, even in times of crisis. Countries such as South Korea and Japan are already acting decisively to stabilise and secure the supply of plastic medical products, such as syringes and catheters. Dialysis equipment has been singled out as a key concern in those countries. Malaysia is not exempt.

Dialysis patients cannot wait for the market to correct itself. Hospitals cannot tell medical officers, specialists and surgeons to postpone care because plastic-based consumables have become too expensive, too scarce or need to be rationed. Stockpiles of a few weeks or months will not be adequate for prolonged geopolitical instability.

We do not know when the hostilities will end, when the Straits of Hormuz will reopen to all traffic, and when consistent and reliable supplies will resume. The government must immediately treat medical supply resilience as part of the national health security agenda.

There are four recommendations to consider:

• First, Malaysia should identify a list of critical naphtha-dependent medical products and consumables, especially those used in dialysis, intensive care, surgery, and emergency medicine. It needs to know exactly which items are most exposed, where they come from, how long existing stocks will last, and where the choke points are.
• Second, strategic stockpiles of essential dialysis consumables and other critical disposables need to be established. Protected reserves for products that sustain life and cannot tolerate disruption.
• Third, public procurement policy must change. It can no longer be driven solely by the lowest price. Reliability, source diversification, and crisis resilience must become public procurement priorities. The cheapest contract is worthless if it fails during an emergency.
• Finally, Malaysia should invest in and incentivise domestic and regional manufacturing capacity for medical-grade plastics, components, finished consumables, and devices more aggressively. This is not about autarky. It is about reducing single-point dependence and ensuring continuity of care when global routes are under stress.

The conflicts in the Persian Gulf may seem far from Malaysia. But its disruptions can travel with frightening speed through supply chains and reach the couch of a haemodialysis patient at a dialysis facility in Petaling Jaya, Alor Setar, Kota Bharu, or Kuching.

This is no longer simply a trade disruption. It is a threat to lives here in Malaysia.