KUALA LUMPUR, May 6 — With little action on cancer in Pakatan Harapan’s (PH) first year in office, advocates are calling for greater access to treatment and updated cancer statistics.
Klang MP Charles Santiago highlighted the Malaysian National Cancer Registry Report 2007 to 2011, saying that cancer data should be less than five years’ old.
Despite the lack of updated information on cancer cases in Malaysia, the DAP lawmaker, who takes care of almost 150,000 voters in his constituency in Selangor, said he has seen anecdotal evidence of a significant rise in cancer.
“I’m not a mathematician or statistician, but just looking at the number of people on Facebook, constituency and so on, we’re looking at a cancer explosion. It’s huge,” Charles told CodeBlue.
“I was looking at Facebook yesterday, there was one lady, she’s my Facebook friend, and she posted that she was diagnosed with cancer, she’s going through stages in chemo and that kind of stuff.
“Last week, I also met someone else who was diagnosed with cancer. I was told in all hospitals, public and private, the number of people waiting to see doctors because they might have cancer is very high.”
According to the Globocan 2018 report by the International Agency for Research on Cancer (IARC), Malaysia had 43,837 new cancer cases and 26,395 cancer deaths in 2018. For both women and men combined, breast, colorectum and lung were the most common cancers in Malaysia last year.
Over half, or 57.3 per cent, of cancer deaths in the world was estimated to happen in Asia in 2018, higher than their share of incidence at 48.4 per cent, which IARC attributed to the higher frequency of cancers with lower survival rates, along with limited access to timely diagnosis and treatment.
Breast cancer five-year survival in Malaysia was only 66.8 per cent for those diagnosed between 2007 and 2011, according to the Malaysian Study on Cancer Survival (MySCan) 2018 report. Survival rates in Australia and the United States, in comparison, were 89.5 per cent and 90.2 per cent respectively for women diagnosed in the 2010-2014 period, according to a January 2018 study published in The Lancet.
When asked about PH’s achievements on tackling cancer the past one year, Charles said more needed to be done, such as urgently updating the national cancer registry and making it public.
He also called for a cap on drug prices.
“That’s really crucial. People are going to die because they can’t afford medicine, not so much because of disease.”
The Klang MP further urged the government to set up a national cancer fund, starting with RM50 million, to help cancer patients as they may not be able to work or live on their own.
The fund, he said, should comprise grants from both the private sector and the government to help not just cancer patients from the bottom 40 per cent (B40), but also the middle class.
“In our area of work, you see a lot of people coming to us because they’re poor. Even the middle class, because of the money they fork out on treatment, people are getting poor.”
When asked if the Finance Ministry’s mySalam critical illness scheme for the B40 should cover early cancers that are currently excluded, Charles said the insurance-like nature of the programme run by Great Eastern Takaful Berhad may not permit that.
“I think the Ministry of Finance has no business in health. The money should be transferred to universal health care coverage,” said Charles, referring to the RM2 billion Great Eastern is giving the government for mySalam that the government is paying the insurance company back in the form of premiums for the B40 for five years.
Grade “B” For Health Minister
National Cancer Society of Malaysia (NCSM) medical director Dr M. Murallitharan graded Health Minister Dzulkefly Ahmad a “B” (above average) for his performance over the past one year on cancer.
He said mySalam and the Health Ministry’s Peka B40 health screening programme for the B40 held much promise for poor cancer patients.
“Some feedback on issues pertaining to cancer patients such as referral charges from private to public sector have been looked at and perhaps even partially addressed, but the solutions offered may need better tweaking,” Dr Murallitharan told CodeBlue.
He said he has received complaints from cancer patients that they are still automatically charged first class rates when they are transferred from private to public hospitals, even though they prefer third class wards that have lower charges.
“A lot of ground level staff are still unable to understand how this works, so they are still charging patients as usual — no choice offered,” said Dr Murallitharan, who is also a member of the Cancer Care Working Group, a coalition of individuals working for improvements in outcomes, treatment and care of cancer.
He urged the Health Ministry to improve treatment indicators, such as negotiating with the private sector to use their infrastructure like radiotherapy or PET scans.
“However negotiations need to be carried out transparently and most importantly, involve a multitude of stakeholders so that a proper working solution is achieved and can be implemented on the ground for the benefit of the patients.”
Dr Murallitharan also called for better access to cancer treatment as patients in public facilities still cannot get new drugs.
“Increasing access for patients remains an important issue that requires smart thinking and innovative solutions. Everyone has been talking about it at so, so many conferences and seminars and meetings.
“Get to it. Find an innovative access option and roll it out. As the scheme works for one group of drugs, it can then be used for others, and not only in cancer.”
He said many people have told the government about implementation issues with schemes like Peka B40 and mySalam.
“Very few” private general practitioner (GP) clinics joined the Peka B40 scheme, he said, while the deputy finance minister had admitted that only two out of over 1,000 mySalam applicants received the RM8,000 lump sum benefit to date.
“Process indicators are telling us that the way some of the schemes are being rolled out, they tend to be ineffective and more importantly, make people frustrated with the government,” said Dr Murallitharan.
Let Cancer Patients Import Three Months’ Supply of Medicines
Together Against Cancer committee member Dr Lim Teck Onn said the PH government has not taken any action on cancer at all in its first year in office.
He urged the new government to establish a cancer task force that must report within a year with concrete solutions.
“Get our cancer data right, set up a screening programme with real accountability (go to jail if the programme fails), get cost of treatment down (this costs taxpayers nothing and is so easy, am surprised no action). With these, hopefully cancer mortality will start declining,” Dr Lim told CodeBlue.
One of the things the Health Ministry can do, he said, is to allow cancer patients to import three months’ supply of cheap generic medicines from countries like India for personal use. Malaysian law currently limits medicine imports to one month’s supply, compared to three months in the United States or Australia.
“We must get rid of the notion just because you tried hard, you deserve a Nobel prize. Everybody always said they tried, what we care is results.”