KUALA LUMPUR, Dec 4 – Health stakeholders criticised the proposed abolition of the Malaysian Health Promotion Board (MySihat), saying this may affect work on the United Nations sustainable development goals.
The Bill by the Ministry of Health (MOH) repealing Malaysia’s independent health promotion body, however, is expected to undergo a second reading in the Dewan Rakyat later today.
MySihat — which is governed by an independent body consisting of representatives from relevant ministries, non-governmental organisations (NGOs), and professionals — was created in 2006 to enhance and strengthen the field of health promotion with intensive community involvement with partnerships of NGOs.
It promotes healthy lifestyles and healthy environment through various settings and sectors. MySihat has previously worked on smoke-free campaigns, which had representatives from Asean countries together with China, Guam and Mongolia sharing their expertise and best practices on smoke-free policies and campaigns around the region.
“Having worked with MOH and having undergone fellowships overseas with exposure in health promotion, closure of MySihat is a move backwards in health prevention and promotion. It is a regressive move,” said Thavaraj Subramaniam, former board member of MySihat, who is now a lawyer.
“In 2014, I was appointed to the Board of Directors for MySihat for four years. In 2018, all the board members got terminated by the MOH before Parliament can close down MySihat,” he expounded to CodeBlue.
“It will be a big loss to the nation. We are going back in time. Even tiny Tonga has set up the board. All nations are moving towards it. In Asia, Singapore, Thailand, Korea and Taiwan [are] in the forefront. Australia has made a lot of progress.”
Dr Zahirah Mohd Zain, a former MOH official and now the medical director for Malaysian Women’s Action for Tobacco Control and Health, said abolishing MySihat was a “regressive” move that would handicap the government’s ability to control and prevent diseases.
“Malaysia may have difficulties achieving a number of the UN Sustainable Development Goals (UNSDG), especially goal number 3,” she said.
UN SDGs are a collection of 17 global goals designed to be a “blueprint to achieve a better and more sustainable future for all”, and its goal number 3 is to ensure healthy lives and promote well-being for all at all ages.
Dr M. Murallitharan, the medical director of the National Cancer Society Malaysia, also echoed the same sentiment.
“For us, it is a very regressive move. By doing that (abolishing MySihat), we are really losing the impact of MySihat.
“Without that kind of support, not many activities can be run well and systematically and in a large scale to benefit the population,” he added.
Bagan Serai MP Dr Noor Azmi Ghazali (Bersatu) also expressed his displeasure in the matter.
“I am worried abolishing MySihat will be a regressive action while other countries around us, such as Thailand, champion in these areas.
“I have nothing against the abolishment of MySihat provided that there is an entity that functions better than we have at the moment,” he further added.
What Could Happen?
MOH is planning to abolish the board and take health promotion works under its wings, Dr Murallitharan told CodeBlue.
While this may be a good approach, Dr Murallitharan feared that this may cause extra focus on the clinical part of health promotion initiatives.
“The problem is it will always be a clinical-driven approach. Health promotion efforts may be increasingly in a clinical setting, such as from the perspective of primary care centers, hospitals and so on.
“Not that it is a bad thing, but we have shown evidence all over the world that there is only so much of benefits to health when initiatives are from this clinical setting, which is why we need to take it from a different approach, from a societal view as well,” he opined.
Dr Zahirah said: “In its current structure, honestly, MySihat does and will continue to have issues with sustainable resources. But it is certainly a lot better than not having a body like it to carry out health promotion.”
Closure of MySihat is also expected to bring the downfall of various community programmes under it, some of which have been running for more than a decade.
“MySihat has been in existence in 2006,” said Thavaraj.
“Now if we close MySihat, what is going to happen to all the programmes and activities we have carried out so far? There will be no continuity. Ongoing activities would suddenly be terminated.”Thavaraj Subramaniam, former board member of MySihat
“There will be no health professionals working with and guiding NGOs, youths, cultural bodies, marginalised groups to support prevention and promotion activities in the community. Anti-smoking and anti-alcohol activities will suffer. So will all the health promotion activities that have been carried out by MySihat with the above groups.
“All ministers have strongly supported the Board except this one. Lack of funding is no excuse. The benefits of the Board outweighs many of other MOH functions and the results or outcome of our efforts are long term,” he added.
What Can Be Done?
Dr Zahirah cited the country’s neighbours, adding that Malaysia should take a leaf out of Thailand’s book.
“Should MySihat be abolished, it must be replaced with a more effective entity that has strong organisation structure and sustainable funding.
“The best model is that of the Thailand Health Promotion Foundation (ThaiHealth) — a world class body regarded as gold standard for health promotion by many countries. Unlike MySihat, ThaiHealth is parked directly under the Prime Minister’s office and it receives funding annually, from 2 per cent tax that is earmarked from taxes paid by the tobacco and alcohol industries,” she said.
Dr Noor Azmi said if MOH wanted to absorb MySihat into its health education division, then the division must be doing better than the health promotion body.
“If not, MOH should just maintain MySihat with more funds with an autonomous status to run a better show in future,” said the government MP.
Dr Murallitharan said that the government’s move to abolish the organisation was unnecessary.
“Is there a need to revamp MySihat? Perhaps. Do we need to change governance structure or its operational structure? Definitely. But do we need to close it down?” he asked.
Thavaraj, on the other hand, believes that the government should improve the quality of MySihat instead of abandoning it altogether.
“MOH has to fund MySihat to sustain it. They don’t need billions. Their budget is less than 10 million. In the last three years, they have been receiving RM5 million a year to survive. This is a pittance,” he said.
“We need good qualified competent staff to carry out health promotion. We need a board consisting of professionals well versed in health promotion and prevention. We do not want political interference.
“The Board should be given the power to source for funds through partnership and through our own projects. We should be able to sustain health promotion activities with our own business activities,” he suggested.
MOH last month tabled Malaysian Health Promotion Board (Dissolution) Bill 2019 in the Dewan Rakyat.
The new Bill states that all properties, rights, interests, obligations and liabilities transferred to and vested in MySihat will be transferred to and vested in the government.
It also dictates that any properties and assets, other than land, which immediately before the commencement date of the Act vested in the board shall, on the date of enactment, be vested in the government.
The Bill is expected to be tabled again in Dewan Rakyat later today for second reading, Deputy Health Minister Dr Lee Boon Chye told CodeBlue.
“It is already in Dewan Rakyat’s agenda. No plan to withdraw the MySihat abolition bill,” he said.