For 15 years, the Malaysian Paediatric Association and its partners have been fighting for the inclusion of the Pneumococcal Conjugate Vaccine (PCV) into the National Immunisation Programme (NIP).
We studied the burden of diseases, researched the serotypes at play in our community, examined the increasing resistance of the bacterium to our arsenal of antibiotics and demonstrated the cost effectiveness of the PCV.
It took a new government in 2019 to appreciate our endeavours, and to empathise with the loss of innocent lives, the disabilities inflicted by the pneumococcus and the need for bigger investment in the health of our children. They rolled out the PCV in our NIP in 2020.
Within the space of a year in office, Pakatan Harapan officials came to understand the ramifications of a critical pediatric health issue which past politicians hid away from public view, and which technocrats in the Ministry of Health (MOH) paid only lip service to and did not prioritise.
The politicians and technocrats paid more attention to secondary, tertiary and curative services patronised by the VVIPs, which therefore took up a large piece of the MOH budget cake.
It is a sad indication of our health care priorities that only when a prime minister gets a CABG (Coronary Artery Bypass Graft) done locally, did the IJN (Institut Jantung Negara) gets set up. And only when a prime minister’s wife succumbs to cancer did we get the IKN (Institut Kanser Negara).
What I am about to suggest next follows this trend of a reactive MOH.
With the Covid mess that we are presently in, I think it is time for the nation to have a Ministry of Public Health. The domain of public health has always been secondary and subservient in the MOH’s scheme of things.
Even government physicians working under Pakatan Harapan had an unfair remuneration deal as compared to their clinician peers, being treated like second-class specialists.
The Ministry of Public Health should be helmed by a physician, not a paediatrician, obstetrician or a surgeon.
A public health physician should prioritise essentials such as preventative health, primary health care, universal health coverage, pandemic preparedness, the cost effectiveness of health interventions, health economics, and socio-economic determinants of health.
These essentials comprise the three inter-related aspects of public health practice, namely health improvement, health protection and health service quality improvement. These aspects draw upon core knowledge and skills like epidemiology, biostatistics, risk communication and data science.
Any discerning member of the public would be able to detect the lack of epidemiological and statistical prowess and authority in the daily presentation of the national Covid-19 infection data.
And to bypass a public health physician and instead allow a non-doctor to convey daily risk communication on the pandemic has been an unmitigated disaster for the rakyat, business community, and damages our international reputation.
Our northern neighbour has a health ministry that emphasises public health, and they have effectively managed the pandemic. The Director General of the World Health Organisation made special mention of them for their success in battling the Covid-19 crisis.
Even if my 2021 wish does not come true, I hope the role of public health in the MOH will be elevated by many notches, and it would be accorded the position it truly deserves in the larger scheme of protecting and promoting the nation’s health.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.