The Challenges Awaiting Khairy As New Health Minister

As health minister, Khairy Jamaluddin is expected to bring the National Covid-19 Immunisation Programme with him to MOH, resolving the peculiar incongruity when the vaccine rollout was placed under his leadership in MOSTI.

As the new health minister in Ismail Sabri Yaakob’s administration, Khairy Jamaluddin’s immediate task is to bring the Covid-19 epidemic under control and to return a semblance of normality in Malaysian life. 

The virus is ripping through the country, as Labuan is the only safe territory with rapidly declining infection and mortality trends, coupled with the lowest case incidence and death rates in Malaysia in the past week, after fully vaccinating about 64 per cent of their total population of fewer than 100,000 residents.

Sarawak hasn’t been spared from a surge of infections, despite fully inoculating 63 per cent of its total population, while its still-low death trend appears to be rising slowly. 

Six states – Penang, Kedah, Johor, Perak, Sabah, and Kelantan – are bearing the full brunt of the virus with a spike in infections and deaths since late June or early July amid poor vaccine coverage, as the previous government focused vaccinations on the Klang Valley during Operation Surge Capacity when the country’s most industrialised region was the Covid-19 epicentre. 

While faster and earlier vaccinations may have prevented outbreaks in Penang, Kedah, Johor, Perak, Sabah, and Kelantan from spiralling out of control, limited vaccine supply left little room to maneuver.

Khairy, as the then-vaccine minister in the Perikatan Nasional government, chose to respond to the immediate and most visible crisis in the Klang Valley when the region’s health care system appeared to be breaking down.

Now, Khairy will have to deal with the same priority problems in deciding which fires to put out first as coronavirus infections surge throughout the country except in Labuan, the Klang Valley, and Negeri Sembilan. Klang Valley also still needs to be monitored carefully, as the virus may make a resurgence if testing and contact tracing capabilities remain poor.

As the new health minister, he is expected to bring the National Covid-19 Immunisation Programme (PICK) with him to the Ministry of Health (MOH), resolving the peculiar incongruity when the vaccine rollout was placed under his leadership in the Ministry of Science, Technology and Innovation (MOSTI).

Now, he will have direct oversight over vaccine procurement, distribution, and administration that had been mostly handled under MOH.

The previous Perikatan Nasional government badly mismanaged the Covid-19 epidemic, as it heeded advice from MOH bureaucrats for perpetual lockdowns that devastated the national economy, while failing to curb the wave of infections and deaths. 

Medical experts, including the World Health Organization (WHO), have repeatedly urged the government to use a combination of public health measures in its Covid-19 response instead of solely relying on vaccines. 

Khairy may well bring in his own team of advisers with experience in infectious disease and public health – Prof Dr Adeeba Kamarulzaman, Dr Christopher Lee, and Prof Dr Lokman Hakim Sulaiman, to name a few – although MOH bureaucrats do not look fondly at outsiders.

He may also be more amenable to working with multiple stakeholders across the medical sector, who have long complained about being ignored not just in the fight against Covid-19, but in various health care issues before the pandemic.

As vaccine minister, Khairy was relatively open about the vaccination programme, as he held regular virtual press conferences with all media outfits, unlike MOH that has consistently held in-person press briefings only for official media.  

Khairy should continue this practice of openness and transparency at MOH and, crucially, disclose Covid-related data, such as testing and positive rates by state; breakthrough infections among Covid-19 deaths; age, ethnic, and district breakdown of Covid-19 cases, fatalities, and vaccination, among others.

This analysis presumes that Khairy will only have a year in office, as the government is expected to call for elections in the second half of 2022.

The next one year will still likely be about managing Covid-19 and in the immediate term, managing the fallout from non-communicable diseases (NCDs), particularly cancer, that were ignored during the epidemic.

MOH has not revealed how many cancer surgeries and screenings were delayed in the past 17 months that will likely lead to increased cancer mortality and higher burden of care as more people turn up in the late stages of their disease.

Despite an expected short term in office, Khairy may still be able to lay the foundation for some reforms of Malaysia’s unsustainable and underfunded health care system in the 12th Malaysia Plan, such as health care financing, besides wrangling a much bigger allocation for MOH in Budget 2022. 

Should Khairy succeed in controlling the coronavirus epidemic in the next 100 days, he will still need to ensure that vulnerable groups – such as low-income Malaysians and migrant workers living in congested housing – are not left behind when living with Covid-19 as an endemic disease.

The poor are more likely to be health illiterate and may not have the means to do regular testing or to skip daily paid work in home quarantine or in hospital for more than a week.   

Khairy may also use the same systematic approach in PICK to develop a pandemic preparedness plan containing lessons learned from Malaysia’s Covid-19 management and necessary investments for future pandemics – an actual document acknowledging missteps, and not superficial coffee table books full of pictures.  

Khairy performed well as vaccine minister, though not without criticism, as he showed foresight in ensuring that Malaysia entered 2021 with Covid-19 vaccines and consistently achieved various targets in PICK ahead of schedule.

Managing MOH’s complex and conservative bureaucracy and Covid-19 – besides dealing with non-Covid diseases that caused deaths during the epidemic as patients were unable to access hospitals full of coronavirus cases – is a much more monumental task than solely running the vaccination programme.

Boo Su-Lyn is CodeBlue editor-in-chief. She is a libertarian, or classical liberal, who believes in minimal state intervention in the economy and socio-political issues.

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