The Budget 2022 tabled by the Finance Minister in Parliament today has mixed implications for Malaysia’s health care.
The allocations related to the Covid-19 crisis, such as the continued procurement of vaccines, drugs, personal protective equipment (PPE), and consumables indicate the government’s continued determination and commitment to addressing this public health emergency, avoids repeating the mistakes of the past budget, and increases the health system’s preparedness and resilience to future pandemics.
The government is sending the message that the threat is not over and there is no time for complacency.
However, there is concern that there has barely been an increase in the health allocation compared to what was allocated for 2021. It is an increase of 1.5 per cent, and the amount is arguably the smallest increment to the health budget in more than a decade.
It gives the wrong impression that despite the crisis that Malaysians have endured over the past 22 months, somehow health needs and service delivery remain the same.
Nevertheless, Budget 2022 includes a significant increase in the allocations for public health of more than RM 200 million, benefiting areas such as disease control, health education and promotion, and family health development.
This is welcome news as it will cover non-communicable diseases (NCDs) such as cancer, kidney disease, and cardiovascular diseases.
That investment will bring benefits in the long run, improving the quality of patients and saving lives. Public health is the most important aspect of our health care system right now and we need it to be strengthened. We cannot afford to look at one crisis at a time.
However, the problem regarding medicines allocations that was identified last year remains present and problematic. The consolidation of the 20000 budget line “Services and Supplies” from each of the different disease programmes into “Medical Supply for Health Facilities” under the 080000 Specific Programmes which occurred last year, has eliminated any possibility for analysts, stakeholders and even parliamentarians to properly understand how much has actually been allocated for treatment and care for diseases such as cancer, diabetes, chronic kidney disease, hypertension and cardiovascular.
The situation remains unclear, inadequately represented, and opaque.
Though mental health was highlighted prominently during the budget speech, the fact is that the allocation for this important area of health care (RM319,580,900) still remains lower than was provided in 2020, which was RM 344 million.
Dealing with the consequences of the Covid-19 crisis such as depression, mental illness and suicide, more should have been provided as the majority of the population still depend on services provided through the public healthcare system.
The announcement of an initiative to provide 130,000 young women from B40 families each month with hygiene products such as sanitary pads is remarkable.
It highlights and responds to a long standing and neglected issue of period poverty affecting thousands of girls and young women, which puts up hurdles to opportunities for education and employment. This is a first, and will have a real impact.
We also welcome the announcement that the government will consider imposing excise duties on e-liquids and juices used for vape and e-cigarettes. However, the duties should extend to include those that are nicotine and non-nicotine.
It was disappointing to not have heard an increase in cigarette taxes which have been frozen since 2015. This was a lost opportunity for increased revenue and funds which could be used to support prevention and treatment of non-communicable diseases.
The findings from the National Health and Morbidity Survey (NHMS) 2019 which was announced last year highlighted the fact that Malaysia was already experiencing a health crisis comprising NCDs and risk factors such as diabetes, kidney disease, cardiovascular disease and obesity which are causing a catastrophic impact and burgeoning cost on the Malaysian health care system and society as a whole.
We are at risk of leaving people behind, and making them more vulnerable than ever before.
3.9 million people are living with diabetes in Malaysia, and by 2030, more than 66,000 Malaysians are expected to be newly diagnosed with cancer each year, and a third of the population are currently suffering from hypertension.
More than ever before, we need to protect the public health care system which provides high quality, accessible and affordable services. We cannot take this for granted.
Azrul Mohd Khalib is CEO of the Galen Centre for Health and Social Policy.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.