Making The Case For NCDs In The Health White Paper

Getting buy-ins from stakeholders has proven to be a “challenge” with MOH’s proposed “generation end game” to smoking. Making the case to prevent diabetes, cardiovascular disease, and cancer in Malaysia won’t be any easier.

KUALA LUMPUR, August 19 – Like the Ministry of Health’s (MOH) arduous bid to create a smoke-free generation, making the case to address non-communicable diseases (NCDs) in Malaysia will unlikely be any easier.

While the health benefits of preventing NCDs such as diabetes, cardiovascular disease (CVD), and cancer in an ageing population like in Malaysia are evident, failure to clearly communicate what steps the nation should take to tackle the growing disease burden will leave the country with an unabated crisis, experts warn.

Dr Feisul Idzwan Mustapha, deputy director for NCDs at the MOH’s disease control division, said getting buy-ins from stakeholders has proven to be a “challenge”, alluding to the MOH’s proposed “generation end game” (GEG) to smoking, as he emphasised the need to appeal to different stakeholder groups by speaking in different languages.

“When we speak to the MOF (Ministry of Finance), for example, or funders, we need to speak about the money, right, that’s how they see it. 

“It’s not about how we can cut childhood obesity [but rather] by doing this, you can save the country X million ringgit,” said Dr Feisul as moderator of a panel discussion during the launch of a report titled “The Direct Health-Care Cost of Noncommunicable Diseases in Malaysia” by the MOH and the World Health Organization (WHO) last week.

The MOH-WHO report showed that the direct health care costs from diabetes, CVD, and cancer in Malaysia exceed RM9.65 billion yearly, based on 2017 data across the public and private health care sectors.

The annual direct health care costs from diabetes alone totalled about RM4.4 billion, more than triple that of cancer (RM1.3 billion) and 11 per cent higher than CVD (RM3.9 billion), although lack of accessible data meant that the costs involved are underestimated.

Martin Taylor, director of the health services department at the WHO Western Pacific Regional Office, said findings from the report could “inform” discussions on the Health White Paper, both in terms of the health financing model Malaysia needs and the kind of health care delivery model the country requires to deal with its growing NCD burden.

“We know that we’ve got a wave of NCDs, and we have a little bit of information now about the costs of dealing with that. It helps us think through what kind of health care system we need to be able to most efficiently address and deal with that growing burden in the future,” Taylor said.

MOH’s deputy director for national health financing Dr Muhammed Anis Abd Wahab said valuable information from the report on NCDs could be used to get more funding and investment into the country’s health care system.

“It’s important that we make the case, not just in terms of how many lives saved – it may sound crass – but we need to put a value to the lives saved, the disability averted, the quality of life, and that comes with the evidence as what we have now,” Dr Muhammed Anis said.

The report noted that coupled with lost productivity costs, the combined annual cost burden of diabetes, CVD, and cancer was estimated at RM22.5 billion.

Malaysia is expected to reach the status of an aged nation by 2030, with people over the age of 65 making up more than 14 per cent of the population. 

With an ageing population and more people expected to live with NCDs in the long term, MOH and WHO estimated an increase in the health and economic burden from chronic conditions over time.

Dr Muhammed Anis said such reports could also help the government design benefit packages such as the Peka B40 health screening scheme.

“Now, this is an example of an explicit benefit package where we are starting our screening with the bottom 40 per cent (B40) income earners. 

“But certainly, there has been proposals [sic] to introduce management of NCDs at both public and private primary care clinics, and this can be used to make the case to expand the benefit package under the Peka B40 scheme to include the management of diabetes, hypertension, and hypercholesterolemia,” Dr Muhammed Anis said.

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