KUALA LUMPUR, Dec 24 — The Parliamentary Special Select Committee (PSSC) on Health has proposed displaying organ donor status to Malaysian driving licences or identity cards to ease registration and reverse a sharp decline in new pledgers.
In a report tabled in Parliament on November 27, the Health PSSC urged the Ministry of Health (MOH) to work with the Digital Ministry, Transport Ministry, and National Registration Department (JPN) to integrate donor sign-ups into MySejahtera, driving licences, or MyKad, allowing Malaysians to register more easily.
New donor registrations have dropped steeply since the surge in 2022 and 2023, when 29,960 and 31,058 people signed up. In 2025, only 15,253 people signed up as new pledgers.
MOH officials told the committee that the decline coincided with the ministry’s shift to MySejahtera as the primary organ donor registration platform. When conducting outreach, officials found that many Malaysians no longer used the app or couldn’t access their accounts.
Bayan Baru MP Sim Tze Tzin, the committee’s new vice chairman, urged the government to adopt a system used in the United States, where organ donor status is displayed on driving licences.
“During Covid-19, I pledged as a donor. I worked in the US before – their system is very simple,” Sim told MOH officials at an October 29 proceeding, according to Hansard. “After you go for your driving test, you pledge whether you want to become a donor or not. Very easy. You just sign and they give you a sticker to place on your licence.”
“Everyone in Malaysia has to take a driving test, like it or not,” he added. “So you should work with JPJ (Road Transport Department) to do that. You save all your outreach programmes and just work through existing structures.”
Sim said a similar approach in Malaysia could significantly expand the donor pool. “If the MOH and Transport Ministry can work out an MoU (memorandum of understanding) and implement it, the system will work,” he said.
The US has a high deceased (cadaveric) organ donor rate at 49.7 deceased donors per million population in 2024, ranking second globally after Spain (53.9 per million population), according to the International Registry on Organ Donation and Transplantation (IRODaT).
Kuala Langat MP Dr Ahmad Yunus Hairi echoed the call, suggesting that donor status could also be added during MyKad renewals for young adults. “At age 18 to 25, when they are able to decide for themselves, we could include information showing whether someone has pledged as a donor,” he said.
Dr Mohd Syafiq Ismail Azman, director of the National Transplant Resource Centre (NTRC) under the MOH, welcomed the proposal but stressed that visible donor status alone does not guarantee actual donation.
“We can use JPJ licences as an identity marker to show someone is a pledger,” he said. “But we must emphasise to the pledgers to convey their intentions to their families. Having many pledgers does not mean they become our ‘supply’. As the data shows, we have 15,000 new pledgers, but not all 15,000 will actually become donors if the family doesn’t allow it.”
CodeBlue previously reported that nearly 90 per cent of potential deceased organ donations cannot proceed because families refuse consent, leaving about 21 patients on the waiting list to die each day.
Although more than 400,000 Malaysians have pledged to donate their organs, officials said many pledgers never become actual donors upon death because their families were unaware of their wishes.
Malaysia’s Organ Donation Rate Among The World’s Lowest
Malaysia currently has about 412,000 registered organ pledgers, with women accounting for 60 per cent of sign-ups. Malays form the largest share of pledgers, a distribution officials say mirrors national demographics. Most pledgers are concentrated in Selangor and Kuala Lumpur, followed by Johor, the country’s largest urban centres.
But experts say the total is far too small for a nation of 34 million. The Health PSSC has called for stronger public awareness campaigns involving religious groups and civil society to meet the government’s target of one million pledgers by next year and three million by 2030.
Malaysia’s cadaveric organ donation rate remains among the lowest globally at 1.3 donors per million population in 2024, up from 0.7 per million in 2022, IRODaT show.
That means Malaysia has only recently reached the threshold of one donor per million population, said Dr Mohamad Zaimi Abdul Wahab, president of the Malaysian Society of Transplantation.
“In the last two years, we finally hit one per million population in [cadaveric] donation rate, but I have 80 kidneys to go around for 55,000 patients,” Dr Mohamad Zaimi told the committee.
Dr Mohamad Zaimi, a transplant nephrologist at Kuala Lumpur Hospital, noted that Malaysia has performed just 3,492 transplant surgeries since 1975, roughly the number the US performs in a single year.
As of this year, 10,736 patients in Malaysia are waiting for transplants: 10,707 for kidneys, five for livers, 12 for hearts, three for lungs, and nine for combined heart-lung transplants.
Opt-Out Model On The Table As MOH Reviews 50-Year-Old Transplant Law
MOH officials told the committee that the ministry is reviewing the Human Tissue Act 1974 (Act 130) to strengthen the legal framework for both living and deceased organ donation.
One proposal under study is whether Malaysia should move from its current “opt-in” system to an “opt-out” model, which officials say could help raise donation rates.
“In Malaysia, we practise an opt-in system, where people choose to become donors,” Dr Mohd Syafiq said. “But in Singapore, they use an opt-out system, where – unless the family states otherwise – the government has permission to retrieve organs after death for patients in need.”
Dr Mohamad Zaimi said the review seeks to make the 1974 law “more comprehensive” by explicitly covering all forms of donation. “There’s only one law that governs our transplantation activity, which is the 1974 act,” he said. “And in fact, this law only touches on deceased donations. It doesn’t spell out specifically about living donation.”
He recounted a case illustrating the gap in the law. “About five years ago, a hospital received a letter from lawyers saying, ‘What you are doing is wrong.’ Living donation is considered as battery. There’s nothing in our law to spell out that living donation is permissible,” he said.
“There was an effort to try and strengthen the Act, but it has been more than 10 years, and we have yet to see the outcome of this reform.”
Dr Mohamad Zaimi also highlighted inconsistencies in post-transplant coverage across different hospital systems. “When you undergo a transplant in UMMC (Universiti Malaya Medical Centre), you are not eligible for full support for immunosuppression – the medication you take to prevent graft rejection. If rejection occurs, the graft stops functioning.
“Patients have to pay more when they do it in MOHE (Ministry of Higher Education) hospitals,” he said. “So this is something we are trying to harmonise with the new policy. It was discussed in 2023, but we have yet to see the outcome.”
