Malaysia’s diabetes epidemic is no longer a looming threat — it is a present and escalating public health failure. With one of the highest diabetes prevalence rates globally and the highest in Southeast Asia, the country now faces a worsening crisis that extends well beyond health care, affecting workforce productivity, household finances, and long-term national development.
The emergence of Type 2 diabetes in children as young as eight years old should serve as a policy alarm bell. Today, one in five Malaysian adults lives with diabetes, while more than half are overweight or obese.
These figures reflect not individual failings, but systemic weaknesses in how Malaysia regulates food environments, builds health literacy, and prioritises prevention.
Despite repeated national strategies and action plans, Malaysia continues to invest disproportionately in treatment rather than prevention. This imbalance is no longer fiscally, medically, or ethically defensible.
Health Literacy: High Education, Low Understanding
Malaysia’s general literacy rate exceeds 95 per cent, yet around one-third of Malaysians have limited health literacy. Many are unable to interpret nutrition labels, assess sugar content, or recognise early signs of metabolic disease. This disconnect explains why health information alone has failed to shift behaviour.
Health literacy cannot be assumed; it must be intentionally cultivated. Nutrition and lifestyle education should be embedded across the formal education system, beginning in early childhood.
This requires structured, age-appropriate curricula that teach practical skills — how to distinguish minimally processed foods from ultra-processed products, understand hidden sugars, and make informed health choices daily.
Schools should be supported by trained nutritionists and health care professionals to guide food policies, conduct basic growth and health risk screening, and trigger early referral for interventions.
Existing platforms such as the Doktor Muda programme and parent-teacher associations (PIBG) provide ready infrastructure but require stronger technical support and accountability.
Without systematic investment in health literacy, downstream health care spending will continue to rise—regardless of how many clinics and hospitals are built.
Sugar-Sweetened Beverage (SSB) Tax: Underpowered And Underutilised
Malaysia’s sugar-sweetened beverage (SSB) tax, introduced in 2019, acknowledged the role of fiscal policy in shaping consumption. However, its current design is insufficient to meaningfully reduce sugar intake or fund prevention.
Between January and November 2025, SSB tax revenue amounted to RM73.8 million, bringing cumulative collections since 2019 to RM521 million.
By comparison, direct health care costs for diabetes exceed RM4.3 billion annually, with productivity losses estimated at over RM23 billion each year.
To put these numbers into perspective, Malaysia actually spends nearly 60 times more managing diabetes than it collects from taxing sugar. This disparity underscores the need for reform, not retreat.
Evidence from other jurisdictions is clear. Malaysia should:
- Increase the SSB tax rate to a level that influences purchasing behaviour.
- Expand taxable products to include sweetened milk drinks, flavoured coffees, 3-in-1 beverages, energy drinks, and high-sugar syrups.
- Adopt a tiered sugar tax, similar to the United Kingdom’s Soft Drinks Industry Levy, which drove a 46 per cent reduction in sugar content through industry reformulation.
- Ring-fence SSB revenue for prevention, including school health programmes, nutrition education, and diabetes risk reduction.
Without earmarking revenue for health, public trust in the tax will remain fragile.
Environments Matter More Than Advice
Malaysia’s approach to non-communicable diseases continues to overemphasise individual responsibility while underestimating environmental influence. Healthy choices are difficult when unhealthy options are cheaper, more accessible, and aggressively marketed.
Policy must therefore focus on reshaping environments. Subsidising culturally appropriate healthy foods — particularly in schools, universities, and workplaces — can shift dietary patterns more effectively than education alone. Institutions should be held accountable for food standards, availability of safe drinking water, and opportunities for physical activity.
Workplaces, where adults spend most of their waking hours, represent an underutilised prevention platform. Simple measures—healthy food subsidies, movement-friendly design, and flexible activity breaks — can deliver measurable population-level impact.
Community-Level Prevention Still Matters
National policies must be complemented by grounded, community-based initiatives. “Just Walk”, a programme supported by Diabetes Malaysia (Penang Branch), illustrates how low-cost interventions can translate policy intent into daily practice.
Walking is accessible, low-risk, and effective in improving glycaemic control, cardiovascular health, and mental wellbeing. By organising community walks and peer-support groups, the programme reduces social and psychological barriers to physical activity, particularly among older adults and high-risk groups.
Scaling such initiatives through local authorities and workplaces would strengthen Malaysia’s prevention ecosystem without significant additional health care expenditure.
Prevention As A Governance Test
Malaysia’s diabetes crisis is not inevitable. It reflects policy choices—what is prioritised, regulated, funded, and measured.
Prevention requires more than slogans. It demands stronger fiscal tools, health-literate systems, supportive environments, and accountability mechanisms.
Failing to rebalance towards prevention will not only cost lives, it will also continue to erode the sustainability of Malaysia’s health system itself.
Dr Dicky Ng (chairperson) and Dr Chow Sze Loon (life member) are from Diabetes Malaysia (Penang branch).
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
