Malaysia Is Becoming Ill, Yet Many Are Unaware
Malaysia today is facing a major, silent, and prolonged health crisis. It does not arrive in the form of an infectious outbreak that shocks the world, does not require movement control orders, and rarely dominates daily headlines.
Yet its impact is far greater, more costly, and far more destructive to the nation’s future. This crisis is non-communicable diseases (NCDs).
Data from the National Health and Morbidity Survey (NHMS) spanning 2006 to 2023 reveal a deeply troubling reality: Malaysia is becoming sicker, at a younger age, and increasingly unproductive.
The consistent rise in diabetes, hypertension, dyslipidaemia, and obesity reflects a systemic failure to protect population health before disease takes hold.
More distressing is the fact that a large proportion of Malaysians are unaware that they are already ill, only seeking care when their conditions have progressed to complications requiring hospitalisation, surgery, dialysis, or lifelong treatment.
Irrefutable Evidence: Worsening NHMS Trends
NHMS data from 2006 to 2015 already showed a significant escalation in NCD risk factors. Diabetes prevalence increased from 11.6 per cent to 17.5 per cent, while obesity rose from 14.0 per cent to 17.7 per cent. Hypercholesterolaemia increased dramatically, nearly doubling within less than a decade.
NHMS 2023 delivers an even more alarming message. More than half of Malaysian adults (54.4 per cent) are now overweight or obese. Nearly one in three adults has hypertension, and one in six lives with diabetes.
Most concerning of all, approximately 2.3 million adults suffer from three or more NCD conditions simultaneously, turning them into a “ticking time bomb” for the national health system.
Young adults are no longer spared. Diseases once associated with old age are now appearing in individuals in their 30s and 40s. This means Malaysia is building its future workforce on a foundation of poor health — before reaching peak productive years.
Failure Of Early Detection: When Malaysians Arrive Too Late
One of the most alarming findings of NHMS 2023 is the high proportion of undiagnosed NCDs, particularly among the B40 income group. Nearly half of this population lives with at least one NCD without knowing it.
This is not merely a matter of individuals “neglecting their health.” It represents a failure of the public health system to:
- Detect risk early.
- Reach vulnerable communities.
- Prevent disease progression before complications occur.
When early detection fails, hospitals become the final destination—not for prevention, but for salvaging lives already on the brink of health collapse.
Overcrowded Hospitals: A Symptom Of Failed Prevention
The congestion seen in public hospitals today is not accidental. It is the direct consequence of failed primary and secondary prevention. Diabetic patients with kidney failure, hypertensive patients presenting with stroke, and obese patients suffering from heart disease are all manifestations of a system that failed to intervene earlier.
Hospitals are now bearing the burden of diseases that should have been prevented, while health care costs continue to rise relentlessly.
This model is not only expensive — it is unsustainable. No nation can afford to continuously treat chronic diseases at advanced stages while incidence rates remain unchecked.
NSP-NCD: Strong Policy, Weak Execution
Malaysia is not lacking in policy direction. The National Strategic Plan for Non-Communicable Diseases (NSP-NCD) 2016-2025 provides a comprehensive framework aligned with World Health Organization (WHO) recommendations. It emphasises prevention, early detection, primary care, and a whole-of-government approach.
However, NHMS 2023 reflects a painful truth: good policies do not guarantee good outcomes when implementation is weak. A significant gap persists between strategic planning and on-the-ground realities, particularly at the state and district levels.
Public Health Medicine Specialists: A Marginalised Pillar
This is where the most critical issue lies. Public Health Medicine Specialists (PHMS) are trained specifically to prevent crises such as this.
They understand epidemiology, human behaviour, health systems, and public policy. Yet their roles remain underutilised and undervalued.
At the Ministry of Health (MOH) level, PHMS at the Public Health Division should monitor national disease prevention health policy and its direction. Without strong public health leadership, the health system inevitably becomes reactive and hospital-centred.
At the State Health Department (JKN) level, PHMS serve as system balancers—ensuring alignment between primary care, communities, and hospitals. A shortage at this level leads to poorly targeted interventions and continued hospital overload.
At the District Health Office (PKD) level, PHMS represent the final barrier before disease becomes severe. When public health expertise is weak at district level, prevention fails at the grassroots.
Thousands Of Specialists Exist, Yet Still Not Enough
Malaysia has thousands of Public Health Medicine Specialists, both active and retired. Yet their numbers remain insufficient relative to the growing complexity and magnitude of the NCD burden.
Even more concerning is that existing expertise is not always deployed strategically with clear targets, leaving vast professional potential untapped.
Failure to strengthen PHMS capacity directly results in:
- Overwhelmed hospitals.
- Escalating national health care expenditure.
- Declining economic productivity.
Hospital Management Specialists And PHMS: A Mandatory Partnership, Not An Option
Hospital Management Specialists play a vital role in managing operations, resources, and efficiency.
PHMS complement hospital management via Public Health Risk Department by providing:
- Epidemiological analysis of hospital patient populations.
- Understanding of social determinants driving disease.
- Long-term planning to reduce hospital dependency.
Together, PHMS, Hospital Management Specialists, and clinical specialists form a critical triad:
- Clinical specialists treat individuals.
- Hospital Management Specialists manage systems.
- PHMS ensure those systems remain relevant, sustainable, and prevention-oriented.
Remove any one component, and the system becomes fragile.
The Nation’s Future Is At Stake
If current trends continue, Malaysia risks becoming a nation that is physically developed but biologically unwell. A sick workforce, a population dependent on hospital care, and an unsustainable health system will become major barriers to national progress.
NCDs are not merely a health issue. They are an issue of national development, economic security, and the survival of future generations.
Conclusion: A Call For Immediate Action
NHMS data have issued repeated warnings. NSP-NCD has outlined the direction. What remains lacking is the political and institutional courage to prioritise public health as a national imperative.
Public Health Medicine Specialists must be given strategic authority, adequate numbers, and full institutional support to lead NCD prevention efforts.
Without decisive change, hospitals will remain overcrowded, costs will continue to rise, and the nation will continue losing citizens who should have been healthy and productive.
This is not a warning for the future. This is the reality of today.
The author is an assistant medical officer (AMO) in the northern region of Malaysia. CodeBlue is giving the author anonymity as civil servants are prohibited from writing to the press.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
