Panel #3: Global Challenges Affecting Malaysian healthcare

Looking at upcoming global healthcare issues and figuring out ways to solve them from the Malaysian context

This panel session will address prevalent global issues that are affecting the world and the panelists will bring it to the Malaysian healthcare context. We took a look at the World Health Organization (WHO)’s report on today’s challenges in global health: regarding the status of health-related Sustainable Development Goals (SDGs), infectious diseases, noncommunicable diseases (NCDs) and mental health were issues of interest. In 2015, 2.1 million people were newly infected with HIV globally. 1.1 million died of HIV-related illnesses. Tuberculosis remains a significant global health issue, despite being a treatable disease. In 2015, there were an estimated 10.4 million new TB cases and 1.4 million TB deaths. As for NCDs, in 2015, 40 million deaths occured due to NCDs, accounting for 70% of the overall total deaths. The majority of such deaths were caused by four main NCDs: cardiovascular disease, cancer, chronic respiratory disease and diabetes. [1]

WHO reported that despite declining trends in communicable disease, HIV/AIDS has become the leading cause of mortality and the single most important contributor to disease burden. While the disease remain to be most prevalent in Africa countries, shockingly, Malaysia is ranked seventh highest at an adult prevalence rate of 0.45% in Asia. In 2015, Malaysia recorded a rate of 10.9 new cases per 100, 000 population which is below the WHO target. [2]

Let’s take a look at some of the key challenges in AIDS/HIV Response progress: Is there a need for the expansion of HIV screening services beyond the traditional health care system in Malaysia? Is there a treatment gap among HIV/AIDS patients? Condom use has been a significant problem in mitigating HIV/AIDS in Malaysia. As such, will sex education — a stigma among many in Malaysia —help? Another incident which has attracted local’s media attention is our attitude towards the LGBT community. As doctors, do our personal opinions of distaste and disdain deter these people from seeking help and treatment? [2]

As for NCDs, Malaysia has the highest levels of obesity in Asia, with nearly half of our adult population classified as obese or overweight. 74% of annual deaths in Malaysia are due to NCDs, this is a reflection of WHO’s report. Among ASEAN countries, Malaysia is highest for total cost of obesity, which is at 10-19% of national healthcare spending.

Just last month, the National Diabetes Institute stated that Malaysia has the highest rate of diabetes in Asia and one of the highest in the world. This particular statistic is aggravated by the fact that the patient’s knowledge of their own disease eludes them. As we have come to learn in our medical curriculum, this problem is worrying as such a disease usually goes asymptomatic… until they lead to a blind eye, kidney failure or an amputated limb, at the very least. [3] As proponents of healthcare, what are some of the necessary steps we need to take to overcome this?

In the mental health field, Malaysia is also guilty from the lack of investment in mental health services and facilities. There is a significant lack of understanding of mental health, and this problem is compounded with the cultural stigma that exists among Malaysians.. According to the National Health and Morbidity Survey, approximately one in three Malaysian adults suffer from a mental health illness, or is at risk of developing one. According to WHO, mental health problems feed into the high number of suicides in Malaysia, with an average of 2000 a year. Most treatment of mental ailments are out of reach to many, with private hospitals containing more resources. However, even some health insurance schemes do not cover mental illness. This leads to an inevitable  gap in healthcare treatment in the area of mental health, which needs to be addressed as mental health illness is a burden to the nation. [5]

References

  1. WHO. (2017). World Health Statistics: Monitoring Health for the SDGs. Retrieved at http://apps.who.int/iris/bitstream/handle/10665/255336/9789241565486-eng.pdf;jsessionid=C24353FBCA1B3C4A397C0B9E9BAC2547?sequence=1
  2. Disease Control Division, MoH. (2016). Global AIDS Response progress Report. Retrieved athttp://www.moh.gov.my/images/gallery/Report/Malaysia%20GARPR%202016_Final.pdf
  3. Free Malaysia Today. (2018). Doctor chided over disdain for LGBT community. Retrieved at http://www.freemalaysiatoday.com/category/nation/2018/08/08/doctor-chided-over-disdain-for-lgbt-community/
  4. The Star Online. (2018). Malaysia has highest rate of diabetes in Asia. Retrieved at https://www.thestar.com.my/news/nation/2018/07/25/malaysia-has-highest-rate-of-diabetes-in-asia-says-nadi-chairman/
  5. Foong LM. (2018). The whole mental healthcare system in Malaysia seems to be behind the times. Southeast Asia Globe. Retrieved at http://sea-globe.com/failing-mental-healthcare-in-malaysia/