Sarawak's population a powerful scientific asset
Population immunology studies how immune responses vary between individuals and populations. These differences are often shaped by genetics. Just as our physical traits – height, skin tone, hair texture, etc. – differ, so do our immune responses to pathogens, medications and vaccinations.
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New Straits Times
2 hours ago
- New Straits Times
Vape groups push for strict regulation, say ban will fuel black market
The vape industry has urged the government to regulate, not ban, vape products, saying prohibition will only push users to the black market and punish legitimate businesses that comply with the law. The Malaysian Vape Chamber of Commerce (MVCC) and Malaysia Retail Electronic Cigarette Association (MRECA) said enforcement and proper regulation under existing laws would be more effective in tackling product misuse and protecting public health. MVCC secretary-general Ridhwan Rosli said banning vape products would drive consumers toward unregulated and potentially dangerous alternatives. "Prohibition has never been an effective solution in tackling misuse. "History has shown that when consumers are denied access to legal vape products, they turn to the black market and risk exposure to unregulated, unsafe substances." Health Minister Datuk Seri Dr Dzulkefly Ahmad told the Dewan Rakyat the government was considering a full ban on the use and sale of electronic cigarettes and vape products. Ridhwan said the root of the problem was the illegal and unregulated market, not the licensed industry. "Banning legal sales would unfairly penalise responsible businesses that are complying with government regulations and supporting harm reduction efforts." He cited the National Health and Morbidity Survey 2019 data which showed that 4.9 per cent of Malaysians, or 1.1 million people, were using unregulated vape products, even when nicotine-based vapes were prohibited. "In Johor and Kelantan, where sales have been banned since 2015, usage remains high, with over 150,000 users in Johor and more than 30,000 in Kelantan. "Even in Singapore, where a full ban is in place, vape use increased from 3.9 per cent to 5.2 per cent between 2021 and 2023, according to a Milieu Insight survey. "These examples show that prohibition does not work." He said the vape industry contributed significantly to the economy, valued at RM3.48 billion in 2023, with more than 31,500 employees and 10,000 retail outlets, many owned by Bumiputera entrepreneurs. "We welcome the formation of the expert committee to study vaping policy, but the legal industry must be included in the discussions, alongside addiction and harm reduction experts. "Excluding key stakeholders will only result in policies that miss the root causes of misuse." Malaysia Retail Electronic Cigarette Association president Datuk Adzwan Ab Manas questioned the Health Ministry's delay in approving vape products, despite companies complying with licensing and documentation rules. "We already have the Control of Smoking Products for Public Health Act 2024. Use it to regulate strictly, not bypass it with a blanket ban." He said the lack of enforcement and transparency was pushing consumers to the black market. "We're ready to help enforce, monitor and clean up the market. But the government must act transparently and professionally, not punish those who comply." Universiti Kebangsaan Malaysia community health specialist Professor Dr Sharifa Ezat Wan Puteh warned that a total vape ban could backfire if not accompanied by robust enforcement and public education. She said other countries had taken varying approaches to regulating vape. "For example, the United Kingdom allows vape products under proper regulation, although it also permits the use of substances like THC (tetrahydrocannabinol). The same applies to the United States. "In contrast, Thailand has banned vape, but continues to allow cigarette use due to its investments in the tobacco industry. "Vape is seen as a competitor, so it is not allowed, even though users still obtain products through illicit means." She said the Philippines, on the other hand, had implemented regulations to allow vape use. "Their Health Ministry encourages smokers to quit by switching to vape under proper regulations." Sharifa said another option that could be considered was the Australian model, where vaping is prescribed as a medical intervention. "It has its pros and cons, but at least the option is there for smokers who want to quit."
New Straits Times
4 hours ago
- New Straits Times
Combatting the superbug
THE rampant misuse of antibiotics in Malaysia highlights the urgent need for responsible healthcare practices. One common but dangerous example is the treatment of sore throats. Although most are caused by viruses and do not require antibiotics, many Malaysians still demand or expect them - fuelling the rise of antibiotic-resistant bacteria. This misuse is not just harmful; it is helping to build a future where simple infections could once again become deadly. In Malaysia, the overuse of antibiotics is particularly concerning — a recent study found that only 2.8 per cent of sore throat cases in public primary care clinics were caused by Group A Streptococcus (GAS), the only common bacterial cause warranting antibiotics, yet 22.3 per cent of these patients still received antibiotics, with over 90 per cent of these prescriptions deemed unnecessary. "The Health Ministry is scaling up national interventions to address antibiotic misuse. Our focus is on policy enforcement, enhancing clinical guidelines, and running large-scale education campaigns to shift both public and professional behaviour," says Klinik Kesihatan Bandar Botanic, Klang consultant family medicine specialist Dr Ho Bee Kiau. Misuse — often driven by misinformation — can lead to treatment failure and drug-resistant infections. Empowering patients with the right knowledge is critical to preventing a future where even routine infections become untreatable, says Kuala Lumpur Hospital head of pharmacotherapy services, Rahela Ambaras Khan. Clinical guidelines like the Malaysian Multidisciplinary Sore Throat Consensus are designed to support better diagnostic decisions. When used correctly, they help reduce reliance on antibiotics for viral infections, which don't benefit from them, adds Professor Dr Baharudin Abdullah, one of the authors of the Sore Throat Consensus. "Our data shows a persistent gap between what's medically appropriate and what's being prescribed. Closing that gap is essential," he adds. Patients often feel uncertain when told antibiotics aren't needed. That's why education is key — not just for doctors, but for the public, says Universiti Malaya faculty of medicine, department of primary care medicine, family medicine specialist Dr Mohazmi Mohamad. When people understand why antibiotics don't work for viral sore throats, they're more likely to accept alternative treatments and avoid contributing to resistance, he explains. In line with promoting responsible sore throat management, the Malaysian Multidisciplinary Sore Throat Consensus also provides healthcare professionals with clear, evidence-based guidance on when antibiotics are necessary — and when they are not. The guidelines highlight the value of accurate diagnosis, patient education, and symptom-targeted care, reinforcing the importance of accessible solutions that help manage viral sore throats without relying on antibiotics.
Daily Express
21 hours ago
- Daily Express
Malaysia's healthcare at a tipping point as costs surge
Published on: Monday, July 28, 2025 Published on: Mon, Jul 28, 2025 By: FMT Reporters Text Size: For illustrative purposes only. PETALING JAYA: Malaysia's healthcare system is edging towards a crisis. According to the Khazanah Research Institute, medical inflation is projected to hit 12.6% this year, outpacing both the global and Asia-Pacific averages. At the same time, insurance premiums are rising well beyond Bank Negara Malaysia's 10% cap, while public hospitals are overwhelmed with long queues, a shortage of specialists and stretched resources. However, instead of focusing on faults, experts say the conversation must shift toward practical and transparent solutions that improve outcomes for all Malaysians. Medical costs are escalating worldwide. Malaysia is no different, experts say, yet in some ways, it is even more exposed. Why are healthcare costs climbing? Private hospital charges are often perceived as excessive, yet data shows they operate on modest post-tax margins of between 7% and 11%—lower than the margins reported by insurers (13%), pharmaceutical firms (15%), and MedTech companies (16%). Up to 90% of private hospital earnings is reinvested in infrastructure, equipment and staffing. This reinvestment is critical in a competitive environment where retaining skilled specialists has become increasingly difficult. Healthcare costs are rising in part because hospitals must bear the cost of globally-priced technologies, imported drugs and rising wages. Meanwhile, the public system remains severely overburdened. Over 70% of Malaysians depend on public healthcare, where the doctor-to-patient ratio exceeds 1,500:1. Those who can afford private treatment gain faster access and a more personalised care environment, complementing the essential services offered by public hospitals. Medical bills also vary depending on a patient's health profile. A young, healthy individual will naturally incur lower costs than an elderly patient with multiple chronic conditions. However, variations are driven by the complexity of treatment, not arbitrary pricing. The insurance factor Patients are often taken aback by the cost of private treatment, particularly in insured cases. However, these outcomes are frequently the result of how insurance policies are structured. Hospitals usually charge the same base prices for treatments regardless of whether a patient pays out-of-pocket or via insurance. However, insurance companies often negotiate business-to-business (B2B) discounts with hospitals premised on patient volume. In such cases, the final bill that an insured patient incurs would likely be lower than the standard rate. Before admission, hospitals typically offer patients an estimated treatment cost based on the clinical recommendations of doctors. Patients are always informed of options available to them if the insurance coverage excludes certain procedures or the treatment cost exceeds their policy limit. Patients who choose to self-pay may, in some cases, incur lower overall costs. This can result from patients opting for less intensive treatment or receiving discretionary discounts and financial aid from hospitals and doctors in deserving cases. While these practices are typically rooted in clinical judgement and goodwill, they may contribute to the perception of dual pricing between insured and self-paying patients. When appraised of the estimated costs, patients can then decide whether to pay for treatment out of their own pocket or seek a transfer to a public hospital. This process ensures decisions are made transparently and with informed consent. Health economist Prof Syed Mohamed Aljunid of IMU University attributes the inflationary pressures to factors affecting both demand and supply. 'On the demand side, an ageing population and the rise in chronic non-communicable diseases are important factors. They require a huge amount of resources—especially in the long term—to treat. 'On the supply side, new technologies, specialised equipment and treatment, and the development of new drugs are also costly,' he told FMT. He said the insurance sector must also be subject to scrutiny as some policyholders have seen premiums rise by as much as 50% over three years—well above official caps. When insurance coverage lapses or is exhausted, patients often fall back on the public system. This shift is especially pronounced in cases of recurring illnesses like cancer, where policies typically cover only the initial diagnosis. Transparency vs. reality in medical billing Unlike retail products, medical costs can't always be quoted upfront. Treatments may evolve in real-time depending on a patient's condition, complications and their recovery trajectory. While hospitals provide detailed, itemised bills post-treatment, estimating exact costs in advance is often impossible. Since May 1, private healthcare providers have had to publicly display medication prices—a move aimed at enhancing transparency. However, industry stakeholders have voiced concern over practical hurdles, from administrative burdens to unclear regulatory oversight. Critics of the move say doctor-patient consultations may end up becoming price-haggling sessions. Smaller clinics, already struggling with rising costs, may find it difficult to absorb the compliance burden. Penalties for non-compliance—up to RM50,000 for individuals and RM100,000 for companies—are also raising alarm. Dr Nomee Ashikin, group medical director at state-owned Selgate Healthcare Sdn Bhd, said private hospitals already operate on tight margins and absorb significant overheads to maintain high standards of care. 'Hospitals have no choice, as they are facing a lot of headwinds. With the current issue of tariffs and a poor ringgit, a lot of these problems will trickle down and be borne by the public,' she told FMT. Other countries offer mixed lessons. Thailand's price controls were met with resistance due to fears of stifling innovation. Vietnam has capped basic services but allowed premium offerings to offset costs. Singapore has sought to balance public and private roles through hybrid funding and structured pricing. What can be done? One critical area is better regulation of the insurance industry, said Nomee. 'When the bottom line is prioritised, it will be to the detriment of the public. We need some sort of regulation. 'We know that the medical doctors are the ones who are being regulated. Our fees have not changed for the last decade. Before, the ratio of medical bills was one to the doctor, three to the hospital. Now it's one to ten,' she said. Some patients have faced steep premium hikes and coverage inconsistencies. Improving transparency around claims and clearly communicating co-payment structures could help rebuild trust. Another priority is strengthening coordination between public and private healthcare. Both sectors are essential, and better collaboration can ease congestion and improve access across the board. At the policy level, reform needs to be cautious and deliberate as overly aggressive regulation could deter investment and affect service quality. Dr Khor Swee Kheng, CEO of Angsana Health, said reforms must be gradual and consultative. 'Reforms should take place with enough notice so that people are not surprised by it. As long as you manage the reforms in a gradual, predictable way that is familiar to people—without scaring them—reforms will work,' he told FMT. He said addressing Malaysia's healthcare challenges will require cooperation from all sides. 'Stop blaming each other. Stop saying that a certain stakeholder has got more duty, more responsibility, and therefore has more on the hook than other stakeholders. 'The middle way must be collaborative, evidence-based and should be implemented in a pilot fashion. If it shows some early promising signs of results, then we go all in,' he said. - FMT * Follow us on our official WhatsApp channel and Telegram for breaking news alerts and key updates! * Do you have access to the Daily Express e-paper and online exclusive news? Check out subscription plans available. Stay up-to-date by following Daily Express's Telegram channel. Daily Express Malaysia
