Superbugs: Huge increase in deaths



Deaths caused by a superbug which usually affects long-term care patients using invasive devices has increased significantly within four years.

Statistics from the Health Ministry showed that deaths from carbapenem-resistant enterobacteriaceae (CRE) cases went up from 15 in 2013 to 150 last year.

The Ministry’s infectious disease national head Datuk Dr Christopher Lee said CRE infections usually happened to patients in hospitals and nursing homes who require the use of devices such as ventilators, urinary catheters, or intravenous catheters which exposed them to recurring infections. This results in the use of certain long-course antibiotics which then cause the bacteria to evolve and become resistant, he said.


“Infections with these germs are very difficult to treat, and can be deadly. One report cites they can contribute to death in up to 50% of infected patients” he said.

Centre for Disease Control and Prevention says carbapenems are a class of highly effective antibiotic agents used to treat severe or high-risk bacterial infections, but CRE is a family of germs that is resistant to antibiotics.

Health director-general Datuk Dr Noor Hisham Abdullah said CRE deaths were monitored since 2013.

The overall death rate of the CRE patients increased from 10% (15 out of 150) in 2013 to 18.3% (150 out of 818) in 2017, he said.

“Anti-microbial resistance (AMR) is becoming an increasingly urgent challenge for Malaysia,” he said when contacted.

Deputy Health Minister Dr Lee Boon Chye recently announced that the World Health Organisation and Malaysia jointly launched a five-year National Strategic Action Plan to contain AMR.

Dr Noor Hisham said that in 2017, surveillance of six multidrug (MDR) organisms showed that for every 10,000 admissions, eight patients get infected by them.

An increase in antibiotic resistance is also seen in a common foodborne pathogen Salmonella sp, with resistance rates of 21.6% against ampicillin last year compared to 18.6% in 2013.

“This is a worrying situation,” said Dr Noor Hisham.

He said doctors should always adhere to guidelines and educate patients regarding their illness and antibiotics treatment.

Pharmacists, he said, must also ensure that these patients have a valid prescription.

Patients should also ask for information about their antibiotics and take them as directed, he said.



/theSTAR 18-11-2018

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Daily reported: Nine new HIV cases, two AIDS deaths



Every day, an average of nine new HIV cases and two AIDS-related deaths were reported in Malaysia..

Deputy Health Minister Dr Lee Boon Chye said the Ministry of Health received 3,347 new HIV cases and registered 892 AIDS-related deaths in 2017.

There is a total of 72,339 HIV- positive patients as of 2017 but only 54% of them were receiving antiretroviral (ARV) treatment, he said. “This treatment can increase their lifespan and prevent full-blown AIDS,” he said when officiating World AIDS Day 2018 here.

He said with ARV, HIV patients could live up to 58 years or more.

“Misconception about HIV is one of the main reasons patients are reluctant to take ARV. “As some HIV-positive patients are symptom-free, they think they do not need the treatment until they develop AIDS,” he said, adding that the government provided the treatment for free at clinics.

Dr Lee also said ARV could help reduce HIV by up to 97%. “We hope to have at least 95% of HIV-positive patients undergo the treatment by 2030,” he said.

He urged the public to take HIV screening, which is available for free at government clinics. “Early HIV detection will reduce the chances of developing AIDS and further spreading the virus to loved ones,” he said, adding that those taking the test could also choose to remain anonymous.

/theSTAR 03-12-2018

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Healthcare budget 2019



The Health Ministry is “happy” and “thankful” to the Prime Minister and Finance Minister for increasing the allocation to his ministry by 7.8%.

“This is very encouraging for all the people in Health Ministry,” he told reporters after Budget 2019 was unveiled in Parliament on Friday (Nov 2).

Finance Minister Lim Guan Eng, who had earlier tabled Budget 2019, said the allocation for health services would be increased to RM29 bil from last year's allocation of RM27 bil.


This allocation includes RM10.8bil to restore clinics and hospitals, as well as for the purchase of medicine and medical equipment.

On the Protection Health Scheme (Peka) for individuals in the B40 group, Dr Dzulkefly said it is expected to benefit 800,000 people. “The scheme for this B40 group starts with RM100mil.

“At the very least we have started with these individuals, which is as many 800,000 people,” he said.

The Peka scheme will involve a pilot health screening project for B40s aged 50 and above.

When asked about the enforcement of no-smoking zones in restaurants and eateries, Dr Dzulkefly said he was not worried about it. “It is not a problem, we will do it, we have enforcement (powers),” he said, adding that he has a “good number” of enforcement officials from his ministry for the matter.

theSTAR 03-11-2018
 
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Malaysia to become ageing population by 2020





GETTING more women to work is one of the key remedies to mitigate the negative impact of an ageing population, according to the Economic Outlook 2019.
It said a rethinking of retirement norms beyond the legal retirement age of 60 is necessary.
Malaysia is at risk of becoming an “ageing population” when 7% of the total population is aged 65 and above, based on the definition set by the World Health Organisation.
As of 2017, the number of people aged 65 and above in Malaysia was about two million or 6.3% of the total population.
In a nutshell, the ageing population would put pressure on economic growth as it would impact productivity, labour participation and saving rates.
It is noteworthy that currently, Malaysia has among the lowest female labour participation rates in Asean, China, Japan and South Korea.
According to a study by Moody’s across the Asia-Pacific emerging markets, closing the gap between the female and male labour force participation by 50% could offset up to 1.7 percentage points of a slowdown in the labour force.
In the case of Malaysia, in 2017, the female and male labour participation rates stood at 54.5% and 80.1%, respectively.
If the gap is reduced by 50%, then it would increase the labour force by an additional 1.3 million to 16.3 million.
The report highlighted that another impact of the ageing population is increasing public expenditure.
The higher life expectancy of the population, particularly pensioners and their dependents, tends to increase pension payments.
Therefore, the current pension scheme may not be sustainable in the long run as it will pose a large financial burden on the government’s fiscal position.
As such, the government should seek ways to reform its pension systems in anticipation of fiscal burdens in the future.
Currently, the civil service pension scheme is adopting the unfunded arrangement of pay-as-you-go, where it is disbursed directly from the government budget.
Therefore, to ensure a sustainable fiscal position in the long run, the civil service pension scheme could be improved and modernised by introducing the defined-contribution scheme for new recruitments in the civil service.

/theSTAR 03-11-2018

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Cancer: More needs to be done



At the  the World Cancer Congress 2018, Kuala Lumpur.

Cancer is the fourth most common cause of death in Malaysia with approximately 37,000 cases reported every year. This is estimated to rise to more than 55,000 newly-diagnosed cases by 2030.

Cancer is responsible for 12.6% of all deaths in government hospitals and 26.7% in private hospitals.

The data and findings from the Health Ministry’s Malaysian Study on Cancer Survival (MySCan), which was released at the conference, make for grim reading.

The first population-based cancer survival report in the country aimed to help guide the development of cancer control strategies, it describes poor survival rates of patients who presented late for treatment, specifically at Stage 3 and 4.

Despite existing screening facilities and programmes, those with breast, cervical and colorectal cancers were coming forward late at 41.3%, 38.5% and 63.8% respectively.

Within the period of the report, around 43% of women diagnosed with breast cancer died; for individuals with cervical cancer, it was 56% and 52% for those with ovarian cancer. Nine out of 10 lung cancer patients did not make it.

Gastrointestinal cancers have an average survival rate of less than 40%. Those of the nasopharynx, which badminton ace Datuk Lee Chong Wei is currently battling, also had a similar number.

With such data, it is not surprising that Malaysia has one of the highest mortality to incidence ratio for breast cancer in South-East Asia.

Besides late presentation of disease, insufficient facilities and specialists (particularly outside urban areas), lack of access to innovative surgical, radiotherapeutic and oncological treatments contributed towards this sad state of affairs.

Compounding these factors are complications caused by financial catastrophe and the lack of allied health professional networks.

It is in this spirit that during the pre-Congress event, “Advancing an agenda of hope and action on cancer in Malaysia”, jointly organised by Galen Centre for Health & Social Policy and the National Cancer Society Malaysia, a series of concrete, short-term and long-term policy recommendations for members of parliament and policy makers was launched.

Developed by Malaysian cancer patients, these recommendations are intended to make policymakers take heed and seriously respond to specific challenges which affect cancer treatment and care in the country.
Five short-term recommendations, which can be achieved with minimal effort, were highlighted as low-hanging fruit for the new government to implement in order to demonstrate its ability to deliver on the promises of increasing the quality and depth of existing healthcare services.

These include removal of dual referral charges at public hospitals, standardisation of treatment fees across public healthcare, improving the quality and availability of national cancer data, and providing support to lower-income patients through integration of cancer screening and diagnosis as part of the Skim Peduli Sihat initiative.

There were eight long-term recommendations which require greater institutional reforms to policies, strategies and services on cancer care.

These included ensuring stronger and improved government accountability of the national cancer strategy, establishing multi-sectoral consultative and partnership mechanisms, adopting sustainable healthcare financing strategies, reforming the Social Security Organi­sation (Socso) legislation and regulations relating to cancer, improving public drug procurement policies to respond better to advances in cancer treatment, and establishment of cancer survivorship services as part of care.

To help realise these recommendations, The Cancer Care Working Group was launched as a new cancer advocacy initiative comprising patients, cancer specialists, health professionals and cancer advocates. They currently work in a number of related areas including health service delivery, research, prevention, information and support, care and treatment, and patient involvement.

The Cancer Care Working Group aims to help influence public policies to improve outcomes, treatment and care of cancer in Malaysia.

It will work towards enhancing and adding value to the government’s implementation of the National Strategic Plan for Cancer Control Programme (2016 – 2020), and campaign for action, improvements and change in cancer policy.

Most importantly, it aims to promote the voices of patients and their empowerment and meaningful participation in public policy consultations and discussions. Patients must continue to be at the centre of policy-making which directly affects them.

Perhaps with the strength of their voices, the current situation can change for the better so that more people with cancer can move from always hoping to living.

/theSTAR 05-10-2018


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Pharmacist's Role: More than Dispensing



THE role of pharmacists is beyond procurement and supply of medicine, says Deputy Health Minister Dr Lee Boon Chye.

Dr Lee said pharmacists are now involved in the production of medicine in the pharmaceutical industry in the country, as well as in the logistics and distribution of local and imported medicinal products.

He said dispensing of medicine is also evolving, and thus dispensing of drugs in government facilities, private hospitals and community pharmacies are carried out by a pharmacist together with drug treatment services, medical safety screening and monitoring of adverse effects of drugs.

“Pharmacists are also involved in clinical activities such as the management of infectious and non-infectious disease drugs.

“They help monitor drug therapy for HIV and tuberculosis patients, the use of antibiotics and monitor drugs prescribed for diabetes, hypertension, heart disease, stroke, rheumatoid arthritis, haematology and asthma.

“Pharmacists are also involved in smoking cessation and weight loss programmes,” Dr Lee said in his speech before launching the Perak state-level World Pharmacists Day 2018 at Ipoh Parade.

The history of pharmacy services in the country, he said, started in 1951 with 20 registered pharmacists, adding that in 1957 there were only 23 registered pharmacists in the public sector.

Dr Lee however said with the rapid development in the profession, the number of registered pharmacists increased yearly. “Until March this year, there are 16,210 registered pharmacists, and out of this, 7,577 work under several divisions of the Health Ministry,” he added.

State Health deputy director (pharmacy division) Leong Weng Choy, who is also Perak Malaysian Pharmaceutical Society chairman, said pharmacists play an important role in determining the success of medication treatment received as an effort to improve a patient’s quality of life.

He said a pharmacist is involved in every aspect of managing the medication, right from the drug formulation until the dispensing of the medication to patients.

As part of the healthcare team, he said pharmacists are required to be in the forefront of all issues involving medicine, health and safety of patients.

Leong said the ultimate goal of pharmacists is to ensure optimum and rational drug therapy.

“This is done through the involvement of pharmacists in the processes associated with the use of such drugs, like providing, distributing, controlling information to those who prescribe, like doctors, and to the end users."

“The responsibility of a pharmacist is becoming increasingly important with the development of new drugs by research scientists and the current challenges faced in relation to medication,” he added.

Leong said every year, thousands of drugs are prescribed to patients and almost all of the dosage are checked first by a pharmacist whether in a hospital, health clinic or community pharmacies.

He said in a mission to empower users and to increase trust among patients, users and pharmacists, several initiatives were taken by the government and the private sector.

Among the initiatives are “Recognise Your Medication” by the Health Ministry which focuses on enhancing awareness of the use of drugs rationally.

Besides that, Leong said the society has also produced posters, videos and pamphlets on the prescription rights, which could be used by pharmacists as a guide in educating patients.

/theSTAR  09-10-2018

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1% Malaysians signed up as organ donors



The number of Malaysians who have registered to become organ donors is still low, with only less than 1% having made the pledge out of 32 million Malaysians.

National Transplant Resource Centre organ and tissues procurement coordinator head Dr Omar Sulaiman said currently, a total of 25,000 kidney patients throughout the country were still waiting for compatible donors.

“Only an average of 40 patients are able to replace their damaged kidney in a year; the figure is small because we record about 1,000 kidney patients a year in Malaysia,” he added.

Dr Omar said this during the Organ Donors Week 2018 launch at Sultanah Aminah Hospital (HSA) here.

He pointed out that besides kidney patients, a total of 18 critical liver patients and six heart patients were also waiting for the right donors.

Dr Omar added that his side was doubling their effort to get more people to become donors through their “Let’s Talk” campaign.

“Many are still unaware that despite having already registered to become a donor, it does not necessarily mean that this person will have his or her organ donated when a death happens. This is because the hospital will still need to get approval from their family members or next of kin, and check on the condition of the organ before starting the process,” he added.

Dr Omar advised those who have already made the pledge to donate their organs to inform their family first to ensure their loved ones were not shocked at their decision and able to carry out their intention.

/theSTAR 11-10-2018

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Ministry of Health: "No hanky-panky in drug procurement"



The Health Ministry says allegations of drug supplies monopoly and corruption levelled against it are baseless.

However, the whistleblower who first made the allegation in June, expressed disappointment and  has given an update to The Star detailing the rising tender contracts value of drug supplies by the top six tendering agents.

A tendering agent, however, begged to differ, explaining that the procurement procedures were transparent and the use of agents was common even in other countries.

The real issue was whether tendering agents should be bumiputra agents only, he said.


On Friday (Oct 19), Health secretary-general Datuk Seri Dr Chen Chaw Min said  that the ministry had investigated the drug supply procurement procedures for hospitals and found they were carried out according to the  guidelines set by the Finance Ministry.

On the issue of the appointment of agents, involvement of politicians or senior government servants in procurement, as well as the monopoly claims, he said the matter had been referred to the Malaysian Anti-Corruption Agency (MACC) and the Malaysia Competition Commission (MyCC).

"So far, nothing out of ordinary has been reported against the ministry."

"With this statement, we hope that no parties will make any assumption or create confusion about the management of the procurement at the Health Ministry," Dr Chen said in a statement on Friday (Oct 19) in response to a Free Malaysia Today report.

The portal had reported that the whistleblower was disappointed with the lack of action after his revelation.

On June 13, The Star carried a report on the allegations in which the whistleblower provided details on high-ranking officials and companies linked to politicians said to have control over billions of  ringgit worth of medical supply to the Health Ministry.

A 12-page document was emailed to Health Minister Dr Dzulkefly Ahmad and forwarded to a few parties including The Star.

It said there were bid-rigging of open tender process, thus enabling the monopoly of medical supply.

In response to the ministry's statement on the matter, the whistleblower provided updates, saying that the top six tendering agents had, to-date, been awarded approximately RM5,934,877,317 or 92.21% of the approximate RM6,435,975,589 total tender contracts value.

The whistleblower said with the latest information, the amount was now approximately RM6.44bil for the period of 2010 to 2018 (and ongoing).

"Collectively the top six tendering agents were awarded approximately RM5,934,877,317 or 92.21% of the approximate RM6,435,975,589 total tender contracts value," he said.

The tendering agent, who disagrees with the accusations, said this was not evidence of wrong-doing, explaining that the procurement procedures were transparent and the use of an agents was common even in other countries.

The agent, who is not one of the top six, said he was surprised a pharmaceutical company would make such allegations because the procedures were transparent.

In fact, he said drug patent was the actual monopoly that is causing drug prices to be high - a legal monopoly according to the World Trade Organisation's agreement, of which Malaysia is a signatory.

Moreover, for some drugs, he said, direct negotiations were required because they were patented with no other companies producing them.

"Why would the government call for a tender if a product is patented? So, it would have to be direct negotiations," he said.

He said multinational companies might say they did not want a middle man, but a lot of countries had some sort of an agency arrangement.

Some companies were big enough to step up operations in Malaysia, some were not and would use the service of a tendering agent, he said.

"So, this requirement is actually global. Now, whether it needs to be a bumi agent or not is the bigger question.

"That is why I tell the MNCs to be clear of what they are against," he added.

He said because the six tendering companies had been around for a long time and pharmaceutical companies were happy with their services, they continue to use the tendering agents.

"If you are number 50 to 75, and you expect the licence to bring in money, then sorry, because none of the principals would want to deal with you," he said.

He said that the pharmaceutical company he represents once "got burnt" as the tendering agent did not pay up for some of the products it supplied.

"That's why I understand why MNCs are comfortable dealing with only certain agents," he said. 

/theSTAR 20-10-2018

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Malaysia: First in region to eliminate mother-to-child HIV/Syphilis transmission



Malaysia is the first country in the World Health Organization (WHO) Western Pacif­ic Region to be certified as having eliminated mother-to-child transmission of HIV and syphilis (eMTCT).


Health Minister Dr Dzulkefly Ahmad was presented with a validation certificate by WHO director-general Dr Tedros Adhanom Ghebreyesus during the WHO Regional Committee for the Western Pacific session in Manila.

With the success, Malaysia is the 12th country in the world to receive the certificate. “Malaysia has achieved a level of health it can be proud of, where the mother-to-child transmission of HIV and syphilis are no longer a key public health threat,” Dr Dzulkefly said in a statement.

He said HIV transmission from mother-to-child was the main cause of HIV infection among children.

Without intervention, between 30% and 45% of children born from HIV positive mothers would get the infection while in the womb, during delivery or through breast-feeding.

To overcome the problem, the ministry launched an infection prevention and treatment programme for the two infections.

To prevent babies from being infected with HIV through breast­feeding, the government had also given free formula milk as a replacement for two years.

For mothers infected with syphilis, 50% of babies born would suffer from congenital syphilis and low birth weight while some mothers suffer from miscarriage, premature delivery, stillbirth and complications from infections.

While the programmes reduced the rate of HIV infection from mother-to-child to less than 2% in 2016, which met the elimination status indicators, the transmission of syphilis had always been low with 50 cases per 100,000 life births, which also indicates elimination.

Dr Dzulkefly hopes that with WHO’s continuous support, Malay­sia would be able to achieve similar success for Hepatitis B.
/theSTAR 09-10-2018 

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First Rehabilitation hospital in Malaysia



Khazanah Nasional Bhd has launched Malaysia’s first 96-bedded rehab hospital in the heart of Petaling Jaya, Selangor, called the Regen Rehabilitation Hospital.
The hospital is owned by Khazanah (60%) and New York Stock Exchange-listed Select Medical Holdings Corp (40%) that is parked under ReGen Rehabilitation International Sdn Bhd with an initial investment of RM100mil.
It provides crucial tertiary treatment not presently covered in acute care hospitals for patients such as those who are bedridden or who have had a stroke to enable them to regain their mobility.
Regen Rehab’s CEO Sue Lee expects to record a positive earnings before interest, taxes, depreciation and amortisation in two years and expects to break even in 4½ to 5 years.
Both Lee and Select Medical’s executive chairman Robert Ortenzio said there are no plans to park this venture under another Khazanah-led hospital group, IHH Healthcare Bhd
Lee said she believes that this rehab hospital meets a largely unmet demand in the Malaysian tertiary healthcare system presently and is confident insurers would eventually start to cover such treatments in the present healthcare insurance schemes.
“There is no availability of rehab hospitals like us. Many people cannot differentiate the different types of hospitals unlike in the United States where there are many types of hospitals in tertiary care.
“Over here, we only have acute hospitals (for example Gleneagles or Pantai Hospital) and after that, it is only nursing homes. There is a big gap here in Malaysia,” Lee said.
“Whereas in the US, they have acute hospitals, step-down unit hospitals, long-term acute care hospitals, in-patient post-acute care hospitals and then only nursing homes.
“There are actually many other types of hospitals to meet the needs of patients other than just acute care which we are used to here in Malaysia,” she added.
Regen Rehab said it is in talks with insurers at the moment to provide such coverage for policy holders for admission into such types of hospitals.
“Outpatient care is covered by healthcare insurance for physiotherapy and occupational therapy and this is not an issue. The only part that healthcare policies do not cover now is post-acute rehab admissions.
“But having said that, we have had promising discussions with the big insurers here to do a pilot project. We can then demonstrate the quality of patient outcomes received to demonstrate how efficient we are in managing medical costs,” she said.
Pertaining to this matter, Ortenzio said rehab treatment is not well known or well accepted yet in Malaysia and that the level of awareness on rehab treatment is around where America’s awareness was some 15-20 years back.
“This standard of care will eventually be demanded by patients who have had a stroke or those who have had spinal cord, head injuries or even cancer. This group of people will really demand this level of care for good outcomes,” Ortenzio said.
/theSTAR 21-09-2018
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Pharmaceutical Price control forthcoming ?



The mechanism for price control on medicines will be announced next month before the tabling of the 2019 Budget, says Deputy Health Minister Dr Lee Boon Chye.

The Ministry, he said, discussed the matter with the Domestic Trade and Consu­mer Affairs Ministry last month.

“Every year, the price of medicines goes up by 10% to 20% and this is normal. That is why for normal medicines, we try to use generic ones,” he told reporters after opening the Second Inter­national Conference of Pharmacy and Health Sciences here yesterday.

The three-day conference, with the theme “Integrating Research In­novation, Technology, Practices To­wards Sustainable Health”, involved 150 local and foreign participants.

Dr Lee said the price increase in medicines was also influenced by the method used to bring them into the country.

Most of the medicines were imported from the United States and Europe, he said.

He said a study conducted in the United States on 13 pharmaceutical companies found that the price increase in medicines was due to advertisement and marketing costs, instead of research and development.

Note: Meanwhile it is observed that the 3 main Pharmaceutical Associations (namely Pharmaceutical Association of Malaysia (PhAMA), Malaysian Organisation of Pharmaceutical Industries (MOPI) and Malaysian Association of Pharmaceutical Suppliers (MAPS) are not being currently engaged by the Ministry of Health in the said formulation of the pricing mechanism that is to be announced.

/Bernama 11-09-2018

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Fertility and Ageing Population



Other than Malay­sians shunning marriage or the prospects of raising more than one child, the other side of the coin is that there are also many Malaysian couples struggling to conceive.

Lower birth rates and falling Total Fertility Rate (TFR) birth rates are key drivers of Malaysia’s ageing population, and so are the results of higher education and late marriage, leading to couples having fewer children, stated a report by the Statistics Department in August 2017.

The TFR birth rates dipped from 32.4 in 1970 to 16.7 per 1,000 population in 2015, according to the department.

“As women gain higher education and better employment opportunities, the number of unmarried people eventually rises, which is common phenomenon in industrialised countries.

“The effects of late marriage resulted in an increase in the mean age of mother at first birth from 26.6 in 2001 to 27.6 in 2015,” it said.

Many point to women’s entry into the workforce and delayed pregnancy as being key drivers of Malaysia’s falling fertility rate. However, young Malaysians are citing the high cost of living and work commitment as their reason for limiting to one child or not having kids altogether.

The Malaysian population is expected to increase to 32.4 million in 2018. The national fertility rate is projected to decline to the lowest level ever recorded since the formation of Malaysia 55 years ago. 

For every 1,000 population, there are only 15.8 live births expected in 2018 compared to 16.1 in 2017, noted Malaysia’s Selected Demo­graphic Indicator 2018.

It also stated that the overall fertility rate of Malaysian women aged 15 to 49 is estimated at 1.9 children, which is below the replacement level of 2.1 children compared with an average of 6.0 children per woman in 1963. 

This is a stark contrast to the world’s most populated country, China, which welcomed 17 million babies in 2017 amid falling birth rates.
 
Concerns of an ageing population are growing in Malaysia, as people are having fewer children.

The younger age groups are too small to counterbalance the growing number of older people, said an economics expert.

“As more aged exit the labour market and with declining fertility, demand for labour will go up and so will industrial wages. “While Malaysia still has several years before the economic impact of an ageing population becomes apparent, it needs to buckle up. Eventually, we may have to rely on foreign labour or robots or get the elderly to become gainfully employed."

“We will have to cope with a fast-­rising population of retired people whose pensions, if any, will have to be paid for by contributions from a shrinking working population.” For example," Prof Xavier said, "at the current rate of retirement of 20,000 to 25,000 civil servants annually, in 10 years the pensions will more than double to RM63bil and the public pension bill is expected to hit RM100bil by 2050.

Contributory pensions, increasing the retirement age to 65 and limiting the intake of new recruits could be considered in order to ease the pressure on the public purse. 

“An increasing amount of medical and health resources will also have to be shunted to care for the ageing population,” said Prof Xavier. 

China, for example, spends 5% of its gross domestic product (GDP) on healthcare while the United States spends 8.3% of its GDP on healthcare. “We require policy refocus as Malaysia only spends 4.3% of its GDP on healthcare,” said Prof Xavier, adding special programmes for the aged also must be intensified.

Government initiatives, such as the Selangor state government’s RM1,000 wedding incentive for couples who marry before 35, could help increase the fertility rate, he said.

“Similarly, income tax incentive for ordinary child relief, that is now RM2,000, can be increased to RM5,000. The relief for children in higher education can also be increased to RM10,000. 

“Such incentives will partially help defray the cost of raising children. If the intention is to increase our population, then any tax incentives are sustainable in the long run,” he said.

 /theSTAR 11-09-2018
 
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Cancer: Increased healthcare spending



Several cancer support groups have lauded Health Minister Dr Dzulkefly Ahmad's recent announcement for his Ministry to increase healthcare spending from 6% to 7% of the country's Gross Domestic Product (GDP).

The groups said the additional budget will go a long way to solve the problems faced by patients, especially among low and middle-income patients seeking treatment at public hospitals.

"There needs to be investments in the whole spectrum of cancer care - from screening, early diagnosis, timely treatment and good quality palliative care of patients," said National Cancer Society of Malaysia medical director Dr. M. Muralitharan in a statement on Sunday (May 27).

He added that medical innovation in cancer treatment is progressing rapidly but said that such innovations have yet to be made available in public hospitals.

The groups also lauded the Government's healthcare manifesto which focuses on cancer care.

It said projections from the International Agency for Research on Cancer showed that the number of new cancer cases in Malaysia are expected to escalate by 54% from 37,000 cases in 2012 to 56,932 cases in 2025.

They also called on the Pakatan Harapan administration to implement a national health insurance scheme in a transparent and equitable manner.

Both groups urged the Ministry to focus on cancers that are most prevalent with a high risk of impoverishment within a year of diagnosis and invest in strengthening and sustaining good cancer care.

They added that the mindset amongst policy makers and healthcare staff that cancer control is too expensive or a burden to the public health system needs to change.

Meanwhile, Society for Cancer Awareness and Advocacy Kuching president Sew Boon Lui urged Dr Dzulkefly to be inclusive in his approach and engage with patient groups, affected patients and caregivers before making policy decisions.

She adds that Sarawak was in dire need of skilled medical manpower, particularly oncologists, and bigger cancer treatment facilities to cope with rising demand in healthcare.

/theSTAR 27-05-2018 

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Allegations of Drug Supply monopoly



The Government will be reviewing the procurement process of medicines, said Health Minister Dr Dzulkefly Ahmad.

“We are committed to do a critical review to achieve supply chain optimisation. We want to make sure the procurement cost of drugs and other consumables will not be so high,” he told reporters on Monday, June 25 2018.

Dr Dzulkefly said he will make sure issues related to third party concessions or any “monopoly issues” is handled properly and effectively. He said the Government may also buy medicines directly from manufacturers. 

Dr Dzulkefly added that the Health Ministry is looking into pooled procurement with other Ministries, such as the Defense Ministry. “With economies of scale, we will have better bargaining power. This will help to bring down the cost,” the Minister added.

“We want a real open tender system, where there is no collusion and no bid rigging. But this is easier said than done. We will look into how to practice this,” said Dr. Dzulkefly.

Dr Dzulkefly also said the Ministry will leave it to the Malaysian Anti-Corruption Commission (MACC) to investigate the allegations regarding rigging of the open tender process for drug procurement. “Let the law take its course. The ministry will not interfere,” he said.

On June 13, a 12-page document was emailed to Dr Dzulkefly alleging that a monopoly controlling billions of ringgit worth of medicines supplied to the Government was linked to high-ranking officials and companies linked to certain politicians.

It also claimed that the tenders went to six main agents, who were collectively awarded RM3.4bil or 90.93% of the total sum.

During the interview with BFM89.9, Dr Dzulkefly said concessionaires such as Pharmaniaga take 35% in drug procurements given by the Ministry, together with five other companies.

Pharmaniaga was accused of monopolising the supply of medicines to the Ministry.

He said via the open tender process, international pharmaceutical companies through their local subsidiaries bid through a tendering agent.

“Where the Ministry's procurement tenders are concerned, they come in through the tendering agent. This tendering agent is given a commission of 3%,” he said.

 /theSTAR 25-06-2018

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4.2 million of Population have Mental Health issues



About 4.2 million Malaysians are suffering from some form of mental health issue, says Health Minister Dr Dzulkefly Ahmad.

“Based on the National Health and Morbidity Survey 2015 by the ministry, the prevalence of mental health issues among adults above 16 years old is 29.2% or 4.2 million Malaysians,” he said in Parliament.

He also said 2.1 million women had some form of mental health issues.He said 57,570 women had sought treatment for mental illness at government hospitals between 2010 and 2017.

He said 958 government clinics nationwide were involved with screening and intervention programmes which included an ante-natal screening package to help expecting mothers deal with stress.

Dr Dzulkefly said the expectant mothers were also screened to determine if they required treatment to prevent post-partum depression. He said measures such as increasing the duration of paid maternity leave from 300 days to 360 days were implemented to help lessen stress of mothers.

“The Ministry is also urging the private sector to provide lactation rooms and daycare facilities for employees with new born babies,” he said.

For the youths, Dr Zulkefly said Program Minda Sihat Sekolah or Healthy Mental Health for Schools was implemented since 2014. He said students with mental health issues were referred to health facilities for treatment after obtaining parental consent.

His ministry also worked closely with The Befrienders to provide counselling to those with emotional problems, depression or have suicidal thoughts.

 /theSTAR 31-07-2018


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80% of HIV cases due to unsafe sexual practices



About 80% of the 73,557 HIV cases in the country are transmitted through sexual behaviours.
This is contrary to the common perception that drug addicts were more prone to the virus due to sharing of syringes.
Malacca State Health and Anti-Drug Committee chairman Low Chee Leong shared this piece of information in his speech at the “First Cities Getting to Zero HIV 2018” National Conference at a leading hotel here.
Low said Malaysia was committed to the global declaration to achieve the three ‘zeroes’, namely on new HIV infection, deaths due to AIDS and discrimination against patients.
“However, our short-term goal is to achieve a breakthrough in drastically reducing the incidence of infection by 2020 with the collaboration of various stakeholders,” he added.
Health Ministry official Dr Anita Suleiman said the infection pattern had changed dramatically over the past 25 years since the HIV case was first reported in the country, whereby more people are infected with HIV through unsafe sexual practices than drug abuse.
“The reason is due to Health Ministry’s intervention which provided methadone replacement therapy and also distributed sterile syringes to hardcore drug users for free, contributing to significant reduction,” she said.
Dr Anita said on the other hand, the ministry noticed a dramatic increase of HIV infection through unsafe sexual practices.
Melaka has about 3,755 people living with HIV and about 1,138 AIDS patient as of last year.
/theSTAR 08-09-2018

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Top Glove: To acquire Aspion



KUALA LUMPUR: Top Glove Corp Bhd
is set to become the world’s largest manufacturer of surgical gloves after its shareholders approved its purchase of Aspion Sdn Bhd for RM1.37bil in cash and shares.
Top Glove executive chairman Tan Sri Dr Lim Wee Chai said the company received shareholders’ approval to purchase Aspion – the group’s largest merger and acquisition (M&A) exercise yet – at an EGM yesterday.
He said the move would enable it to move into the final phase of the acquisition process.
“This acquisition would further enable us to deliver innovative surgical glove products for our global customers as well as create significant value for our shareholders,” he said.
image: https://content.aimatch.com/default.gif
image: https://content.thestar.com.my/smg/settag/name=lotame/tags=Eve_Business_Audience,Eve_Prog_Business,tsol,Fatin_GSC_Insight_ALL,all,Eve_Affluent_Audience,Eve_Investors
Of the total RM1.37bil purchase consideration, RM1.233bil will be in cash and the balance via the issuance of 20,505,000 new Top Glove shares.
Lim pointed out that the purchase of Aspion was its largest M&A exercise yet, but this was only the beginning.
“Top Glove is only 27 years old this year and as a young company, we are still on expansion mode.
“We look forward to successfully carrying out more such exercises in order to grow and solidify our leadership position in both the glove and healthcare industry,” he said.
The shareholders’ approval for the company, which is the world’s largest manufacturer of gloves, was to become the world’s largest surgical glove maker as well.
To recap, in January this year, Top Glove had entered into a share purchase agreement with Adventa
Capital to acquire Aspion for RM1.37bil in cash and shares.
It said the proposed acquisition was well-aligned with Top Glove’s strategy to effectively and sustainably grow its business inorganically, in tandem with its organic expansion.
Upon completion, Top Glove would be well-positioned to serve its enlarged customer base more effectively, with an enhanced range of high-quality and cost-effective medical gloves across multiple categories, including surgical gloves, examination gloves as well as other market-leading innovative glove products.
Top Glove will fortify its market leadership position by leveraging on Aspion’s technologies and innovations, as it continues to focus on research and development initiatives.

Read more at https://www.thestar.com.my/business/business-news/2018/03/09/top-glove-shareholders-approve-aspion-acquisition/#3YbropcOXqqCK3GC.99
KUALA LUMPUR: Top Glove Corp Bhd
is set to become the world’s largest manufacturer of surgical gloves after its shareholders approved its purchase of Aspion Sdn Bhd for RM1.37bil in cash and shares.
Top Glove executive chairman Tan Sri Dr Lim Wee Chai said the company received shareholders’ approval to purchase Aspion – the group’s largest merger and acquisition (M&A) exercise yet – at an EGM yesterday.
He said the move would enable it to move into the final phase of the acquisition process.
“This acquisition would further enable us to deliver innovative surgical glove products for our global customers as well as create significant value for our shareholders,” he said.
image: https://content.aimatch.com/default.gif
image: https://content.thestar.com.my/smg/settag/name=lotame/tags=Eve_Business_Audience,Eve_Prog_Business,tsol,Fatin_GSC_Insight_ALL,all,Eve_Affluent_Audience,Eve_Investors
Of the total RM1.37bil purchase consideration, RM1.233bil will be in cash and the balance via the issuance of 20,505,000 new Top Glove shares.
Lim pointed out that the purchase of Aspion was its largest M&A exercise yet, but this was only the beginning.
“Top Glove is only 27 years old this year and as a young company, we are still on expansion mode.
“We look forward to successfully carrying out more such exercises in order to grow and solidify our leadership position in both the glove and healthcare industry,” he said.
The shareholders’ approval for the company, which is the world’s largest manufacturer of gloves, was to become the world’s largest surgical glove maker as well.
To recap, in January this year, Top Glove had entered into a share purchase agreement with Adventa
Capital to acquire Aspion for RM1.37bil in cash and shares.
It said the proposed acquisition was well-aligned with Top Glove’s strategy to effectively and sustainably grow its business inorganically, in tandem with its organic expansion.
Upon completion, Top Glove would be well-positioned to serve its enlarged customer base more effectively, with an enhanced range of high-quality and cost-effective medical gloves across multiple categories, including surgical gloves, examination gloves as well as other market-leading innovative glove products.
Top Glove will fortify its market leadership position by leveraging on Aspion’s technologies and innovations, as it continues to focus on research and development initiatives.

Read more at https://www.thestar.com.my/business/business-news/2018/03/09/top-glove-shareholders-approve-aspion-acquisition/#3YbropcOXqqCK3GC.99
KUALA LUMPUR: Top Glove Corp Bhd
is set to become the world’s largest manufacturer of surgical gloves after its shareholders approved its purchase of Aspion Sdn Bhd for RM1.37bil in cash and shares.
Top Glove executive chairman Tan Sri Dr Lim Wee Chai said the company received shareholders’ approval to purchase Aspion – the group’s largest merger and acquisition (M&A) exercise yet – at an EGM yesterday.
He said the move would enable it to move into the final phase of the acquisition process.
“This acquisition would further enable us to deliver innovative surgical glove products for our global customers as well as create significant value for our shareholders,” he said.
image: https://content.aimatch.com/default.gif
image: https://content.thestar.com.my/smg/settag/name=lotame/tags=Eve_Business_Audience,Eve_Prog_Business,tsol,Fatin_GSC_Insight_ALL,all,Eve_Affluent_Audience,Eve_Investors
Of the total RM1.37bil purchase consideration, RM1.233bil will be in cash and the balance via the issuance of 20,505,000 new Top Glove shares.
Lim pointed out that the purchase of Aspion was its largest M&A exercise yet, but this was only the beginning.
“Top Glove is only 27 years old this year and as a young company, we are still on expansion mode.
“We look forward to successfully carrying out more such exercises in order to grow and solidify our leadership position in both the glove and healthcare industry,” he said.
The shareholders’ approval for the company, which is the world’s largest manufacturer of gloves, was to become the world’s largest surgical glove maker as well.
To recap, in January this year, Top Glove had entered into a share purchase agreement with Adventa
Capital to acquire Aspion for RM1.37bil in cash and shares.
It said the proposed acquisition was well-aligned with Top Glove’s strategy to effectively and sustainably grow its business inorganically, in tandem with its organic expansion.
Upon completion, Top Glove would be well-positioned to serve its enlarged customer base more effectively, with an enhanced range of high-quality and cost-effective medical gloves across multiple categories, including surgical gloves, examination gloves as well as other market-leading innovative glove products.
Top Glove will fortify its market leadership position by leveraging on Aspion’s technologies and innovations, as it continues to focus on research and development initiatives.

Read more at https://www.thestar.com.my/business/business-news/2018/03/09/top-glove-shareholders-approve-aspion-acquisition/#3YbropcOXqqCK3GC.99
Top Glove Corp Bhd is set to become the world’s largest manufacturer of surgical gloves after its shareholders approved its purchase of Aspion Sdn Bhd for RM 1.37 bil in cash and shares.

Top Glove Executive Chairman Tan Sri Dr Lim Wee Chai said the company received shareholders’ approval to purchase Aspion – the group’s largest merger and acquisition (M&A) exercise yet – at an EGM yesterday. He said the move would enable it to move into the final phase of the acquisition process.

“This acquisition would further enable us to deliver innovative surgical glove products for our global customers as well as create significant value for our shareholders,” he said.

Of the total RM 1.37 bil purchase consideration, RM 1.233 bil will be in cash and the balance via the issuance of 20,505,000 new Top Glove shares.

Lim pointed out that the purchase of Aspion was its largest M&A exercise yet, but this was only the beginning. “Top Glove is only 27 years old this year and as a young company, we are still on expansion mode.

“We look forward to successfully carrying out more such exercises in order to grow and solidify our leadership position in both the glove and healthcare industry,” he said. The shareholders’ approval for the company, which is the world’s largest manufacturer of gloves, was to become the world’s largest surgical glove maker as well.

To recap, in January 2018, Top Glove had entered into a share purchase agreement with Adventa
Capital to acquire Aspion for RM 1.37 bil in cash and shares. It said the proposed acquisition was well-aligned with Top Glove’s strategy to effectively and sustainably grow its business inorganically, in tandem with its organic expansion.

Upon completion, Top Glove would be well-positioned to serve its enlarged customer base more effectively, with an enhanced range of high-quality and cost-effective medical gloves across multiple categories, including surgical gloves, examination gloves as well as other market-leading innovative glove products.

Top Glove will fortify its market leadership position by leveraging on Aspion’s technologies and innovations, as it continues to focus on research and development initiatives.

/theSTAR 09-03-2018

Disclaimer: Views or opinions expressed are solely those of the Author and should be used with discretion. The Author shall not be held liable for any acts or omissions arising from the use of the information. The user will be personally liable for any damages or other liability arising hereof.

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