KEYNOTE ADDRESS DIRECTOR GENERAL OF HEALTH DELIVERED AT MALAYSIAN PHARMACEUTICAL SOCIETY STRATEGIC PLANNING MEETING

Ladies & Gentlemen

1.​First and foremost, I would like to thank MPS for inviting the Ministry of Health to participate in this meeting which I understand is to develop a strategic plan for the way forward for pharmacy in Malaysia.
The Honorary Minister of Health is unable to be with you today and has requested me to deliver the keynote address.

2.​In any organization, be it government or non-governmental such as MPS, it is vital to map out a strategic plan so as to give direction and focus for the way forward. I am happy to note that the MPS works in close collaboration with the Pharmaceutical Services Division as both parties should share a similar vision and mission which is in tandem with the overall plan for healthcare in Malaysia.

3.​Malaysia is a dynamic country, which has enjoyed economic growth and political stability since it obtained independence 57 years ago. It has always been said that health is wealth and we are very fortunate that we have a very good healthcare system. The fact that Malaysia was rated as having the 3rd best healthcare system after France and Uruguay in a global survey by the American publication International Living is testimony to this. It was stated that the medical expertise of Malaysian healthcare practitioners is “equal to or better than what it is in most of Western countries”.

4.​The government’s commitment towards universal access to affordable and high quality care is ensured by the dominance of public health services, which ranges from health promotion, illness prevention as well as curative and rehabilitative care.

5.​There has been a steady decline in maternal mortality rates from 44.0 in 1991 to 28.0 in 2009 and this is expected to reduce further to 11.0 in 2015. Infant mortality rate has also reduced from 13.1 in 1991 to 7.0 in 2009 and projected to be 4.4 in 2015. Average childhood immunizations coverage in Malaysia currently is more than 94%.

6.​However, we have identified other areas which in need of improvement as shown in the 2011 National Health and Morbidity Survey (NHMS IV) which revealed some alarming statistics including:

Diabetes Mellitus
• 15.2% (2.6 million) of adults 18 years and above have diabetes
o 7.2% are known to have diabetes
o 8.0% are previously undiagnosed with diabetes.

Hypertension
• 32.7% (5.8 million) of adults 18 years and above have hypertension
o 12.8% are known to have hypertension
o 19.8% are previously undiagnosed with hypertension

Hypercholesterolemia
• 35.1% (6.2 million) of adults 18 years and above have hypercholesterolemia
o 8.4% are known to have hypercholesterolemia
o 26.6% are previously undiagnosed with hypercholesterolemia

Nutritional Status
• Adults, 18 years and above (based on CPG 2004 Classification)
o 33.3% (5.4 million) are pre-obese
o 27.2% (4.4 million) are obese
• Children below 18 years (based on weight for age status)
o 3.9% (0.3 million) are obese

7.​These results indicate the need for continuous efforts from various stakeholders including Non-Governmental organizations such as MPS towards improving the health status of Malaysians through greater awareness on screening programs, promotion of healthy lifestyle and wellness campaigns, weight management programs and better eating habits.

8.​MOH, as the custodian of health for the nation, has been tasked to address the national mission thrust to improve the standard and sustainability of quality of life and contribute towards achieving the status of a high income economy.

9.​Three health sector development Key Result Areas have been identified:
a)​Health sector transformation towards a more efficient & effective health system in ensuring universal access to healthcare
b)​Health awareness & healthy lifestyle
c)​Empowerment of individual and community to be responsible for their health

10.​The desired outcome from each KRA is as follows:
a.​Health Sector Transformation towards A More Efficient & Effective Health System in Ensuring Universal Access To Healthcare (KRA 1)
•​Integrated public -private health services delivery
•​Universal Access and Equity of access – physical ease of access
•​High quality and safe care
•​Universal access – Equity of access – financial
•​Cost containment
•​Sustainability of healthcare delivery system
•​Compliance to defined quality and standard
•​Responsiveness to population needs

b.​Health Awareness & Healthy Lifestyle (KRA 2)
•​Increase access to health knowledge
•​Motivate individuals, family and community to
acquire knowledge skills
•​Increase opportunities to practice healthy lifestyle at workplace,schools, home etc.
•​Formulate and enforce public policy towards healthy lifestyle

c.​Empowerment Of Individual And Community To Be Responsible For Their Health (KRA 3)
•​Strategies to increase health literacy
•​Provision of health information, including cost of care and governance policies
•​Providing avenues for effective complaints or enquiries regarding health providers
•​Mobilize civil society (NGOs, support groups, ​community leaders)

11.​Under the National Health Sector Development Program, the main functional programs that will play important roles in the setting and implementing the strategic direction and foci of the health sector during the 10MP are:

i.​Population Health Program
•​Healthy (and Active) Lifestyle Movements Prevention and control of diseases in reducing morbidity and mortality

•​Nutrition Improvements
Activities under nutrition planning and development include planning, developing and evaluating nutrition programs and activities, and monitoring and evaluating the implementation of the National Plan of Action for Nutrition of Malaysia (NPANM) 2006-2015.

•​Empowering Community, Family and Individuals.
Implementation of annual communication campaigns through mainstream mass media which include healthy eating, exercise and physical activity, no smoking, and stress management

•​Communicable Disease Control (CDC), Crisis and Disaster Preparedness

Build a strong and coordinated linkages to the other relevant departments/ ministries/ organizations inevitably contributes to certain degree of weakness in the present systems and programs

•​Food Safety and Quality.
The areas of concerns to be addressed in 10MP include Establishment of the Food Safety Authority (FSA), Strengthening Food Safety Control System, Strengthening Food Safety Surveillance, Strengthening Food Legislation, Strengthening International and Regional Trade Framework, and Strengthening Food Safety Education

•​Community and Family Health Development.
Provision of equitable distribution and universal access to quality family health services that is targeted at community-level interventions to nationwide universal programs, focusing on wellness, early identification and prevention, will be strengthened aiming at the reduction of morbidities and mortalities and hence well-being of the nation.

ii.​Personal Health Program

•​Integrated Primary Health Care (PHC)
The “comprehensive heath primary health care scope of services be made available very accessible both in ‘time and space’ and equitable in both breadth and depth” is the vision that has been placed as the goal for this strategy.

•​Secondary Care.
Secondary medical services need significant strengthening and expansion of 9 specialties comprising of internal medicine, surgery, obstetrics and gynecology, pediatrics, orthopedics, clinical pathology, anesthesiology, radiology and emergency medicine (includes pre-hospital care) to improve accessibility and quality of medical services.

•​Tertiary Care.
Subspecialties development will continue to be strengthened in regional hospitals in line with needs and demands as evident in the “Burden of Disease” study (2000) and the changing pattern of care from new technology and interventions. New technologies and interventions enable patients to receive more complex treatment that improve health outcomes.

iii.​Research and Innovation

This program is needed to enhance fast-paced innovations and productivity, and facilitate the service delivery of the above programs towards achieving the nation’s health system’s goals including efforts to control the rising health costs.

iv.​Human Capital Development for Health Sector

This program is important as the health sector is labour intensive. Numerous categories of creative, productive and competent human capital is needed to ensure that the health service delivery effective and of quality as well meet the present needs and in line with the Vision for Health.

12.​MPS as a society is able to strategies on how and where pharmacists can play a role towards achieving these goals. I believe pharmacists with their knowledge on medicines are in an ideal position to ensure quality use of medicines, promote the use of cost effective therapies and work together with other healthcare professionals in promoting preventive medicine.

13.​Today, all countries are faced with the challenge of managing escalating healthcare costs. Therefore, we must look at ways and means of optimizing our services and manpower resources through smart partnerships, public-private ventures, outsourcing, sharing and pooling of assets.

14.​With regard to the issue on GST, as you are aware, while healthcare services will be exempted from GST, medicines being considered as products would be subjected to the 6% tax. We in the Ministry of Health have been engaging in discussions with the Customs and also on MOF on this issue. While we would very much like to see all medicines, especially prescription drugs, being exempted from GST, we have had to come to a compromise that at least the 320 components in the National Essential Medicines List will be zero rated which translates into approximately 4200 products being zero rated.

15.​There has also been a lot of discussion in the press the past week on medicines pricing. We have been engaging with all the stakeholders as well as MyCC to come up with a drug price structure. I am aware that MPS has been party to many of the workshops, which have been held by the Pharmacy Division, and we hope to see the realization of a drug-pricing model for Malaysia next year.

16.​I hope that MPS will look at all the current issues affecting the country in developing its strategic plan. For dispensing separation to become a reality, all the building blocks need to be put into place.

17.​We must think out of the box, formulate blue ocean strategies and come up with win-win solutions where the government, private sector and public all stand to benefit. The underlying framework must always be based on quality, value for money and we should always settle for nothing less than excellence.

Thank you.

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