11 October, 2010

Sixty-First Session of the World Health Organization Regional Committee for the Western Pacific


1.        I wish to warmly bid “Selamat Datang” to your Excellencies, honourable ministers, distinguished delegates, ladies and gentlemen to Putrajaya, Malaysia for this sixty-first session of the WHO Regional Committee for the Western Pacific. It is truly an honour and privilege for my country to be chosen as the venue for your session this year.

2.        The WHO Regional Committee Meeting for the Western Pacifc Region is an important forum for health ministers and experts throughout this Region and this year’s session is particularly significant because, amongst other things, it provides an opportunity for the various experts to examine the response and effects of global Pandemic Influenza A (H1N1) that we all experienced about a year ago.

Ladies And Gentlemen,

3.        We are now in the post-pandemic phase of the H1N1 pandemic. Like most countries, we have followed the recommendations of the WHO with regards to our national influenza preparedness strategies. Truly, the H1N1 pandemic has been a baptism of fire for us. We had to balance important public health considerations with the multitude of opinions, especially during the implementation of many of the containment phase strategies. The H1N1 pandemic tested our risk communication strategies in facilitating public vigilance and the avoidance of panic.

4.        One good case study is the immunization coverage that we recommended. As advised by WHO, we made the decision to provide enough vaccines for our front-liners i.e health care workers, those providing essential services and high risk groups. But the pressure was on us to cover our entire population, just like what was being done then in developed nations which began ordering the vaccines early, as soon as they were available.  Fortunately, the pandemic turned out to be a mild one and we were spared the dilemma of disposing vaccines that were not used. One wonders what would have happened if the pandemic evolved into a serious and severe pandemic?

5.        Any responsible government would do whatever it takes to protect its people, even if the costs are daunting. This is where we stand guided by international and reputable organisations like the WHO which must demonstrate strong and firm leadership backed by impeccable technical competency. Member states look towards the WHO in providing appropriate guidance and advice as such threats are often unprecedented.

6.        l believe this important conference can provide the input for future global action against pandemics and other trans-boundary diseases affecting all countries and communities, especially developing countries. Indeed, the H1N1 pandemic represented the first major test on the efficiency and relevance of the International Health Regulations (IHR 2005). Let us learn from the H1N1 pandemic, evaluate the responses of the International System to the H1N1 pandemic and equip ourselves better in facing more challenging pandemics in the future.

Your Excellencies, Ladies And Gentlemen,

Non-communicable disease (NCD)

7.        Another health challenge in our Region is non-communicable diseases or NCD. According to WHO, cardiovascular diseases, cancers, chronic respiratory diseases and diabetes represent a leading threat to human health and development. These four diseases are the world’s biggest killers, causing an estimated 35 million deaths each year – 60% of all deaths globally – with 80% in low- and middle-income countries.

8.        The prevalence of NCD and NCD risk factors in Malaysia, as well in our Western Pacific Region, are increasing at an alarming rate. The staggering increase of NCDs over the past two decades threatens the quality of life of those affected.  In addition, it poses an unprecedented challenge to health care systems in the Region, many of which are unprepared and in transition. The Western Pacific Region can be viewed as a critical area for global public health as the majority of the global population now live in this region which is now one of the most populous and dynamic regions of the world. How we grapple with these NCDs challenges, will shape the future of this region and beyond.

9.        In developed countries, it is estimated that about half of the decline in NCDs mortality, is influenced by lifestyle changes and the other half by better treatment and care. Although we are making headway in the treatment of chronic diseases, we must emphasise the importance of primary prevention, early NCD risk factor identification and NCD risk factor intervention. Continuing health promotion, especially targeted towards younger persons, together with creating an environment that supports healthy living, are important in curbing and decreasing the prevalence of NCDs. Having said that, we can achieve a more immediate effect by targeting intervention at those with highest risks of developing NCDs.

10.       To stay healthy, individuals need to embrace a healthy lifestyle.  They must be constantly reminded that health is an important and vital resource for living.  Now is the time for them to give serious attention to the importance of a healthy lifestyle.  They must be made to be responsible for their own health as they have the capacity to influence it.  Amongst the things they must now focus on would include healthier eating choices, staying physically active and refraining from resorting to a sedentary lifestyle.  Non-smokers must maintain their status whilst smokers must quit smoking.

11.       Recently, NCDs have garnered more political awareness and policy makers’ attention. The recent adoption of the United Nations General Assembly resolution on the prevention and control of non-communicable diseases is the manifestation of that political commitment at the highest level. It seeks to halt the increasing trends in premature deaths from non-communicable diseases worldwide.

12.       To overcome NCDs threats, it is necessary to strengthen health systems. The health care delivery system must be “re-engineered” to provide quality care that is coordinated and cost-effective, rather than focusing on high-burden services and acute episodes. In order to do this, countries, especially the middle and lower-income countries of the region, would need a formidable health workforce.

13.       In Malaysia, the National Strategic Plan for NCD represents our approach to operationalise existing knowledge and current scientific evidence in reducing the burden of NCD. The Ministry of Health will continue to enhance smart partnerships with other government agencies and other stakeholders, to further reinforce NCD prevention and control programmes in Malaysia.

Malaysia’s 1Care for 1Malaysia

14.       In our quest to become a developed high income nation the Malaysian health care system will be transformed into a more efficient and effective system in ensuring universal access to health care. The blueprint is currently being worked out to develop 1Care for 1Malaysia, a restructured health system that is responsive in meeting the health care needs of the population, provide choices of quality health care and ensuring universal coverage based on solidarity and equity.

15.       Malaysia has been cited by international bodies as being a good model in health care, especially in terms of primary health care for the rural population. So some may ask why we need to change a model that has served us well for more than five decades. The reason is simple enough. We want to do better. Like other countries in the world, Malaysia has to grapple with challenges brought about by the epidemiologic and demographic transitions, overall health care cost escalation, increasing out-of-pocket spending, overstretched public facilities and increasing client expectations.

16.       The goals for restructuring are to enhance universal coverage in line with 1Malaysia concept. We propose an integrated public and private health care delivery system; ensure that health care remains affordable & sustainable; improve equity in terms of access and financing, ensure efficiency, quality of care and optimal health outcomes; improve effective safety nets for catastrophic payments; enhance responsiveness of the health care system; increase client satisfaction; increase provision of personalised and community care and reduce the brain-drain especially to overseas markets.

17.       But as Malaysia continues its accelerated action towards universal access to primary health care and moves towards high income status, safety nets to address the hard core poor, the vulnerable groups and catastrophic expenditure will still be given our foremost attention. The restructuring proposal includes establishing a sustainable healthcare financing system, with the government continuing to uphold its responsibility in maintaining a strong social safety net.

18.       Primary health care will remain the thrust of this transformed health service delivery system in order to manage rising health care costs and ensure better equity in health, through better utilization of resources. This will be implemented without compromising on the universal coverage and ensuring services that are efficient, responsive and of good quality.

Climate Change

Your Excellencies, Ladies and Gentlemen,

19.       With global warming projected to increase two to ten times greater than the last decade, we are indeed heading towards potentially disruptive and irreversible changes to the ecosystem, which will not only impact on human health and well being, but may even ultimately compromise human survival on this planet earth.

20.       Throughout the world, the prevalence of some diseases and other threats to human health depend largely on local climate. Extreme temperatures can lead directly to loss of life, while climate-related disturbances in ecological systems, such as changes in the range of infective parasites and life cycle of vectors such as mosquito, can indirectly impact the incidence of serious infectious diseases.

21.       The Asia Pacific region in particular, has been subjected to challenging climate-sensitive mosquito borne disease and I here I am referring to Dengue. It is the fastest emerging viral infection and the maximum burden is borne by the countries in this region. It is estimated that out of the 2.5 billion people at risk of the infection globally, 1.8 billion or 70% reside in the Asia Pacific Region, mostly in the developing countries.

22.       Regional and international cooperation and collaboration is vital to mitigate the effects and reduce the impact of climate change. There is a need for stronger partnerships and international action in Asia and the Pacific Region, emphasising that it is essential for the donor and international community, to maintain their commitments for aid and assistance during the crisis period. Towards this end, the Government of Malaysia has signed an agreement with the World Food Program to establish the first United Nations Humanitarian Response Depot (UNHRD) in Asia, based in Subang, Malaysia. The UNHRD in Subang, the fifth such hub in WFP’s global emergency response arsenal, is designed to deliver humanitarian relief items within 48 hours of a crisis occurring.

23.       We are aware that a Regional Working Group on Protecting Health from Climate Change was established in 2008 to address climate change and health issues relevant to WHO programmes in the Region. This initiative should continue as the main platform to enhance regional cooperation and harmonization in addressing the challenges of climate change of our future generations.

Closing Remark

24.       It is my sincere hope that the sixty-first session will strengthen co-operation and collaboration between Western Pacific countries, especially in exchanging information and ideas on health issues of common concern. Since we are all living in a global village, regional and international cooperation in public health administration remain the most essential weapon against the spread of infectious diseases across countries.

25.       Finally, I wish all the delegates and participants a successful meeting and I hope all of you will have an enjoyable stay in Malaysia.

Thank You.

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