My 2021 wish list a Ministry of Public Health – Dr Musa Mohd Nordin

Kuala Lampur — For 15 years, the Malaysian Paediatric Association and its partners have been fighting for the inclusion of the Pneumococcal Conjugate Vaccine (PCV) into the National Immunization Program (NIP).

We studied the burden of the disease, researched the serotypes at play in our community, examined the increasing resistance of the bacterium to our arsenal of antibiotics and demonstrated the cost effectiveness of the PCV.

It took a new government in 2019 to appreciate our endeavours, empathise with the loss of innocent lives, the disabilities inflicted by the pneumococcus and the need for bigger investment in the health of our children. They rolled out the PCV in our NIP in 2020.

Within the space of a year in office, the Pakatan Harapan guys in the health and finance ministries, understood a critical paediatric health issue which the bygone politicians hid in the back burners, and which the technocrats in the MOH paid only lip service to and did not envisage as a priority.

The politicians and technocrats paid more attention to secondary, tertiary and curative services patronised by the VVIPs, which therefore gouged an increasing piece of the MOH budget cake.

It is a sad testimony of our state of healthcare priorities when a PM gets a CABG (Coronary Artery Bypass Graft) done locally and the nation gets IJN (Institut Jantung Negara). And a PM’s late wife succumbs to a cancer and we get IKN (Institut Kanser Negara).

What I am about to suggest next follows this trend of afterthoughts of a reactive MOH.

With the Covid mess that we are in, I think it is time for the nation to have a Ministry of Public Health (PH). This domain of Public Health has always been secondary and subservient in the MOH scheme of things.

Even the PH physicians had a raw remuneration deal as compared to their clinician peers, they were like “second-class specialists”.

The Ministry of Public Health should be helmed by a PH physician, not a paediatrician, obstetrician or a surgeon.

The specialty and sub-specialty training is simply 180 degrees apart. The culture of work is different as captured in this doctors’ joke:

Physicians – wait and see (reflective nuances)

Surgeons – cut and see (radical nature)

Paediatricians – play and see (jovial kid like persona)

Obstetricians – D and C (this was the joke bit I think)

The PH physician wasn’t even featured in the joke!

I think I would propose, PH Physician – ABC (they give priority to the ABC, the back to basics of medicine i.e. preventative health, primary health care, universal health coverage, pandemic preparedness, the cost effectiveness of health interventions, health economics, socio-economic determinants of health, etc).

The abovementioned examples describe the three inter-related but distinct aspects of PH practice namely, health improvement, health protection and health service quality improvement. These draw upon core knowledge and skills of epidemiology, biostatistics, risk communication and data science.

Any discerning person, let alone a doctor would be able to detect the lack of epidemiological and statistical prowess and authority in the daily presentation of the national Covid-19 data.

And to by-pass a PH Physician and instead allow a non-doctor to undertake daily risk communication on the Covid-19 pandemic has been an unmitigated disaster for the rakyat, business community, and our international reputation.

Our northern neighbor has a health ministry, with an emphasis on public health thus called, Public Health Ministry, and look at how well they have managed the Covid-19 pandemic. The Director General of the WHO made special mention of them for their success in battling the Covid-19 crisis.

Even if my 2021 wish list does not come true, I hope the role of PH in the MOH will be elevated by many notches and it would be accorded the position it truly deserves in the mega scheme of protecting and promoting the nation’s health.

*This is the personal opinion of the writer or publication and does not necessarily represent the views of Malay Mail.