Using funds effectively for healthcare

THE allocation for health services in the 2021 Budget can be found across several ministries – Health, Higher Education, Defence and Rural Development. The lion’s share, of course, goes to the Health Ministry – but there is a slight reduction in operating expenditure from RM27.9bil in 2020 to RM27.2bil in 2021.

As expected, the government has made provisions for immediate requirements for fighting the Covid-19 pandemic, such as to procure vaccines for the population. The amount directly committed to fighting Covid-19 in 2021 is RM1bil, slightly less than that allocated for 2020, but there is an additional RM3bil that has been earmarked for Covid-19 vaccines.

It is not clear how many doses are expected for the allocated amount as that would depend on the unit price of the selected vaccine or vaccines.

There is an allocation of RM50mil for teaching hospitals (which are under the Higher Education Ministry rather than the Health Ministry) to cope with Covid-19 patients, as they are also part of the fight against the virus. However, the amount is not large and will need to be spread out among a number of hospitals.

A total of RM100mil has been allocated especially for infectious disease research, which is really welcome. Some of this infectious disease research funding should go towards epidemiological modelling of the current pandemic to assist us in fighting the current wave of infections.

The country also needs to carry out behavioural science research to ameliorate pandemic fatigue and look into the long-term health, economic and sociocultural consequences of the pandemic. This would give us some much-needed data and help Malaysia improve its pandemic preparedness plan.

We hope that some of this infectious disease research allocation will go towards accelerated development of fast and reliable Covid-19 diagnostics, which would reduce our dependence on foreign diagnostic antigen test kits and RT-PCR (reverse transcription polymerase chain reaction) tests. Details are not available at this point in time, but this is likely to become clearer in due time.

The off-take allocation for vaccines would hopefully be used not just for fill and finish but for vaccine technology transfer, which would form the basis for our own indigenous capability. This would go beyond Covid-19, of course. It is not entirely clear which ministry or ministries will get this allocation as most researchers specialising in infectious diseases are in the universities.

These allocations for fighting Covid-19 will go some way in helping during this pandemic war but probably a bit more would have been helpful. The extra allocation could have been used to address prevention efforts, which are urgently needed to reduce the impact of Covid-19 in the community.

In parallel, there is some tax relief for other vaccines too, like the pneumococcal and influenza vaccines. This will be helpful to make sure that the population has reduced susceptibility to other respiratory infections.

An increased tax exemption, from RM6,000 to RM8,000, for other medical expenses is also welcome, and an increased tax exemption, from RM500 to RM1,000, for medical check-ups is also welcome, although this is not directly related to Covid-19.

A special allocation for mental health has been made available, which is nice and will go some way towards alleviating mental health issues caused by the pandemic. Some provision has also been made for claims made under the mySalam national insurance scheme.

However, there does not appear to be any special allocation for preventive or promotive health (other than the above), which is really needed in these times because non-communicable diseases contribute to increased morbidity in Covid-19 cases. A special allocation for preventive and promotive health is badly needed what with the increasing prevalence of obesity and its associated disorders in Malaysia.

It remains to be seen whether these allocations for health will be enough to see us through the Covid-19 crisis as this depends very much on how well we deal with the current wave of infections and whether there will be subsequent waves.

A large part of the budget focused on tackling the economic impact of the pandemic. Undenia-bly, this is important, as the indirect impact of the pandemic is socioeconomic, and tackling the socioeconomic impact is important for health too.

Fellow, Academy of Sciences, Malaysia

The opinion piece was first published on the Star Newspaper.

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