People will always need healthcare. As an aspiring hub for Healthcare in Asia, Malaysia should invest more money and resources in its healthcare system. Recently we heard a pledge by Malaysia’s Health Minister, YB Khairy Jamaluddin, who advocates allocating 5% of the country’s GDP to healthcare. As the nation grows, its healthcare system should match its development strategies and goals. Allocation for healthcare should be scrutinised to ensure equitable access to quality healthcare in the country. As the President of SCAN, Mr Chris Cheng strongly hopes the government will not overlook healthcare needs in East Malaysia and the cancer community.

With 95,3% of the size of the Peninsular, Sarawak is the largest state in Malaysia, although it lacks transportation infrastructure. The Health Minister stated that the Ministry of Health is overly centralised, which results in excessive bureaucracy and the neglect of regions in the periphery during a recent town hall meeting in Kuching. The top decision-makers in the Health Ministry may not fully comprehend the difficulties in Sarawak, which makes matters more complicated. Decentralising our healthcare system to the state level with the appropriate institutions and resources is a significant priority. Decentralisation and the autonomy that comes with it will enable local decision-makers to better handle the problems faced locally, resulting in a healthcare system that is more equitable, effective, and resilient.

One of the more pressing issues in Sarawak is the old infrastructure. The wards, operating theatres, treatment rooms and even consultation rooms are always packed and not conducive for cancer patients. The building that house the Oncology unit is over 30 years old! Our Deputy Premier, YB Dato Sri Prof Dr Sim, has proposed a Cancer Hospital in Sarawak to solve this obstacle. We hope that in this budget, the necessary allocations have been made to make this hospital a reality. This must be not only the physical building but also the proper equipment and sufficient maintenance budget.

Infrastructure is only one part. The allocation of human resources must not be overlooked. The government must also train more oncologists, especially those from East Malaysia. Currently, there are only 7 oncologists under the Ministry of Health in Sarawak for a population of 2.56 million. This is far from the recommended number of 1 oncologist per 100,000 population. Other healthcare professionals will also be needed to have an adequately run hospital.

Cancer treatments can be costly. Advanced targeted therapy drugs like Osimertinib (for lung cancer) and Palbociclib (for breast cancer) can have six-figure prices, and these drugs are not yet covered by our government. They must be paid for by the patients. These medications are financially poisonous for B40 patients and even those in the M40 because they are so expensive. SCAN urges the government to find ways to deliver newer drugs to patients who need them, especially with the increase in healthcare funding that has been promised. Even though demanding that all medical procedures are fully subsidised may be impractical, other measures such as the implementation of value-based reimbursement/pricing, the creation of a cancer fund, or even special national Cancer insurance should be considered.

Technology should also be leveraged in its application and research to increase the accessibility to care. In Sarawak, the 7 oncologists serving in the public hospital system are all based in Kuching. Telemedicine will allow the oncologists to do telementoring, guiding the medical officers in the district hospitals with cancer patients. Telemedicine will also increase the pool of oncologists available as we will not be limited by those living in the state. Research is also another critical area. More funding for research such as clinical trials and drug development will also help get the necessary treatments for our cancer patients in Sarawak.

The government must make many difficult decisions about budget allocation, but we genuinely hope that this budget, as well as upcoming ones, will slice the pie fairly and holistically. Do not overlook those living outside the centre of power. Let’s not abandon anyone.