Oleh/By : DATO' SERI DR. MAHATHIR BIN MOHAMAD
Tempat/Venue : THE CROWN PRINCESS HOTEL,
KUALA LUMPUR
Tarikh/Date : 19/09/94
Tajuk/Title : THE OPENING OF THE 45TH SESSION OF
THE WORLD HEALTH ORGANISATION (WHO)
REGIONAL COMMITTEE MEETING
I wish to thank the organisers and the World Health
Organisation (WHO) for giving me the opportunity to open
this 45th Session of the World Health Organisation Regional
Committee for the Western Pacific. Malaysia is indeed
honoured that it has been chosen to host this event. I would
like to welcome all delegates and other participants from
abroad to Malaysia.
2. We have worked closely together with WHO since the
mid-fifties when we gained our independence and became a
member country of the Organisation a year later in 1958. One
of the first campaigns at the time was against yaws which
was prevalent among the rural people. Over the years,
Malaysia's support and cooperation with WHO were
continuously enhanced.
3. We are proud of the recognition accorded to our
Institute for Medical Research in Kuala Lumpur by WHO which
has led to it being made the WHO Regional Centre for
Research and Training in Tropical Diseases and Nutrition
since 1978.
4. The setting-up of four WHO Collaborating Centres, three
of which are under the Ministry of Health and one in the
University of Malaya, further attests to the closeness of
this relation ship.
5. Of crucial importance to us is WHO support in the field
of training. Government health services in Malaysia have
faced manpower shortages for many years. Appropriately
trained and skilled manpower is vital in such circumstances
to compensate for staff shortages which have now become
chronic.
6. Some people have said that Malaysia is one of the most
planned countries. We make no apology for believing in
planning as it has paid off handsomely. A multiracial
country almost totally dependent on rubber and tin for its
wealth, we have had to devise and execute a number of 5-year
Plans, and plans within plans, in order to rehabilitate
ourselves after the collapse of commodity prices in the
sixties.
7. When we gained our independence in 1957, the social
sector including Health was made an integral part of the
national development process. Since most of the health
facilities were in the towns during the colonial period, we
gave priority to health infrastructure development in the
rural areas.
8. We are especially proud of our rural health services
which deliver a basic package of promotive, preventive,
curative and rehabilitative care through some six hundred
health centres with nearly two thousand rural clinics, all
built after independence. Services of this type were later
formally advocated by WHO in the Primary Health Care
strategy of Health-for-All at Alma-Ata in 1978. Our
coverage by these services exceeds 95 percent in Peninsular
Malaysia and about 70 percent in Sabah and Sarawak. For
existing under-served areas, we have outreach mobile
services including "flying doctor" and riverine services,
and also jungle health posts for the Aborigine Health
Service.
9. The continued improvement in the economy has helped us
to achieve a more equitable health service as between urban
and rural areas. At the same time, following our policy of
making the private sector the engine of economic growth, we
have weaned the more well-to-do citizens from their
dependence on Government health care. As a result no
citizen is deprived of reasonable health care even when they
are poor or are not insured. A non- contributory scheme for
workers ensure that injuries at workplaces are catered to.
10. The private sector has shown an unprecedented
growth. To-day, there are more than 3,000 general
practitioners or GP clinics countrywide, and some 190
private hospitals and nursing homes with more than 5,800
beds. The quality and standard of care offered are
comprehensive and obviate the need to go abroad for medical
treatment.
11. Government hospitals which are among the best equipped
in the country, number 114 with nearly 32,500 beds provide
highly subsidised quality care in an hierarchical system of
ascending medical complexity to look after patients based on
need. It is free for those who cannot afford to pay.
12. The provision of dental care in this country also
follows a public-private mix with the dental services of the
Ministry of Health as the main public provider.
13. The Government is determind that the health of the
people will remain a major concern and will provide the most
up-to-date amenities through adequate allocation in the
yearly budget.
14. I would like to congratulate WHO on its continued
effort to cooperate with the developing countries in the
Western Pacific region for the development of health
services especially in the prevention and control of
communicable diseases. The latest example is the excellent
coordination by WHO of the Global Programme on AIDS as a
measure for worldwide surveillance of AIDS and HIV
infection.
15. Malaysians have benefited from the use of appropriate
technology, training and skills development and in
collaboration for research. Our health development efforts
to benefit Malaysian women have also had useful support from
WHO. Life expectancy has shown an upward trend from 72.9
years at birth in 1981 to 73.7 years in 1992. For the same
period, maternal mortality rate has fallen from 0.59 to 0.2
per 1,000 live births. Children too have benefited: infant
mortality fell from 19.71 in 1981 to 11.6 per 1,000 live
births in 1992. One of the important contributions to this
success is Malaysia's well-implemented Extended Programme of
Immunisation or EPI advocated by WHO in which for example,
we have attained immunisation coverages in 1992, of 91.9
percent against diphtheria, whooping cough and tetanus, and
91.1 percent against poliomyelitis with its eradication
targeted for 1995.
16. In Malaysia, although in general, there has been a
great deal of improvement in population health status,
changes have taken place in the pattern of disease and
population affected. Heart and pulmonary diseases have
become the principal cause of death from 1980 onwards
replacing diseases of early infancy. Cerebrovascular
diseases were the third commonest cause of death in 1992
with accidents ranking fifth. Heart attacks are the major
cause of premature deaths among males between the ages of 45
to 64 years with a dramatic rise in the cohort 30 to 44
years. Thus the pattern seems to show that the younger
Malaysians of the critical group in our workforce are
falling prey to the so-called lifestyle diseases.
17. In our attempts to resolve the effects of this change
in epidemiological pattern, Malaysia has embarked on
intensive campaigns to alter the lifestyle of its people.
18. At the same time, we have also strengthened the health
education process with legal enforcement in relevant areas
such as our anti-smoking campaign. We are indeed heartened
to see the tremendous public support and consumer response
that we have received in our enforcement of non-smoking
areas in designated public premises and public transport
starting on May 15 this year.
19. Many countries in this region have been blessed with
strong economic growth and can look forward to greater
improvements in socio-economic development as well as in the
quality of life of their populations. We need to consider
our concept of "health". It can be viewed as a resource and
ill health in the community is a depletion of this resource.
Those in the health sector need to consider the issues which
can be the focus for advocacy in health strategies.
20. Although priorities for health action may differ in
different regions and in different countries, we need to
address the important issues of safe water, sanitation,
waste management, education, housing, recreational
facilities and other issues which can contribute towards
better health. This will result in a healthier community
and a healthier work force which are of economic importance
to the country. Addressing these issues will also result in
greater equity not only in national development but also in
health. It is important therefore, that we play a strong
role in creating greater awareness for the need to invest in
"health".
21. We are advocating for Malaysians the way to a better
lifestyle, fully aware of the changes taking place in the
world around us, not only from the sociological but more
importantly, from the economic and political perspectives as
well. The rapid advancement of technology today,
particularly in the communication field with its information
superhighways, has made the world smaller; reduced, and
perhaps made insignificant geographical and political
borders, and bridged the knowledge gap of people globally.
In relation to health promotion for example, its
effectiveness may well be enhanced through better
coordination and concerted effort, taking full advantage of
these advancements particularly in relation to strategies of
social marketing and advocacy for health.
22. It is against this background that we urge WHO to
advocate to countries in the Western Pacific region the need
to focus their efforts for health upon healthy lifestyle
strategies to prevent the wastage of a country's prime work
force to cardio- vascular disease, AIDS and other diseases.
We wish also to highlight the possible negative influences
to health which may result from the information explosion
that is taking place in many developing countries. Thus,
governments have the social responsibility not only to
improve the quality of life of their people but also to
ensure that the people get the right message and receive the
right information which can contribute towards better
response by the people to the amenities provided.
23. On that note I wish you a successful meeting and I am
optimistic of the many positive outcomes which will emerge
from your thoughts and deliberations.
24. It is with pleasure that I declare open this 45th.
Session of the World Health Organisation Regional Committee
for the Western Pacific.
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