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.