Materia Medica Malaysiana

March 30, 2004

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Heart disease still No. 1 killer in S’wak

Heart disease and diseases of pulmonary circulation were collectively the most common causes of death recorded in Sarawak government hospitals from 1998 to 2000.

Such deaths accounted for 1,416 or 13.8 per cent of total deaths, according to heath department statistics.

The higher percentage of heart patients were among people below the age of 45, who suffered from severe coronary heart disease compared to the situation in developed countries.

Meanwhile, the development budget for Sarawak Health Department has increased from RM72.5 million in the Fourth Malaysia Plan (1981-1985) to RM316 million in the current plan.

The manpower had also increased from about 4,000 in 1980 to 11,465 until February this year.

As for the doctor to population ratio, it had also improved from 1:8, 420 in 1980 to 1:2, 476 in 2002.

The number of government hospitals in the State had been increased from 15 in 1980 to 21 this year, whereas health clinics increased from 136 in 1980 to 246 last year.

March 29, 2004

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Reports link Jui Meng’s exit to feng shui and political careers

Former Health Minister Datuk Chua Jui Meng’s exit from the Cabinet generated a host of reports in the Chinese dailies yesterday, including those touching on the co-relations of “feng shui” and political careers.

Sin Chew Daily, with a front-page headline which read “Chua Soi Lek replaces Chua Jui Meng,” ran a story along the lines that the two men shared the same surname.

The daily also highlighted that MCA ministers who held the post of health minister always saw the end of their political careers.

The daily ran a list of MCA MPs who had been appointed to the post from 1977 and detailed how all of them were “banished politically” after taking up the position.

First on the list was former MCA deputy president Tan Sri Lee Siok Yew, who lost his Cabinet post within 24 hours after having fallen out of favour with then party president Datuk Lee San Choon in 1977.

Subsequent health ministers were dropped after one term in office, sacked following internal party conflicts, not nominated as candidates or defeated during general elections.

The daily named Chua as the latest casualty, adding that his predecessor, Tan Sri Lee Kim Sai, had advised him to consult a “feng shui” master when handing over the post to him.

It is learnt that Chua had indeed consulted a “feng shui” master twice during his two-term tenure as Health Minister from 1995 to 2004. He has been the longest serving Health Minister.

Nanyang Siang Pau reported that friends and relatives of Chua were shocked and saddened that he was dropped from the Cabinet line-up.

In a news analysis, the daily concluded that Chua, who was viewed as the “third force” in the aftermath of the party’s two-year power struggle, was sacrificed for the sake of unity in MCA.

March 27, 2004

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Panel formed to promote reproductive healthcare

NEW YORK: Malaysia has taken several initiatives to ensure family planning services are provided under a broader package of reproductive health, the United Nations Commission on Population and Development was told.

Malaysia’s representative to the 37th session of the commission, Fatimah Saad, told the gathering that a co-ordinating committee on reproductive health had been formed to look into policies, strategies and ways of integrating other reproductive health components into the primary health care system and into family planning programmes.

Fatimah said for greater understanding of the concept, scope and operation of reproductive health, training updates had been intensified and standard operating procedures for model reproductive health clinics developed.

There were also efforts to promote greater participation of males in reproductive health and household responsibilities.

An educational module on fatherhood had been developed and implemented.

“Emphasis is now on high risk as well as adolescent reproductive health (ARH) and high parity mothers including those living in poverty,” she said.

Some elements of ARH had been incorporated into the school curriculum to address adolescents’ sexuality issues, while at the same time educational and training programmes were being conducted for adolescents with the aim of instilling greater resilience, positive values and promoting healthy lifestyles.

A technical working group of sexuality education was also incorporated into the National Social Policy last year.

Fatimah also spoke on the great strides made by Malaysian women in all areas of development, stating that 58.8% of undergraduates were females, resulting in almost half the working population being women.

“The female labour force increased from 41.9% in 1991 to 46.7% in 2002,” she said.

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New Health Minister

Prime Minister Abdullah Badawi has announced the new Cabinet.
Chua Jui Ming is out and in comes Chua Soi Lek (incidentally also an MCA man, also a Chua and also from Johor!)

March 26, 2004

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Flourishing global herbal mart

There is big money in herbs, and the Malaysian Herbal Corporation is
gearing Malaysia to become a global player by 2010 to capitalise on the
local market expected to be worth RM8 billion by then.

The current value of the local market is RM3.8 billion, while the global market is estimated at US$80 billion (RM304 billion).

Gabungan Wawasan Generasi Felda chairman Tan Sri Rozali Ismail said of the current herb market of RM3.8 billion, RM2 billion went to herbal remedies, RM1.6 billion on flavours and fragrances, and RM1 billion on pharmaceuticals and nutraceuticals.

Annual growth was expected to be 15 to 20 per cent, he said.

The World Bank anticipates that the market will hit US$5 trillion by 2050.

The major herbal products markets are Europe, North America, China and Japan.

In 1996, the World Health Or-ganisation estimated that 3.5 billion people in developing countries relied on plants as key components of their primary health care.

“Besides aquatic animals, medicinal and aromatic plants, Malaysia has 15,000 species of flowering plants besides lower plants and soil microorganisms. Of these, 1,200 species have potential pharmaceutical value,” he said at the launch of the four-day Herbal Asia 2004 expo at the Mid Valley exhibition centre, organised by Forest Research Institute Malaysia and Gitex (M) Sdn Bhd.

Herbal Asia 2004 is the first international herbal exhibition and trade show of its kind in Malaysia, bringing together international and local farmers, planters, manufactur-ers, retailers, researchers, agri-scientists and non-governmental or-ganisations.

It showcases the industry’s herbal products, technology and services to the latest in alternative medicine, and provides a platform for producers and manufacturers, investors, health and industry-related professionals to meet, exchange ideas and promote this rapidly growing industry.

Rozali said traditional medicine continued to flourish, due also to the failure of modern medicine to treat AIDS and cancer.

“The belief is that herbal medicine is natural and bears less side-effects,” he said.

Earlier, MP for Beruas Datuk Seri Dr Lim Keng Yaik said the Malaysian Industry-Government Group for High Technology (MIGHT) had drafted plans to turn Malaysia into one of the biggest global producers of herbal raw materials and products by 2010.

In a speech read by the ministry’s secretary-general Datuk Dr Abdullah Mohd Tahir, Dr Lim said the everexpanding market for herbal products had increased demand for raw materials.

The State Forestry Departments have licensed and regulated extraction and movement of medicinal and herbal plants from forests to curb indiscriminate harvesting.

To ensure continuous supply and reduce pressure on natural forest, the Forestry Research Institute of Malaysia has launched a pilot project in Maran, Pahang, to systematically cultivate herbal plants like Tongkat Ali and Kacip Fatimah.

Dr Lim said the use of herbs as alternative medicine was reflected in the increasing sales of herbal products.

To gain a foothold in the global herbal market, Malaysia must compete in terms of quality, efficacy, safety, pricing and even packaging besides meeting the requirements of the European Union, Japan and US.

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Revisiting healthcare

IT has been eight years since the Government adopted a national-level strategy to leapfrog the country’s healthcare system to a new e-Health paradigm. With the Multimedia Super Corridor Telehealth Project and MSC Telehealth Blueprint (1997) in place, the Government hopes to transform the healthcare system to a nation of healthy individuals, families and communities via the adoption of information technology (IT).
To support the developments in e-healthcare, the country also went on to define the legal framework with new cyberlaws such Telemedicine Act 1997, Digital Signature Act 1997 and Personal Data Protection Bill.
Even a Telehealth Unit under the Health Ministry was established to oversee the project implementation and play a strategic role in aligning future IT projects undertaken by the Ministry. The unit is also responsible for the development of code sets, policies, health informatics standards and functional specifications of e-Health applications.
Several significant developments have taken place since the launch of the MSC Telehealth project. Among them are the establishment of two hi-tech hospitals with total hospital information systems (Selayang Hospital and Putrajaya Hospital), 37 health centres and two hospitals (Hospital Kajang and Hospital Seremban) with clinical information systems, and 42 health centres with teleconsultation facilities. Another 14 hi-tech hospitals will be rolled out by next year, and another 20 are in the planning process.

Lacking human capacity
Though the e-Health endeavour has come a long way, the country is currently facing a shortage of domain experts or health informaticians in the design, development and deployment of the e-Health projects, says Dr H.M. Goh, secretary for both Malaysian Health Informatics Association and Asia-Pacific Association for Medical Informatics.
He attributes this shortage to the lack of awareness by the stakeholders and healthcare community about health informatics.
The field of health informatics provides the training and research opportunities to develop and implement new technologies that will enhance decision support to healthcare professionals and biomedical scientists.
“While our doctors need to be more IT savvy, so must IT professionals be more medical savvy,” Dr Goh says. “We need a good mix of both type of professionals to exchange ideas and collaborate in research and development.”
“We cannot provide quality, safe and efficient healthcare without IT, so there will be a direct impact to the cost of healthcare. As Malaysia is getting more developed, demographics have changed too and people are living longer. We will be dependent on strategic information to manage our national health and policy-making. We can’t get timely information for planning if we don’t computerise,” he explains.
In addition, he believes that if the country is serious about health tourism to attract international patients, she must be better equipped and IT-ready, otherwise patients will choose to seek healthcare elsewhere.

People development
Dr Goh calls for a more structured national training programme to be established and given high priority. This, he says, is to ensure that Malaysia has sufficient human resource expertise to meet the demand for the e-Health projects.
He suggests that academic institutions look into developing a more structured curriculum to churn out more health informaticians, and that the country emulate some of the successful initiatives undertaken by countries such as Taiwan, South Korea and Japan in human capital development.
Taiwan has started many postgraduate programmes in health informatics while Korea and Japan have recognised professorship in health informatics. These, Dr Goh says, have created a strong research foundation for health informatics development.

Standards development
Apart from people development, standards development in healthcare is equally important, points out Dr Goh.
To meet national objectives, standards must be in place so disparate and fragmented systems can work together, interface and collaborate, he says. This way, health information can be standardised among different healthcare facilities, and a more continuous and seamless care can be achieved.
These standards need not necessarily be created, according to Dr Goh. “Some of the standards have already been developed elsewhere and we can actually evaluate them for possible adoption and integration. Additionally, we can localise some of the international standards for our own use,” he says.

March 24, 2004

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Philips eyes govt sales for iU22

Dutch firm Royal Philips Electronics is scouting for procurement opportunities in Malaysia to supply at least 10 units of its new iU22 Ultrasound Systems machines this year.

The 10 units, which are worth between RM9.5 million and RM11.4 million, would be for government hospitals and private medical establishments, said its senior vice president for medical systems Victor H Reddick at a press conference after the launch of iU22 in Singapore on Friday.

Officials from Universiti Kebangsaan Malaysia Hospital and Kuala Lumpur Hospital were present at the launch.

“Malaysia is an interesting market for us (Philips). Its government adopts a clear direction on the healthcare industry. It has been investing in new hospitals and rehabilitating existing ones,” he said.

iU22, Philips’ latest ultrasound product in the premium market segment, costs between US$250,000 and US$350,000 a unit. The machine’s smart features include intelligent control and advanced ergonomic design, real-time imaging, voice-activated control and automated image optimisation technologies.

Reddick said clinicians would be more confident in their diagnosis due to image clarity and higher patient-handling time instead of equipment-toggling with voice-recognition feature.

The company will demonstrate iU22 to local doctors and physicians at a Magnetic Resonance Imaging event in Kuala Lumpur on April 4.

Philips expects to supply more than 200 units of iU22 to the Asia Pacific region, in which Malaysia, Singapore and Thailand are its lead medical equipment markets.

Philips Electronics Singapore Pte Ltd chairman and chief executive officer Mourad Mankarios said Philips was also planning to work out financing arrangements for its iU22 customers that may involve tie-ups with the local banks and finance companies.

Philips has shipped seven units of iU22 and will deliver 30 more to Singapore by the end of this month. The company has forecast that medical equipment sales in the Asia Pacific market will contribute 30% to the group’s revenue this year from 22% a year earlier. For the financial year ended Dec 31, 2003, it posted a net profit of €695 million.

March 22, 2004

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American dream

Today a respected specialist surgeon in America, a health policy lecturer and an author of medical textbooks, Dr Lee Keat Jin was just a naïve, sheltered schoolboy in Penang half a century ago. ZACK YUSOF speaks to the doc about his struggles and journey to self-realisation

The Star has an interesting write up on a local boy who made good in Malaysia in the filed of medicine.

Excerpt:

In late 1958, Lee was enrolled at Harvard University, after an interminable five-week boat trip. However, when he went to Harvard, he found out that nuclear physics was not his strength and duly made the switch to medicine. After graduation, he proceeded to Columbia University College of Physicians and Surgeons, completing his formal training in otolaryngology surgery at Harvard Medical School.

Fast forward to the present day, Dr Lee is now a successful and widely respected doctor who practises and teaches at Yale. These days, he can also be found travelling around the world lecturing on heath policy. In practice for over 30 years and widely regarded as something of a pioneer in his field, Dr Lee has authored several articles and many books and has also invented about a dozen medical instruments, including a drill for pituitary surgery. In addition, he has also pioneered new surgical procedures to treat disorders of the ear, nose and throat.

Now residing in Cambridge, Massachusetts, Dr Lee was back in Malaysia for six days last month to conduct a series of lectures on various health-related issues. Generously taking time out from his busy schedule, he took a stroll down memory lane back to his childhood days in idyllic Penang during a recent interview.

March 19, 2004

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MOH steps up campaign against measles

About 4.5 million schoolchildren aged between seven and 15 will receive free measles vaccinations in a nationwide campaign due to start in April.

Health Minister Dato’ Chua Jui Meng told reporters that the campaign would cover children below 15 as many would not yet have received a booster vaccination. The current immunization practice for measles, where jabs are given at age one and seven, was only introduced in 2002; previously, booster doses were not given.

The national immunization program successfully reduced the number of cases from almost just over 9,000 in 1982 to about 500 in 1990. In the 1990s, the average number of cases was 300 to 615 per year. However, about a decade later, the rate increased to 6,200 with seven deaths.

These outbreaks began in children who were not immunized or did not obtain adequate protection from the vaccination.

According to Chua, measles remains the biggest killer of children of all the vaccine-preventable diseases.

“Every year for the last 5 years, we have seen a total of 30 million measles cases and 875,000 deaths from measles globally. [It is still] a major threat to mankind even though immunization programs have been launched by the WHO,” said Chua.

The local campaign will run from April to June followed by a “mopping up” campaign from July to September to vaccinate children missed in the initial phase. Trained healthcare staff from the public health department and health clinics will visit schools to ensure all the children are immunized. Parents will also be able to bring children who have missed the campaign or who are not schooling to the nearest health clinic for the free vaccination.

“Children will be immunized irrespective of whether they had been immunized in the past or had measles in the past,” Chua said.

He urged parents to fully cooperate with the Health Ministry, reminding them that measles can be fatal due to accompanying complications, such as pneumonia and severe diarrhea.

March 16, 2004

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Korean vaccine-maker drawn to BioValley

A Korean biotech company is planning to set up Southeast Asia’s largest human vaccine plant in Malaysia’s BioValley, sources say.

Sources say the company, Glovax, will produce the Japanese encephalitis (JE) vaccine and plans to develop a vaccine for dengue as well at the Malaysian plant.

A source familiar with the plan says Glovax is looking to raise up to US$100 million (RM380 million) for this venture, with one of the main financiers being Malaysian Debt Ventures (MDV) Bhd.

The funds raised will be used to build the factory, for equipment purchase and hiring of scientists.

Glovax, a privately owned company, is renowned for its patents and production of the JE vaccine.

It has outsourced the production of the JE vaccine to a Chinese company in Chengdu, China. The Chinese plant is the only one producing the vaccine at the moment, catering only to the domestic market. Glovax is, therefore, looking for a location for a new plant and has decided on Malaysia, drawn to the BioValley initiative.

Glovax is believed to have been attracted to the BioValley because of its incentives such as a 10-year rent-free offer — an incentive expected to be one of the attractions to lure investments into BioValley.

“They are also attracted to Malaysia because of the availability of funds here, mainly MDV,” says a source close to the proposed plan.

Malaysia’s BioValley is situated on an 800ha site in Dengkil, Selangor, south of Cyberjaya and Putrajaya. It is within the larger Multimedia Super Corridor.

The RM2 billion BioValley, which will include research, commercial, educational, recreational and residential facilities, is expected to be fully completed by 2009.

Sources say that Glovax’s plan may also involve a number of financial backers apart from MDV, including government grants and private venture capitalists, due to the large amount of funds needed.

It is learnt that MDV is likely to ask for permission from the Japanese government to allow it to invest more than the current cap of 10% of its total funds.

MDV uses the money loaned from the Japanese government to provide loans to deserving technology and non-technology ventures in Malaysia and abroad, which traditional financial institutions will not fund.

Based on MDV’s total funds of RM1.6 billion, the 10% cap would mean that MDV could lend only up to RM160 million per company.

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