Bangladesh warned of high prevalence

Malaysian public health experts have warned of high prevalence of non-communicable diseases (NCDs) like heart diseases, cancer, and diabetes both in Malaysia and Bangladesh.

They recommended investing more in preventive care, adding that sharing of expertise between the two countries could help tackle the situation.  

“We both share a similar demographic situation in terms of prevalence of heart diseases,” said Dr Kumara Gurupparan Ganesan, cardiologist of the National Heart Institute in Kuala Lumpur.

Fatty food, smoking, sedentary lifestyle are the major factors behind the high prevalence, he said.

According to the Malaysian National Health and Morbidity Survey in 2011, obesity in Malaysia is estimated to be 15.1 percent among adults aged 18 years and above, Type 2 diabetes 15.2 percent, and hypertension 35.1 percent.

The National Cancer Society, Malaysia says there are about 90,000 to 1 lakh people in Malaysia living with cancer at any given time, while the National Cancer Registry of  Malaysia records 21,773 Malaysians being diagnosed with cancer every year, but almost 10,000 cases remain unregistered.

Meanwhile, deaths from NCDs in Bangladesh soared by seven percentage points from the 2008 figure to 59 percent in 2012, according to a 2015 report by the World Health Organization (WHO).

Of the total 8.86 lakh deaths in 2012, 17 percent were caused by cardiovascular diseases, 10 percent by cancers, 11 percent by chronic respiratory diseases, three percent by diabetes, 18 percent by other NCDs, and nine percent by injuries, it said.

Dr SA Balan, consultant urologist at Pantai Hospital in Kuala Lumpur, said industrialisation and smoking were major contributors to the rise of cancer cases.

Malaysia is working with local universities and global experts to assess its health system, Dr Noor Hisham Abdullah, director general of Health Malaysia, wrote in a letter to the New Straits Times on June 22 last year.

It has adopted the "family doctor" concept to strengthen the primary healthcare service in Malaysia in which each family will be assigned to a doctor who will take the responsibility of their healthcare "from womb to tomb", he said.

These initiatives are underway when Malaysia already heavily subsidises the health sector. Its health ministry recovers less than 3 percent of actual expenditure in the public healthcare system.

Kavitha Mathuvay, regional director of market development at the Malaysia Healthcare Travel Council (MHTC), said Malaysia was focusing on wellness care rather than treatment.

The argument is "why not educate people towards preventive care and take care of their health" in terms of lifestyle, eating pattern, smoking, and sugar intake, she said.

The picture of preventive care in Bangladesh, however, is still dismal.

According to the Bangladesh National Health Accounts (BNHA) 1997-2012, spending on preventive care -- primary healthcare, immunisation, nutrition and public health awareness -- was only 13 percent of the total healthcare expenditure in 2012.

On the other hand, expenditure on medicines and curative purposes accounts for 67 percent.

Prof AK Azad Khan, president of the Diabetic Association of Bangladesh, said lifestyle diseases were emerging as an epidemic, but authorities did not seem to be proactive in taking appropriate policies on prevention. 

“For example, we sent a proposal to the government on a national policy on prevention of diabetes five years back, but nothing has happened,” he told The Daily Star last week.

Meanwhile, Bangladesh High Commissioner to Malaysia Shahidul Islam said they were planning exchange of learning visits by the health ministers of Bangladesh and Malaysia.

“We can share our experience on medical science and exchange research personnel for the benefit of both the countries,” he told a group of journalists in Kuala Lumpur last month.