Malaysia faces a significant public health challenge known as the triple burden of disease, encompassing non-communicable diseases (NCDs), infectious diseases, and the health implications of an ageing population. These interconnected challenges are further compounded by environmental and planetary health issues, requiring a comprehensive and integrated approach.
Non-Communicable Diseases (NCDs)
NCDs, including cardiovascular diseases, diabetes, cancers, and chronic respiratory conditions, are the leading causes of mortality globally, accounting for 74% of deaths (World Health Organization [WHO], 2022). In Malaysia, the situation is similar, with NCDs responsible for 71% of total deaths annually (Institute for Public Health [IPH], 2020). The National Health and Morbidity Survey (NHMS) 2019 revealed alarming figures: 50.1% of Malaysian adults are overweight or obese, while diabetes prevalence has reached 18.3%, more than double the global average of 8.5%.
Adding to these concerns, environmental pollution, particularly microplastic contamination, poses emerging risks to human health. Microplastics, classified under “novel entities” in planetary boundaries, have breached safe limits globally (Stockholm Resilience Centre, 2023). These tiny particles, found in water, air, and food, can disrupt endocrine systems, cause inflammation, and increase the risk of cancer and cardiovascular diseases (Galloway, 2022). Addressing NCDs requires targeted prevention strategies, such as lifestyle modifications, environmental policies, and the integration of planetary health principles into public health measures.
Infectious Diseases
The COVID-19 pandemic highlighted Malaysia’s vulnerability to infectious diseases, with over 5 million confirmed cases and more than 39,000 deaths as of December 2023 (Ministry of Health Malaysia, 2023). Zoonotic diseases, which account for 60% of emerging infectious diseases globally, pose a significant threat, particularly in tropical Malaysia, where rich biodiversity and human activity intersect (Centers for Disease Control and Prevention [CDC], 2022).
Lessons from the pandemic underscore the importance of the One Health approach, which integrates human, animal, and environmental health to prevent and manage infectious diseases. Malaysia’s geography and climate also make it prone to vector-borne diseases like dengue and malaria, as well as waterborne diseases exacerbated by frequent floods. Strengthening cross-sector collaboration, improving surveillance systems, and addressing environmental factors are critical to reducing the burden of infectious diseases and preparing for future pandemics.
Ageing Population and Elderly Health
Malaysia is transitioning towards an ageing society, with the proportion of individuals aged 65 and above projected to reach 14.5% by 2040 (Department of Statistics Malaysia, 2016). This demographic shift brings an increased prevalence of age-related health conditions such as dementia, osteoporosis, and frailty. The healthcare system faces mounting challenges in managing the complexities of geriatric care, including multimorbidity, limited access to specialised services, and inadequate long-term care facilities.
Geriatric illnesses are further compounded by social and economic factors, such as financial insecurity and insufficient family support. Effective management requires the development of age-friendly policies, expanded healthcare services for older adults, and increased investment in geriatric education and training for healthcare professionals.
Conclusion
Malaysia’s triple burden of disease—NCDs, infectious diseases, and elderly health challenges—underscores the urgent need for a multifaceted public health response. Addressing these issues requires prioritising prevention, enhancing healthcare infrastructure, adopting the One Health approach, and integrating planetary health principles into national strategies. Collaborative efforts across sectors and alignment with global best practices are essential to ensure a healthier, more resilient Malaysia.
References
Centers for Disease Control and Prevention. (2022). Zoonotic diseases. Retrieved from https://www.cdc.gov/onehealth/basics/zoonotic-diseases.html
Department of Statistics Malaysia. (2016). Population projections (revised), Malaysia, 2010-2040. Retrieved from https://www.dosm.gov.my/v1/index.php
Galloway, T. S. (2022). Health implications of microplastic pollution. Retrieved from https://www.environment-prize.com/ceremony/2022/
Institute for Public Health. (2020). National Health and Morbidity Survey (NHMS) 2019: Non-communicable diseases, healthcare demand and health literacy. Retrieved from https://iku.moh.gov.my/nhms-2019
Ministry of Health Malaysia. (2023). COVID-19 updates. Retrieved from https://covid-19.moh.gov.my/
Stockholm Resilience Centre. (2023). All planetary boundaries mapped out for the first time, six of nine crossed. Retrieved from https://www.stockholmresilience.org/research/research-news/2023-09-13-all-planetary-boundaries-mapped-out-for-the-first-time-six-of-nine-crossed.html
World Health Organization. (2022). Noncommunicable diseases. Retrieved from https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases