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ALARMING: Muhyiddin says matter should not be taken lightly.

PUTRAJAYA: MALAYSIA is looking at the likelihood of recording more than 60,000 dengue cases this year.

Deputy Prime Minister Tan Sri Muhyiddin Yassin said the health authorities made the alarming projection yesterday based on last year’s trend of dengue cases which saw a 98 per cent increase or 43,346 cases compared to 21,900 in 2012.

“We cannot take the matter lightly. This is obviously a dangerous situation,” he said after chairing the National Local Government Council meeting here yesterday.

Also present were Urban Wellbeing, Housing and Local Government Minister Datuk Abdul Rahman Dahlan and several menteris besar, including Terengganu Menteri Besar Datuk Seri Ahmad Said, Negri Sembilan Menteri Besar Datuk Seri Mohamad Hasan and Selangor Menteri Besar Tan Sri Khalid Ibrahim.

Muhyiddin said the statistics included the dengue death toll, which had increased by 163 per cent or 92 deaths last year, compared with 35 the year before.

Last year, he said there were 44,066 dengue outbreak episodes involving 2,988 localities of which 70 per cent were in urban areas at several states.

Between Jan 1 until yesterday, there were 18,165 dengue cases recorded, an increase of 316 per cent, compared to 13,795 cases recorded in the same period last year, the deputy prime minister said.

PUTRAJAYA: Private medical fees are up, but there is confusion over the exact percentage of the rise.

While the Health Minister said the increase has been capped at 14.4% – less than half the amount the Malaysian Medical Association had requested – the medical schedule showed hikes of a few hundred per cent on certain fee ceilings.

Consultation fees, for instance, increased from a range of RM10-RM35 to a new range of RM30-RM125.

While the Health Minister Datuk Seri Dr S. Subramaniam said that the fees were the maximum amount that doctors were allowed to charge and they were free to charge less.

“Those (in the fee schedule) are the maximum rates. We are protecting the people from being charged exorbitantly by the private sector,” he told a press conference here on Wednesday.

On Monday, it was highlighted that the amendment to the 13th Schedule of the Private Healthcare Facilities and Services Act 1998 was implemented without sufficient publicity and awareness of the issue.

The Private Hospitals and Other Private Healthcare Facilities Regulations 2006 of the Act, which was published in the federal gazette on Dec 16 last year, provides for the maximum chargeable fees for registered medical and dental practitioners practising in private hospitals in terms of their professional fees such as consultation and performance of procedures.

These fees were based on Malaysian Medical Association (MMA) Schedule of Fees 4th Edition 2002.

by Loh Foon Fong.

Read more @ http://www.thestar.com.my/News/Nation/2014/03/05/Medical-fee-increase/

THE Health Ministry has advised the public to stay indoors to avoid the heat and haze as well as  to wear face masks as precautionary measures when outdoors.

Its director-general, Datuk Dr Noor Hisham Abdullah, said the public should avoid open spaces under the heat and haze and to drink plenty of water to avoid  health-related complications.

“Schools should also avoid conducting any outdoor activities during this period.

“Students should not be out for long hours under the heat and haze,” he told the New Straits Times yesterday.

He added that the public should keep themselves updated on the Air Pollutant Index (API) of their respective areas regularly.

“Those who are likely to be affected by the haze, such as those who suffer from illness, should take full precautionary measures, including wearing  face masks.”

The ministry had earlier urged the public to take precautionary measures to reduce the risk of haze by wearing surgical masks.

This reminder was issued over the weekend as the haze began blanketing parts of the country.

Health Minister Datuk Seri Dr S. Subramaniam had said that although the API was not categorised as unhealthy in some areas, forest fires in other areas of the country could worsen the air quality.

“The public should take care of their health, avoid staying too long in the sun as well as  drink plenty of boiled water when doing outdoor activities,” said Subramaniam.

Read more: Health Ministry issues haze advisory – General – New Straits Times http://www.nst.com.my/nation/general/health-ministry-issues-haze-advisory-1.497616#ixzz2v1fN9vBz

KOTA KINABALU: Dengue cases in the State are on the rise. A total of 251 dengue cases were recorded from January 1 to February 27, representing a 47 per cent increase from the 171 cases reported during the same period of last year.

Kota Kinabalu recorded the most cases with 55, followed by Tawau and Tuaran with 51 and 29 cases respectively.

Sabah health director, Dr Christina Rundi said that Sabah recorded an average of 20 to 30 dengue cases a week so far this year.

Nationwide, 2,000 to 2,500 cases of dengue have been reported every week.

In January alone, Malaysia recorded 9453 dengue cases with 17 deaths, according to a recent report in The Sun.

“We monitor dengue cases every day,” Dr Christina told reporters after officiating at the ‘Jom Hapus’ (Let’s Destroy) programme at Taman Sempelang, here, yesterday morning.

She pointed out that although campaigns to heighten awareness and to prevent the breeding of aedes mosquito (dengue carrier) were done every year, the people were still not taking the matter seriously.

“Out of the 51,411 premises inspected up to February 22 this year, 621, which are mostly households, were found to be aedes breeding grounds,” she said.

Dr Christina also said 43 compounds totaling to RM20,700 have been issued thus far.

Read more @ http://www.newsabahtimes.com.my/nstweb/fullstory/75761

As cancer cases and deaths shoot up, doctors and patients are outraged by the exorbitant cost of medicines and call for action to be taken.

MY Global Trends article last week on the effects of the Trans-Pacific Partner­ship on access to cancer medicines came out at almost the same time as The Star’s report on the Health Minister’s reaffirmation that Malaysia wants tobacco to be excluded from the TPP.

Datuk Seri Dr S. Subramaniam, who was opening the World Cancer Day Conference stressed that Malaysia’s position was “not negotiable from the health perspective as smoking is a clear threat to health”.

The Minister said there were 21,700 cancer deaths in Malaysia in 2012, and smoking was linked to 20% of these.

Worldwide in 2012 there were 14.1 million new cancer cases, 8.2 million cancer deaths, and 6.3 million women living with breast cancer, according to a New York Times article.

In response to my article, I received an e-mail letter from Dr Lim Teck Onn, a consultant in clinical research, and formerly a Ministry of Health staff.

Dr Lim says: “I appreciate very much your efforts to bring to the public attention the crucial matter of affordability of life saving medicines.

“My own research has shown that much of cancer deaths are avoidable in Malaysia and half are attributable to lack of access to treatment. You mentioned that Indian companies are leading the fight to make medicines more affordable. There are also Malay­sian companies engaged in a similar battle.”

A journal article that Dr Lim wrote with four other Malaysian researchers estimated the number of deaths due to breast cancer that would be avoidable if all Malaysian patients had access to the care provided by leading centres in Malaysia.

They found that of the reported 2,572 deaths due to breast cancer, 1,299 (50%) were avoidable.

Of these avoidable deaths, 647 (50%) were attributable to late stage presentation while 652 (50%) were due to lack of access to optimal treatment.

by Martin Khor.

Read more @ http://www.thestar.com.my/Opinion/Columnists/Global-Trends/Profile/Articles/2014/03/03/Of-cancer-and-high-drug-prices/

Kota Kinabalu: The Queen Elizabeth I (QEH I) Tower Block is 98 per cent completed and is finally scheduled to open in June, Health Minister Datuk Dr S. Subramaniam announced during a working visit, Tuesday.

He said workers are busy placing all the equipment and when completed it would have about 1,500 beds, making it the third general hospital for the city after QEH II and the Sabah Women and Children’s Hospital in Likas.

“The cost of building this complex is RM365 million, while the Ministry has spent about RM120 million for equipment.

So in total it costs RM485 million,” he said.

The completion of the tower block had been delayed several times due to, among other things, labour and cement shortage. It stands where the State’s first hospital was built but had to be demolished due to structural problems related to the use of sea sand during its construction.

Dr S. Subramaniam also proposed the development of seven health zones as the Ministry’s next move to improve healthcare services in Sabah.

Read more @ http://www.dailyexpress.com.my/news.cfm?NewsID=88508

Of all the issues being negotiated in the TPPA – none are more important than life-saving medicines at affordable prices.

IF you or some family members or friends suffer from cancer, hepatitis, AIDs, asthma or other serious ailments, it’s worth your while to follow the Trans Pacific Partnership Agreement negotiations, now going on in Singapore.

It’s really a matter of life and death. For the TPPA can cut off the potential supply of cheaper generic life-saving medicines, especially when the branded products are priced so sky-high that very few can afford them.

The fight for cheaper medicines has moved to cancer and other deadly diseases, when once the controversy was over AIDS medicines.

Last week, a cancer specialist in New Zealand (one of the TPPA counties) warned that the TPPA would prolong the high cost of treating breast cancer because of new rules to protect biotechnology-based cancer drugs from competition from generics. And this will affect the lives of cancer patients.

Some cancer medicines can cost a patient over US$100,000 (RM329,600) for a year’s treatment, way above what an ordinary family can afford. But generic versions could be produced for a fraction, making it possible for patients to hope for a reprieve from death.

In India, local companies are leading the fight to make medicines more affordable to thousands suffering from breast, kidney, liver and gastro-intestinal cancer and chronic leukeamia.

For example, an Indian company produced a generic drug for kidney and liver cancer 30 times cheaper than the branded product – US$140 (RM461) versus US$4,580 (RM15,100) for a month’s treatment – after it was given a compulsory license.

India has a patent law that disallows patents for newer forms of drugs or known substances unless it improves the medicine’s efficacy or effectiveness. Under WTO rules, countries are free to set their own standards for novelty, or whether a product is novel enough to be eligible for a patent.

Also, in many countries, including Malaysia, the patent law allows for companies to obtain compulsory licences to import or make generic versions of original medicines.

Governments grant such licences if the branded products are too expensive and the original companies do not offer attractive terms for a voluntary licence to other firms.

Multinational companies have strongly opposed compulsory licences or the Indian-type laws that allow for patents only for genuine innovations.

by Martin Khor.

Read more @ http://www.thestar.com.my/Opinion/Columnists/Global-Trends/Profile/Articles/2014/02/24/A-matter-of-life-and-death/

CURE IMMINENT: Malaysians should not be overly alamred over the discovery of the Den-5 dengue virus because it isn’t the culprit of the current virus of the current dengue epidemic, “nor is it likely to cause any major problems anytime soon”. Meanwhile. a vaccine for the other four serotypes of the virus is imminent, virologist Prof Emeritus Datuk Dr. Lam Sai Kit, a high impact research consultant at Universiti Malaya,  tells Tan Choe Choe.

Question:   Malaysia intends to step up the use of a biological agent to fight the dengue epidemic  as a staggering 2,000 cases of the viral infection are being reported each week. The agent, Bacillus thuringiensis israelensis, or BTi, is a bacterium found naturally in soil  and has been used worldwide to combat mosquitoes and black flies since 1982. The health minister said this was the first time BTi was being used on a large scale against a dengue epidemic. How effective will BTi be in combating dengue?

Answer:  There are several measures that have been used for the control of dengue mosquito vectors. Fogging with insecticide is effective against the adults, while using Abate for larvicide is also good. Combining insecticide with BTi was considered by the Ministry of Health (MoH) a long time ago and I am surprised that this is only now being considered — perhaps there were some logistical problems with it earlier on.    But there’s a problem with the use of BTi or Toxorhynchites splendens (a species of mosquito) larvae to destroy   Aedes larvae  — you have to make sure they land in the same breeding container or site. This is not easy to achieve as the breeding sites are all over the place, so its significance for widespread application is doubtful.

Question: So, you view this as a desperate measure?

Answer: Well, I view it as an additional measure. Whether it’ll be effective, time will tell. But I have my doubts. I think all these are fire-fighting methods. In the end, some may work, while some may not be sustainable in the long term.

Question: There was a lot of talk about using GM (genetically modified) mosquitoes to mate with female Aedes mosquitoes to ensure the eggs do not turn into larvae. What is your opinion on this? Answer: This is a non-starter as far as I am concerned. It is an interesting piece of science but I doubt it can be applied as a control measure on a wider scale. There are many issues which work against its use. — For one, there’s public perception.

GM mosquitoes, like anything labelled GM, has a stigma to it and will find it hard for the community to accept. Also, the flight range of mosquitoes is short, so one has to release millions of mosquitoes at frequent intervals at multiple sites. It will definitely cost the government a lot of money. It is difficult to sustain such control measures even if it works.

Question: It was reported that there’s a fifth dengue variant in the country, the Den-5 virus, and that it has been discovered in the blood sample of a man from Padawan, Kuching. However, deputy director-general of health (public health) Datuk Dr Lokman Hakim Sulaiman has dismissed the existence of the Den-5 virus. Is Den-5 a new threat to Malaysians?

Answer: I think we must not be alarmist and think the Den-5 will be a new threat to the country. Being a sylvatic strain (simian strain), it is unlikely to cause any major problems anytime soon. For example, the Sylvatic Den-2 strains have been reported in only very few cases, even in Africa, after many years. Apparently, these types of dengue viruses do not seem to spread readily or cause diseases once introduced into the human cycle. It is a well-known fact that dengue viruses have a zoonotic cycle in the jungle. This was documented in the early 1960s in Malaysia by the Hooper Foundation, University of California, when monkeys hoisted up in cages in forest canopies got infected and viruses were

by Tan Choe Choe
Read more @: Stay calm, wait for the dengue vaccine: Virologist – General – New Straits Times http://www.nst.com.my/nation/general/stay-calm-wait-for-the-dengue-vaccine-virologist-1.485053#ixzz2tW64JwMf

KOTA KINABALU: The Health Ministry has taken several measures to prevent the spread of Influenza A (H7N9) following the confirmation of the first case in the country.

Sabah Health Director Dr Christina Rudi said yesterday that the actions include stepping up check for influenza cases across the country, especially in the state including increasing the number of sentinel locations in Sandakan and Kota Kinabalu from eight to 12.

They are also strengthening laboratory capacity in Sabah to test H7N9, increasing infection prevention and control in all health facilities and cooperating with the Veterinary Department to increase the surveillance of birds.

The health authorities are also getting the cooperation of travel agencies which are

arranging visits of tourists from avian influenza-hit countries to advise their customers to postpone the trip. If any of the tourists have respiratory symptoms, they have to seek immediate treatment at the nearest health facility.

The Ministry of Health also advises individuals who have visited the avian influenza-hit countries and have respiratory symptoms after returning home to wear surgical masks and immediately seek medical treatment.

Those planning to travel are advised to avoid visiting markets selling live poultry.

In addition, they should always adopt a high level of personal hygiene such as washing hands frequently with soap and water orsanitizer, especially after coughing and sneezing; avoid touching any surface contaminated by stool and/or blood of poultry;

not to hold birds found dead without protective equipment and report the unnatural death of birds to the nearest veterinary office; and ensure food is fully cooked before eating.

Human infections with a new avian influenza A (H7N9) virus were first reported in China in March 2013. Most of these infections are believed to result from exposure to infected poultry or contaminated environments, as H7N9 viruses have also been found in poultry in China.

While some mild illnesses in human H7N9 cases have been seen, most patients have had severe respiratory illness, with about one-third resulting in death. No evidence of sustained person-to-person spread of H7N9 has been found, though some evidence points to limited person-to-person spread in rare circumstances.