Equal access, extra spending and an equilibrium shift: Preparing for the next pandemic

After two harrowing years that saw millions of deaths and unprecedented lockdowns, the world is slowly recovering from the COVID-19 pandemic. But the next global healthcare crisis could be around the corner.

This was the warning issued by Malaysia’s Health Minister Khairy Jamaluddin, who cautioned: “The question of another global pandemic in the foreseeable future is not a matter of if, but rather when.”

As the pace of urbanisation, climate change and global connectivity accelerates, he noted that this could also exacerbate the spread of more zoonoses – infectious diseases that are transmitted between animals and people – like SARS, MERS, and COVID-19.

Mr Khairy was speaking at the Public Health Thought Leadership Dialogue on 2 June, organised by the NUS Saw Swee Hock School of Public Health (SSHSPH). Now in its 10th edition, the event focuses on major health issues that affect local and regional populations, with this year’s topic revolving around how countries can future-proof their public healthcare systems.

Observing the pressing need for long-overdue reforms that COVID-19 has highlighted, Mr Khairy noted, “The systems we have today are arguably stuck in paradigms of past models, population profiles, or ways of working that no longer serve us.”

For countries like Singapore and Malaysia, there is also another worry besides acute pandemics: ageing populations. With non-communicable diseases such as diabetes and cancers becoming more prevalent in older adults, meeting these changing demands is another reason why healthcare systems need to be reviewed.

“We need to build back better… towards a resilient health system that is capable of absorbing shocks such as public health emergencies or managing demographic challenges like an ageing population,” he added.

A healthcare makeover

To do so, Mr Khairy underscored four key areas of reform.

First, countries have to ensure that basic healthcare needs are equitable for all, in terms of quality and efficiency. One way to achieve this aim is by fostering strong public-private partnerships. 

He raised the example of Malaysia proving the effectiveness of this approach during the pandemic. When cases spiked last year, the government transferred non-COVID patients to private facilities, allowing the public hospitals to fully focus on the fight at hand and preventing more deaths and severe illnesses.

Second, an increase in healthcare financing is necessary. Thanks to the pandemic, it is increasingly seen as an investment rather than an expense. Now, the Malaysian government is engaged in serious discussions to raise its spending on healthcare, which has been chronically underfunded for years.

“The COVID-19 pandemic has lifted the veil and shown the true human cost of not resolving this issue,” said Mr Khairy, noting that Singapore has been at this critical juncture before. In 2013, the Republic had revamped its healthcare financing framework by having the government shoulder a larger portion of healthcare costs through subsidies and schemes.

Third, countries need to pivot from a curative, treatment-focused mindset to a holistic approach that emphasises wellness and preventive healthcare. “We need to genuinely bring health back into healthcare. Right now, it is more ‘sickcare’,” he quipped.

As part of its preventive healthcare approach, Malaysia is looking to introduce a smoking ban for those born after 2005. The move will also be closely followed in Singapore, said SSHSPH Vice Dean (Global Health) Associate Professor Hsu Li Yang in his opening address.

“Malaysia and Singapore share a history that extends beyond economic ties…the health and wellbeing of our people are also linked,” said Assoc Prof Hsu. “We (NUS) also study and learn from the health policies and interventions of both countries.”

Finally, countries need to ensure wide-changing reforms and increased spending are also accountable. This is where governance is critical.

Malaysia’s Health Ministry, for example, is proposing to establish a healthcare reform commission that will independently monitor, advise and report on the status of reform implementation to the government and people. Such transparency would “help inject institutional checks and balances”, said Mr Khairy. 

Power of partnerships

At a subsequent panel discussion moderated by Associate Professor Jeremy Lim, Director at SSHSPH’s Leadership Institute for Global Health Transformation, speakers also highlighted how cooperation can better prepare healthcare systems for future challenges.

“When we want to future-proof healthcare, we cannot think of it as silos,” said Dr Ong Suan Ee, Chief Operating Officer and Senior Health Systems Researcher at social enterprise Research for Impact. “We have to think of these issues as intertwined… and requiring a lot of collaboration among different parties.”

Referring to Mr Khairy’s point about strong public-private partnerships, Dr Lei Hsien-Hsien, Chief Executive Officer of The American Chamber of Commerce, narrowed partnership down to three areas for potential collaboration: product, platform and processes.

For instance, private firms can harness public data to create health platforms that focus on preventive healthcare.

Countries can also come together to generate greater results. During the question and answer session, Mr Khairy revealed his hope for Singapore and Malaysia to explore avenues for developing digital health capabilities together. 

“If we can get the regulations in place, it can be seamless both ways,” he said.