The portable X-ray machine (held by an NCSM staff member here) is so small that it can be packed in cabin luggage and carried onto planes for programmes in East Malaysia. — Photos: NCSM
A “Cinderella disease” – that is how World Health Organization (WHO) Director-General Special Envoy for Chronic Respiratory Diseases José Luis Castro describes chronic obstructive pulmonary disease (COPD).
This is because it is a common, costly and devastating, yet too often overlooked, condition.
For years, COPD has remained largely invisible in both health policy and public discussion, despite its growing impact.
The condition is a progressive lung disease that restricts airflow and makes breathing increasingly difficult.
It is one of several chronic respiratory diseases, which also include asthma and post-tuberculosis lung disease.
Although smoking is the main cause of COPD, Castro stresses that the condition is not just a smoker’s disease.
“Anyone who breathes can develop COPD,” he says.
“Clean air, healthy lungs and the ability to breathe freely should never be privileges – they are human rights.”
Exposure to air pollution, biomass fuels and workplace hazards places billions of people at risk daily, he adds, underscoring the need to treat COPD as both a global environmental and public health challenge.
Globally, this condition is the third leading cause of death, claiming more than 3.5 million lives each year and affecting an estimated 390 million people.
A public health priority
(From left) Castro, Dr Noraryana and consultant respiratory physician Dr Helmy Haja Mydin spoke to the press during a recent World COPD Day press conference in Kuala Lumpur in November (2025).
Chronic respiratory diseases such as COPD place a significant burden on Malaysia’s healthcare system and economy, with health sector estimates putting the annual cost at RM2.8bil.
To address these challenges, the Health Ministry is rolling out the National Lung Health Initiative (LIH) 2025-2030, a comprehensive strategy covering COPD, asthma, pneumonia, lung cancer and post-Covid complications.
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Health Ministry Disease Control Division director Datuk Dr Noraryana Hassan says that lung cancer remains a leading cancer in Malaysia, with most patients only diagnosed at an advanced stage.
With smoking a major risk factor for this cancer, the five million Malaysians who continue to use tobacco are a cause for worry.
To try and tackle this risk factor, Dr Noraryana shares that: “Rather than framing smoking cessation purely around avoiding disease, which many struggle with due to addiction, the LIH promotes lung health as a positive and achievable goal.”
The initiative is also shaped by lessons from the Covid-19 pandemic, the ongoing burden of pneumonia and Malaysia’s long-standing tuberculosis (TB) challenges.
Through the LIH, the Health Ministry aims to elevate lung health as a national, regional and global public health priority, working with the WHO and partners like the National Cancer Society Malaysia (NCSM).
Improving access
Key components of the LIH include:
Currently available in Klinik Kesihatan Pendang in Kedah, Klinik Kesihatan Seberang Perai in Penang, Klinik Kesihatan Kok Lanas in Kelantan, Klinik Kesihatan Beserah in Pahang, Klinik Kesihatan Kajang and Klinik Kesihatan Batu 9 in Selangor, and Klinik Kesihatan Luyang in Sabah, this enables doctors to quickly identify lung abnormalities and decide on any further tests.
Each clinic is further linked to one of six hospitals for further referral if needed.
These programmes bring mobile X-ray units directly to communities for screening, thus increasing accessibility and convenience for the public.
Some of these programmes are run in collaboration with NCSM.
In line with the WHO Framework Convention on Tobacco Control, public campaigns that warn about the harms of smoking and that support quitting will be run.
Linked to planetary health, these policies will aim to reduce air pollution to protect people’s lungs while also safeguarding the environment.
Frontline clinics will be given better tools and training to detect lung diseases like COPD earlier.
Respiratory Medicine National Head Dr Mat Zuki Mat Jaeb shares that the LIH replaces previously-fragmented lung care pathways by linking public clinics, hospitals and private providers into a single, coordinated system.
“Patients are now screened at public or private clinics using AI-assisted chest X-rays and directed into appropriate care pathways based on their risk factors,” he says.
Since July (2025), more than 3,000 screenings targeting people with respiratory diseases, smokers and communities exposed to air pollution have been carried out under the initiative, with abnormalities detected in nearly every session.
The Health Ministry plans to expand the facilities offering screening and improve treatment pathways, including COPD management and smoking cessation services, next year.
The aim is reduce deaths from COPD, lung cancer and TB by 30% within five years.
Reducing accessibility barriers
A visitor breathes into a handheld monitor that measures carbon monoxide (CO) levels in the breath – an indicator of recent tobacco smoke exposure – during NCSM’s recent corporate pop-up at The Bousteador in Petaling Jaya, Selangor.
NCSM managing director Dr Murallitharan Munisamy shares that the non-governmental organisation (NGO) has three approaches when it comes to screening:
- Partnering with public health clinics
- Corporate pop-up stations, and
- Mobile rural community services.
The aim is to make it easier and more convenient for healthy working adults and those living further from health facilities to get screened.
In line with the LIH, NCSM has added another component to their usual screening services: AI-assisted chest X-rays.
Together with insurance company MCIS Life, it has also introduced LungShield, a micro-insurance model linked to lung cancer diagnosis.
Offered at a reduced annual fee of RM179 (normal cost is RM479), the micro-insurance package covers access to key diagnostic procedures for suspected lung cancer.
“With this model, patients can be fast-tracked through partnered public or private pathways, reducing delays in diagnosis,” Dr Murallitharan says.
It includes AI-assisted chest X-ray screening and further covers diagnostic investigations from CT (computed tomography) scans to biopsies and molecular testing, where needed.
While the focus is on cancer detection, AI-assisted chest X-rays can also flag other lung abnormalities.
Patients suspected of having conditions such as COPD are referred to appropriate care pathways for further assessment and management.
Jasmine Gan, 30, not only bought the micro-insurance for herself, but also sponsors it for her staff.
“I cover the RM179 cost for each employee.
“The convenience and the structured follow-up make it worthwhile,” says the chief marketing officer for SBS Digital Holdings Sdn Bhd.
She adds that workplace-based initiatives can play an important role in preventive care.
“Employees should not have to manage their health alone,” she says.
“When companies support early screening, it reassures staff that their well-being is taken seriously.”
The accessibility and convenience of NCSM’s corporate screening stations, which recently popped up near her office in Petaling Jaya, Selangor, also makes it easier for her and her staff to undergo the screening.
According to Dr Murallitharan, NCSM manages to screen around 100,000 people each year through all its screening intiatives.
Castro, Gan and the doctors were sharing their thoughts and experiences with the media during a recent workshop on chronic respiratory diseases from Nov 12 to 14 (2025), organised by the Pace University Center for Global Health in partnership with WHO, in Kuala Lumpur.
