“Nanti lah (Later lah).”
It is a phrase many Malaysians say almost reflexively.
A lingering cough? “See first lah.”
A health screening? “Next month lah.”
A doctor’s appointment? “When work is less busy lah.”
According to Pfizer Malaysia, Indonesia, Singapore and the Philippines Cluster Lead Deborah Seifert, this mindset is increasingly common across South-East Asia.
“Across the four markets I have the privilege of leading, I have seen one pattern emerge again and again when it comes to adult health,” she says.
“It’s one small word: ‘later’.
“‘Nanti lah,’ they say in Malaysia. ‘Nanti saja’ in Indonesia. ‘Mamaya na’ in the Philippines. And in Singapore, just as often, ‘next time lah’.
“Different words, the same quiet delay.”
Yet respiratory illnesses such as pneumococcal pneumonia, influenza, respiratory syncytial virus (RSV) and Covid-19 do not wait for a convenient moment to strike.
“They disrupt lives, families and livelihoods often without warning.
“And the adults most at risk are frequently the ones least likely to have had the conversation with their doctor,” Seifert says.
According to a YouGov survey, between 70% and 83% of adults across the four countries aspire to be fit and healthy.
However, at least one in three admits that they do not take care of their health as much as they should.
Work and family first
Healthcare professionals say respiratory health often remains overlooked until it begins disrupting everyday life.
Singaporean general practitioner (GP) Dr Lim Wee Peng says many adults assume they are healthy as long as they can continue functioning normally.
“If someone is still going to work, caring for family and functioning normally, it’s easy to assume everything is fine,” he says.
In primary care, Dr Lim says doctors encounter this pattern frequently.
“Adults generally do care about their health, but respiratory health is not really the first thing on their minds.”
Instead, work responsibilities, financial pressures and family commitments often take priority.
“So the conversation gets postponed until there is a bad infection, a prolonged recovery, or even a hospital admission,” he says.
Healthier SG – a national programme encouraging Singaporeans to build long-term relationships with primary care doctors – may help strengthen preventive healthcare conversations.
“When people have an ongoing relationship with a regular family doctor, we have a better chance of raising these issues earlier calmly and practically, before respiratory illness becomes a major disruption,” he explains.
Financial considerations
The consequences of delayed healthcare often extend beyond the individual, placing emotional and financial strain on families.
In the Philippines, pneumonia remains a leading cause of hospitalisation.
Filipino infectious disease physician Dr Karl Hansen says hospital doctors frequently witness the effects of postponed treatment.
“We tend to get called when cases become severe or complicated in the hospital,” he says.
“I am part of the team that sees the impact of delaying preventive strategies and important health decisions almost every day.”
According to Dr Hansen, financial pressure remains one of the biggest barriers to preventive healthcare in the Philippines.
“We have a very different healthcare system compared to places like Singapore, where many patients pay out of pocket,” he notes.
As a result, many people prioritise immediate daily necessities over long-term health.
“If you don’t have money to buy rice, then that becomes the priority,” he says.
Dr Hansen adds that perceptions of what matters most in life often vary from person to person, especially when families are struggling financially.
“It’s up to us physicians to have that conversation with patients and drive home the point that health matters,” he says.
“Health decisions, health interventions and preventive strategies matter.”
Seeking social media advice
While some delay medical care, others increasingly turn to social media and online searches for health advice before speaking to a doctor.
In Indonesia, 62% of adults cite social media as a source of health information, compared to only 30% who rely on doctors and healthcare professionals.
In Malaysia, 56% turn to social media for health advice.
However, Indonesian internal medicine physician Dr Dirga Rambe warns that while social media helps spread awareness, it does not always provide accurate information.
“People read about influenza, Covid-19, pneumonia and RSV, but they do not fully understand it,” he says.
“So misinformation is common.”
The survey also shows that half (51.3%) of Indonesian adults research treatment options on their own before consulting a doctor – similar to Malaysia (51.9%).
Rather than viewing this negatively, Dr Dirga says it reflects growing public interest in health awareness.
“If patients come after reading about influenza, pneumonia or Covid-19, it means they care,” he says.
“As doctors, we should welcome these patients and invite them to talk.
"That is how we turn information into conversation, and information into action.”
However, only 57.2% of Malaysians agreed that they normally only use drugs recommended by their doctors.
Filipino cardiologist Dr Anthony Cueto Leachon says that doctors should become more active in communicating respiratory health risks in ways people can relate to.
“The way to address it is both at the doctor’s clinic and at the social media level,” he says.
“Doctors should not stay only in the clinic.
“They should go out there, share data-driven information and engage with social media influencers – but of course, without fake news.”
Dr Leachon adds that health messaging often fails because medical information is not communicated in a way that resonates with the public.
“I think the barrier is that we are not explaining it in a way people can relate to,” he says.
“As doctors, we are powerful if we can think.
“We are powerful if we can speak.
“But we are most powerful if we can write.”
“Then we can add value to this problem of ignorance and education,” he notes.
Maintaining independence
But beyond misinformation and delayed care, doctors are also concerned about how seriously some respiratory infections continue to be underestimated – a virus many people still associate only with infants and young children.
Universiti Malaya consultant geriatrician Prof Dr Tan Maw Pin says RSV in older adults remains widely under-recognised despite its serious health consequences.
“RSV has emerged almost out of nowhere, and we’ve suddenly realised that it kills more older adults than children,” she says.
“But it’s not just death that worries us.”
According to Prof Tan, RSV infection in older adults can be more severe than influenza.
“When you get RSV, you are more likely to develop secondary bacterial infections, which can land you in the hospital,” she says.
Besides the infection itself, RSV can trigger inflammation throughout the body, increasing the risk of heart attacks, strokes and clots in the lungs.
It may also lead to muscle wasting, sarcopenia, kidney problems, functional decline, and even dementia in older adults.
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“What worries older adults most is losing independence,” she notes.
“The likelihood of moving from being able to do everything yourself to needing assistance with daily activities becomes much higher after serious respiratory infections like RSV.”
The impact often extends beyond older adults themselves, placing added pressure on the “sandwich generation” – middle-aged adults caring for both ageing parents and young children.
ALSO READ: Navigating life as a member of the Sandwich Generation
However, Prof Tan believes that older adults should also be empowered to take proactive steps to protect their health and independence before they become dependent on others.
“A lot of times we direct the message to the sandwich generation – ‘do this, do that’ – but what we should really be doing is getting the message across earlier, before the older adult needs assistance,” she says.
“That way, they can take proactive steps themselves – ideally, together with their peers – to prevent respiratory infections.”
For Prof Tan, what matters most to older adults is remaining independent – continuing to make their own decisions and care for themselves, rather than becoming a burden to the people they love.
“To be able to contribute to grandchildren, and to see great-grandchildren come into this world – that is probably what most older adults would want,” she says.
Seifert, Dr Lim, Dr Hansen, Dr Dirga, Dr Leachon and Prof Tan, as well as Selangor-based GP Dr Rokeshwar Hari Dass were speaking at the launch of Pfizer Malaysia’s regional respiratory health campaign “For the Reasons That Matter” in Kuala Lumpur.
