Healthcare areas that need to be addressed in 2026 include costs, infectious diseases, NCDs, HCW issues and the impact of new technologies, among others. — Filepic
There was no objective evidence of improvement in Malaysian healthcare in 2025.
Some of the pertinent issues for Malaysian healthcare in 2026 are discussed below.
Nicotine addiction
The Control of Smoking Products for Public Health Act was implemented on Oct 1, 2024.
During the preceding 18-month period when nicotine sales were unregulated, the floodgates opened to the advertising, promotion and sales of nicotine products; entry of tobacco companies to the vaping market; and legalised sales to everyone, including minors below 18 years.
It appears regulators are oblivious to the fact that the effects of nicotine addiction would only be obvious in the medium to long term.
Various announcements were made on the delayed banning of vaping, which, hopefully, will be implemented in 2026.
Hopefully, the conundrum on the regulation of the safety standards and manufacturing of smoking devices by the Domestic Trade and Cost of Living Ministry and the Investment, Trade and Industry Ministry respectively, will be resolved in 2026.
Infectious diseases
Dengue cases decreased in 2025.
Hopefully, the trend will go further south in 2026, or at least, not increase.
Covid-19 infections continue to occur, but in much smaller manageable numbers.
A review of 429 studies between July 5, 2021, to May 29, 2024, estimated that the global prevalence of long Covid was 36%.
Studies of long Covid by the National Institute of Health have yet to find themselves in the medical literature.
However, a study of 976 healthcare workers (HCWs) in Universiti Malaya Medical Centre, who had Covid-19 between Jan 1, 2020, to March 1, 2024, revealed that 49.2% had long Covid.
The sufferers had lower self-rated job performance and lower absolute presenteeism, with higher economic loss.
The new H3N2 variant of influenza A (subclade K) has rapidly become dominant in Malaysia, Japan, Europe and North America with increasing cases and hospitalisations.
It causes more intense symptoms, but thankfully, it is covered by the trivalent vaccine, which is strongly recommended for children under five years, the pregnant, senior citizens, diabetics, asthmatics, and those with heart/lung disease, HIV/AIDS and other chronic conditions.
Hopefully, Malaysians will heed the call to get vaccinated.
The virus with pandemic potential that is worrying is avian influenza (i.e. bird flu), which has infected hundreds of millions of farm animals, spilled into mammals at an unprecedented scale and devastated wildlife globally.
It has established itself in dairy cattle in the United States.
According to the World Health Organization (WHO), as of Dec 18 (2025), a total of 480 cases of human infection have been reported in Cambodia, China, Indonesia, Laos, Vietnam and Australia, of which 318 (66.3%) were fatal.
Although human cases are currently rare, the trajectory of its increase is worrying, the data is patchy and the future uncertain.
Some scientists are warning that bird flu could spark a human pandemic in 2026.
The factors contributing to vaccine hesitancy, which include safety, efficacy, religious incompatibility, misperceptions about alternatives and conspiracy theories remain unaddressed.
More effective efforts are needed in 2026 to educate parents on the benefits of vaccination.
Otherwise, uptake may decrease, particularly with social media messages from prominent anti-vaxxers, thereby contributing to a resurgence of preventable infectious diseases.
Non-communicable diseases
Non-communicable diseases (NCDs) will continue to rise with increasing undiagnosed and uncontrolled numbers, due to uncoordinated and poor control.
This will impact on their complications and long Covid, and endanger healthcare delivery.
Inadequate or no treatments for NCDs will inevitably lead to premature and excess illness and death, thereby impacting the country’s economy.
The 2024 Prevention and Control of Noncommunicable Diseases in Malaysia: The Case for Investment report by the Health Ministry (MOH), WHO and the United Nations Inter-Agency Task Force on NCDs reveals the economic burden of NCDs to be RM64.2bil (4.2% of the 2021 GDP, comprising RM12.4bil in public healthcare costs and RM51.8bil in productivity losses).
The report provided a detailed implementation roadmap with emphasis on multi-sectoral collaboration and a whole-of-system approach.
It highlighted the potential to save over 180,000 lives and recover RM30bil in economic output over the next 15 years.
Hopefully, the report’s implementation will commence in 2026.
Patient safety
Patient safety continued to be an issue in 2025 with increasing judicial awards for maimed patients.
Hopefully, 2026 will witness a definitive action plan to upgrade the 46 public hospitals, which are more than 50 years old, and the more than half of equipment that are more than 10 years old, both of which pose patient safety hazards.
The public has a right to know the level of healthcare safety in the public sector.
Healthcare workforce
HCWs’ crucial role in healthcare delivery was evident during the Covid-19 pandemic.
The chaotic junior doctors’ situation will continue in 2026.
The decreased incentives for service in Sarawak and Sabah will lead to decreased HCWs to meet the states’ increasing needs.
Poor coordination between Putrajaya and public sector facilities; ignorance of facilities’ needs and requests; and an insensitivity to the attitudes and needs of the junior doctors will hopefully improve.
Medical unemployment and disgruntlement will continue with junior doctors’ issues inadequately addressed.
The best and brightest will continue to seek employment abroad.
Medical technologies
New technologies have impacted on healthcare with breakthroughs continuing in 2026.
Diabetes management will be improved by continuous glucose monitoring and glucagon-like peptide-1 (GLP-1) drugs, which will become an option in the treatment of obesity.
The first blood test for Alzheimer’s disease approved by US Food and Drug Administration (FDA) in May (2025) will, hopefully, be available in Malaysia in 2026.
The MOH’s statement that electronic health records (EHR) will be rolled out throughout Malaysia by 2026 is very unlikely to occur.
If a third or half the country has EHR, it would have done very well already.
Issues of patients’ confidentiality and security, patient safety, and the successes and failures of the new technologies, will be increasingly problematic.
The accountability and framework of the safe and effective use of generative AI to meet the needs of all users will need to be addressed in 2026.
Increasing healthcare expenditure
Healthcare expenditure and medical inflation will continue to rise leading to increased demands on the underfunded, overworked and crowded public sector, which is on the road to collapse.
It is sad that policymakers, in their so-called attempt to control medical inflation, cannot get their act together to provide a coordinated approach.
Increasing out-of-pocket expenditures will lead to more families facing financial ruin if they or their relatives get catastrophic diseases, e.g. cancer, heart attack and stroke, or are made redundant.
More general practitioner (GP) clinics and some private hospitals will close, because of financial unsustainability, staff burnout and the bureaucratic regulatory maze.
Hopefully, the long overdue GP fee schedule amendments will be gazetted in 2026.
There will be mergers, acquisitions and closures of some private medical schools and managed care organizations because of financial unsustainability and reducing demand.
GPs’ minimal or non-involvement in management of NCDs of public sector patients will impact negatively on population health.
Public trust and health policies
Healthcare will be increasingly provided by non-health actors with technological tools, posing regulatory problems.
The MOH’s 2026 budget cannot assure improved patient safety and quality care unless wastages, inefficiencies, and the role of middlemen and rent seekers, are reduced markedly; and it has an open and just culture.
It is notable that a think-tank has described the MOH’s 2026 budget as paltry.
At best, it appears that the situation is akin to that of a patient en route to the High Dependency Unit (HDU) in the hospital, which is next door to the Intensive Care Unit (ICU).
The RakanKKM programme is unlikely to succeed without any investment in new facilities and equipment.
Public trust will continue to wane for various reasons, including poor risk communication; non- or poor compliance to standard operating procedures; no meaningful engagement with the private sector, universities and civil society; misuse and abuse of social media; lack of transparency; and poorly considered policies.
Numerous examples of irresponsibility, unaccountability and incompetence underpinned by arrogance and poor insight were exposed in recent years.
There is limited or no available data of improved population health in 2025.
The political parties in the government spouted health and healthcare in their manifestos.
Yet, the hype about the Health White Paper adopted by Parliament in July 2023 has been reduced to a whimper.
Will there be meaningful changes in health and healthcare management in 2026, or will it continue to be another year of reckoning for the public healthcare system?
Stay healthy
Healthcare is avoidable by staying healthy.
A healthy diet, maintaining an appropriate weight, regular exercise, sufficient rest, safe sexual practices, avoiding nicotine exposure, moderate alcohol consumption and keeping vaccinations current are necessary.
This requires effort, smart lifestyle choices and the occasional medical check-up.
NCDs, infectious diseases and other health risks can be minimised by compliance with one’s individual responsibilities and vaccination.
Wishing all readers good health in 2026.
Take care of yourself and stay safe.
Dr Milton Lum is a past president of the Federation of Private Medical Practitioners Associations and the Malaysian Medical Association. For more information, email starhealth@thestar.com.my. The views expressed do not represent that of organisations that the writer is associated with. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
