Non-communicable diseases (NCDs) are long-term conditions like cardiovascular (heart) diseases, diabetes, hypercholesterolaemia (high cholesterol levels), obesity and cancers, which can affect people of all ages and often require ongoing, lifelong care.
The 2023 National Health and Morbidity Survey (NHMS) confirmed that Malaysia is an unhealthy nation with a high prevalence of NCDs.
Malaysia's numbers
The overall prevalence of diabetes in Malaysians was 15.6% (i.e. one in six adults), comprising 9.7% known diabetics and 5.9% (i.e. two in five adults) who did not know they were diabetic.
This was an increase of 4.2% from the overall prevalence of 11.2% in 2011.
Most of those who did not know they were diabetic were in the 18-39 years age group.
Of the known diabetics, 56% did not have satisfactory blood glucose control.
The overall prevalence of hypertension (high blood pressure) was 29.2% (i.e. one in three adults), comprising 17.3% known hypertensives and 11.9% who did not know they had hypertension.
This was a reduction from the overall prevalence of 32.7% in 2011.
Like diabetes, most of those who did not know they were hypertensive were in the 18-39 years age group.
Of the known hypertensives, 91% were on medications, with 48% having their blood pressure under control.
The overall prevalence of hypercholesterolaemia was 33.3% (i.e. about 7.6 million adults), comprising 15.2% known to have hypercholesterolaemia and 18.1% who did not know they had hypercholesterolaemia.
This was a reduction from the overall prevalence of 35.1% in 2011.
The survey found that 54.4% of adults were overweight or obese, comprising 32.6% overweight and 21.8% obese.
This compared to an overall prevalence of 44.5% in 2011.
The prevalence of abdominal obesity, based on waist circumference of more than 90cm in males and more than 80cm in females, had increased from 45.4% in 2011 to 54.5% in 2023.
More than half a million Malaysians (2.5% of the adult population) live with four NCDs, i.e. diabetes, hypertension, hypercholesterolaemia and overweight/obesity, which are major risk factors for heart disease and stroke.
About 2.3 million Malaysian adults live with three NCDs:
- 5.1% with diabetes, hypertension and hypercholesterolaemia
- 2.9% with hypertension, hypercholesterolaemia and obesity
- 1.2% with diabetes, hypertension and obesity, and
- 0.4% with diabetes, hypercholesterolaemia and obesity.
One in three Malaysian adults were not physically active, with 84% not walking, cycling or active in sports/fitness activities.
One in two adults lead sedentary lifestyles.
Two in five Malaysians did not undergo health screening in the year prior to the survey.
Their reasons were that they felt healthy (90%), had no symptoms (84%) and had no time (39%).
Risks with long-term care
NCDs are a global problem.
This was reflected in the United Nations declaration on NCDs and mental health, which called for strengthened prevention and long-term management of NCDs.
The achieving of these commitments requires access to safe and quality care.
People with NCDs require continuous care over long periods of time and in multiple healthcare settings.
This poses potential safety risks from prevention, diagnosis, treatment and long-term care, including self-care.
The potential safety risks are also influenced by challenges in healthcare delivery systems and the broader determinants of health.
Each safety risk may interact with each other and may be compounded.
Improvements in the safety of NCD care requires addressing risks related to the complexity of care, strengthening health systems through a primary healthcare approach and addressing the wider determinants that can increase the risk of harm.
World Patient Safety Day, which will be commemorated on Thursday (Sept 17), brings together governments, healthcare providers and facilities, as well as communities, to focus attention on patient safety and accelerate action to reduce avoidable harm in healthcare.
Keeping safe
The focus of 2026’s World Patient Safety Day is “Safe Care for NCDs” with the slogan “Safe care for life”.
In this respect, the World Health Organization (WHO) has messages for all stakeholders.
The primary messages for people with NCDs or who are risk of it, and their caregivers, are: “Stay informed. Stay engaged. Stay safe”.
The measures include:
> “Don’t miss opportunities for prevention
“Learn about NCD risk factors, participate in recommended screening and preventive care, and seek help early when you notice warning signs.
> “Know your condition and safety risks
“Understand your diagnosis, tests, treatments and possible sources of harm related to your condition.
“Follow basic safety practices such as hand hygiene and double-checking your medications.
> “Know your rights and be an active partner in your care
“Take part in healthcare discussions and decisions about your care.
"Ask questions, confirm your understanding and speak up if you have concerns or notice safety practices being missed.
> “Be your own ‘information officer’
“Keep an accurate record of your symptoms, test results, medications and appointments, including when travelling or when away from home.
"Use tools like electronic records, reminders or trusted health apps to track your readings, medications, test results and appointments.
> “Navigate transitions safely
“Stay alert during ‘handover’ moments between health practitioners, and during referrals and discharge.
“Make sure you are clear about your medications, follow-up appointments and who to contact if your symptoms worsen.
"Follow up on your test results – ‘no news’ is not always good news.
> “Master your self-care
“Know how to use your medications, medical devices and digital health tools correctly.
“Know your warning signs and when to seek help.”
The primary message for healthcare providers is: “Make NCD care safe at every step”.
The measures are:
> “Prioritise meaningful engagement
“Partner with people living with NCDs as expert team members.
"Support shared decision-making.
“Empower people living with NCDs to recognise risks, manage their care safely and identify warning signs that require action.
> “Promote prevention and reduce risk
“Identify and address modifiable risk factors, support healthy lifestyles and provide evidence- based preventive interventions.
> “Ensure early detection and accurate diagnosis
“Reduce delays, avoid missed or incorrect diagnoses by maintaining a high index of suspicion about NCD-related risks, and interpret tests carefully, especially in people with multiple conditions.
> “Identify risks and prevent harm
“Take proactive steps to prevent harm across the continuum of care, such as missed prevention opportunities, delayed or incorrect diagnoses, medication errors, procedural risks and device-related harm.
> “Ensure continuity and coordination of care
“Communicate clearly, manage transitions safely and maintain follow-up across health practitioners and settings.
> “Learn and improve continuously
“Report incidents, share good practices and contribute to a culture of safety and continuous improvement.”
For those in charge
The primary message for healthcare facility managers is: “Establish systems that enable safe NCD care”.
The measures include:
> “Prevent harm through early action
“Establish systems that support evidence-based preventive services and risk assessment, early detection, timely management and ongoing follow-up.
> “Enforce rigorous safety standards
“Standardise care and implement protocols to address the major sources of harm.
> “Ensure continuity and coordination of care
“Establish standardised processes for handovers, referrals and discharge across practitioners and healthcare settings.
> “Embed meaningful engagement within facility governance
“Involve people living with NCDs in facility boards, safety committees and the design of care processes.
> “Support and enable the workforce
“Provide training, resources and supportive working conditions.
"Foster teamwork and open communication between staff members.
> “Use lived experience and data to improve care
“Establish a safety culture, promote incident reporting by health workers and patients, and use lived experience to drive continuous improvement.”
The primary message for policymakers and healthcare leaders is: “Embed safety in every NCD policy and programme”.
The measures are:
> “Integrate safety into NCD policies and legislation
“Ensure safety is embedded in national strategies to deliver on commitments from the 2025 UN Political Declaration on NCDs.
> “Promote prevention and early detection
“Strengthen policies and programmes that support risk reduction, preventive services, screening and early detection of NCDs.
> “Strengthen primary healthcare for safe NCD care
“Build integrated, people-centred systems that provide continuous and coordinated care, and address barriers that prevent people from accessing safe NCD services.
> “Ensure sustainable financing and financial protection
“Mobilise and sustain resources, and reduce financial barriers, for accessing safe essential NCD services for all.
> “Invest in a capable health workforce
“Train, support and retain health workers with the competencies needed to deliver safe NCD care.
> “Engage people with lived experience
“Establish mechanisms to involve civil society in the design, delivery and accountability of NCD care.”
In short, everyone has a part to play to ensure safe practices in the continuum of care for people with NCDs and to reduce avoidable harm.
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.
