MALAYSIA is no longer waiting for El Nino. The weather cycle is only expected to peak between November and February 2027 but already parts of Sarawak have recorded air pollution index (API) readings above 150, some past 200 – readings over 200 are considered unhealthy so schools had to cancel outdoor activities.
The 1997-1998 El Nino cycle broke the national temperature record, triggered a state of emergency in Sarawak, and cost Sabah and Sarawak an estimated RM12.87bil.
This time, the same force arrives on top of an additional decade of accumulated warming and a health system still working through its pandemic-era backlog.
And to complicate matters further, meteorological agencies around the world are now telling us that this El Nino will be the strongest event of its kind on record.
The clearest sign this is no longer a forecasting exercise is that people are already dying. Between January and July, the Malaysian Health Ministry recorded 73 heat-related illness cases nationally, including four deaths (two adults, two children, one of whom was left inside a vehicle), while conditions sat at only the mildest warning level.
Two women developed dangerously high fevers while resting indoors after childbirth. This shows that extreme heat can harm people indoors too, not just outdoors. This is the baseline before El Nino has even peaked. Whatever framework Malaysia builds now is being built while the death toll is already rising.
I keep returning to this El Nino because it is a textbook example of what a tipping point feels like from the inside, even if El Nino itself is a recurring oscillation rather than a threshold crossed once and locked in.
If you think about them at all then you likely understand tipping points as slow-motion catastrophes: melting ice sheets, bleached coral reefs, deforestation of the Amazon; crossing thresholds we cannot uncross.
But the science also recognises a more hopeful category: positive tipping points, where a small push in the right direction, at the right moment, triggers a self-propelling shift towards a better state. Solar power’s cost collapse is the clearest example: once the price of solar panels and related equipment crossed a price threshold, the need for subsidies to accelerate adoption fell away.
The question facing us now, and very urgently, is how much damage this El Nino will do and whether Malaysia can trigger a positive tipping point of its own in how it governs climate-linked health risk.
Institutional design is the first place this plays out. A brief published in August 2026 by the Institute of Strategic and International Studies Malaysia argues Malaysia’s approach to climate change has remained largely reactive rather than proactive because governance remains fragmented across federal and state lines, without climate ever being formally treated as a non-traditional security priority.
It recommends a dedicated, inter-ministerial security council to close that gap. I have made a similar recommendation: that the National Security Council (NSC) charter and chair such a unit, modelled on the single-source communication Malaysia built during 2020’s Covid-19 pandemic, with standing membership from Health, Environment, Education, Finance, and Economy ministries.
The pieces already exist: MetMalaysia (the Malaysian Meteorological Department) has briefed ministries more than 70 times since February; the National Disaster Management Agency (Nadma) convened a seven-agency effort in July; Sarawak activated its own API-based school triggers.
What’s missing is coordination, a single mechanism turning forecasting into synchronised advisories and public messaging before exposure occurs.
The distinction is important because the two bodies are built for different jobs: a disaster agency manages the emergency once it arrives, and the NSC decides, in advance, that the emergency is coming. Nadma can coordinate a response, but only the NSC can compel one, and after four deaths already on the books, coordination without compulsion is no longer enough.
This is where positive tipping point thinking becomes useful. A coordination unit built under emergency pressure this August could easily be dismantled once the crisis passes; business as usual, agency by agency. Or it could convert, from day one, into a standing body reconvening every year ahead of the dry season, its annual briefing becoming something ministries and the public expect.
The second proposition is a positive tipping point in institutional form; a one-time investment of political will that, once created, lowers the cost of every future response.
Institutions alone will not tip anything if the public does not understand what they are responding to. I discussed in last month’s column how there is currently no unified public health campaign on heat and haze precautions, such as symptoms, masking, home care, who is most at risk (Ecowatch: Malaysia needs a heat action plan).
This is the other half of the tipping point that the NSC cannot manufacture on its own: positive social tipping points are seeded in public understanding long before they show up in policy. A population that recognises sustained high fever in a postpartum mother or knows an API of 150 is a signal to act, becomes a constituency that keeps political attention alive after headlines fade.
Malaysia can draw on the same mechanism here: the trusted, single-source communication that it relied on through our response to Covid-19, with scientists, planetary health experts, civil society, and media translating warning levels into guidance people act on.
The lead time El Nino forecasting bought Malaysia is now partly spent, and the dry season is closing that window fast. Whether this El Nino becomes only the second costly repeat of 1997-1998, or the moment Malaysia’s climate-health governance tips towards something more durable depends on how quickly the coordination unit and the public campaign are put in place.
Prof Tan Sri Dr Jemilah Mahmood, a physician and experienced crisis leader, is the executive director of the Sunway Centre for Planetary Health at Sunway University. She is the founder of Mercy Malaysia and has served in leadership roles internationally with the United Nations and Red Cross for the last decade. She writes on Planetary Health Matters once a month in Ecowatch. The views expressed here are entirely the writer's own.
