In the ongoing battle against diabetes, Malaysia faces significant challenges. Azrul Khalib, CEO of the Galen Centre for Health and Social Policy, argues that removing sugar as a gazetted item under the Price Control and Anti-Profiteering Act 2011 would be a more effective measure than introducing a grading system for sugar content. This approach, he contends, would better address the nation’s escalating diabetes crisis.
The Subsidy Paradox
Malaysia, despite not being a sugar-producing country, has some of the lowest sugar prices in the world, thanks to government subsidies. These subsidies, intended to keep sugar affordable, inadvertently contribute to higher consumption rates. “The price of sugar is currently being kept artificially low and under the ceiling price due to incentive payments made by the government to the sugar industry,” Khalib explains. This paradox undermines efforts to combat sugar-related health issues.
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The financial implications of this policy are staggering. Diabetes alone costs Malaysia over RM3 billion annually, not to mention the additional burden from related diseases such as kidney disease and cardiovascular conditions. Khalib argues that it is illogical to simultaneously subsidize sugar and wage a “war on sugar.” The current policy, he suggests, requires a more coherent strategy that aligns financial incentives with public health goals.
Non-Communicable Diseases: A Growing Crisis
The 2023 National Health and Morbidity Survey report highlights a dire situation: Malaysia has the highest diabetes rate in the Western Pacific region and ranks among the highest globally. Projections indicate that by next year, seven million Malaysian adults aged 18 and older will be pre-diabetic or diabetic, with many remaining undiagnosed and unaware of their condition.
Khalib points out that these alarming statistics underscore a broader non-communicable diseases (NCD) crisis. Addressing this crisis requires more than just surface-level interventions. It calls for systemic changes in how the government manages health-related subsidies and regulations.
Innovative Solutions for Public Health
In response to proposals such as banning 24-hour eateries, Khalib suggests a more balanced approach: imposing a 10% surcharge on food and beverages sold in licensed establishments between midnight and 6 AM. The revenue generated from this surcharge could exceed the RM5 billion currently collected from sin taxes on cigarettes and alcohol. This approach would not only deter late-night eating, which contributes to unhealthy lifestyles, but also provide additional funds to treat NCDs, including diabetes, cardiovascular disease, and cancer.
Moreover, Khalib advocates for increasing excise duties on cigarettes and tobacco products and limiting nicotine concentration in vape products to 2%. Raising the excise tax rate to RM0.77 per cigarette stick, or 61% of the retail price, could generate an additional RM771.8 million in tax revenue. This increase would align with efforts to reduce smoking-related illnesses, which cost Malaysia an estimated RM16 billion annually in treatment.
Aligning Policy with Health Objectives
Implementing a hard ceiling of 2% nicotine concentration in vape products would bring Malaysia in line with international standards and further protect public health. Khalib emphasizes that these measures are not just about generating revenue but are crucial for sustaining the healthcare system. “How will we continue to pay for the treatment of these chronic diseases which will last for years and cost billions? The money must come from somewhere,” he asserts.
Malaysia’s diabetes crisis
Addressing Malaysia’s diabetes crisis requires more than just introducing a sugar grading system. It demands a comprehensive approach that includes removing sugar subsidies, implementing targeted surcharges, and increasing excise duties on harmful products. These measures would help align Malaysia’s financial policies with its public health objectives, ultimately reducing the burden of diabetes and other NCDs on the nation’s healthcare system. As Khalib aptly puts it, “We cannot afford half measures.” By adopting these strategies, Malaysia can take meaningful steps towards a healthier future.
