Sustainable Immunization Financing in Asia Pacific: Malaysia Country Brief

Key messages

Context

• Malaysia’s goal to achieve high-income status by 2020 is a key government priority, with the healthcare sector identified as driver of economic growth.
• Four of the top five leading causes of mortality being NCDs, the epidemiological transition in Malaysia is more advanced than in most neighboring countries.
• Due to the complex political environment and the high chances of a change of government, key reforms and policy changes for healthcare will likely be postponed until the next parliamentary elections, due to take place August 2018.

Immunization Financing

• In Malaysia, immunization is financed and administered vertically by the Ministry of Health. Both vaccine procurement and program costs are financed as a central budget line item.
• The public budget for immunization has remained stable over the past years.

Key Findings

• Financing of the current NIP schedule is sustainable and the Ministry of Health is not employing nor considering innovative financing tools.
• Fiscal sustainability and lack of political will are key barriers to the introduction of new vaccines in Malaysia. The National Committee on Immunization Practices (NCIP) prioritizes budget considerations and political support when considering adoption.
• The National Immunization Program (NIP) is quite comprehensive and all vaccines are provided free of charge in public health facilities. A number of new and underutilized vaccines are already included in the National Immunization Program routine schedule, though it is unlikely to expand soon without political support.
• A Dengue vaccine is of interest for the Ministry of Health and Malaysia is hosting Dengue vaccine clinical trials.
• Malaysia’s healthcare system is highly centralized. The Ministry of Health is the funder, provider, and regulator of public healthcare in Malaysia, which is highly centralized and heavily subsidized. As purchaser and provider, the Ministry of Health procures vaccines centrally and is responsible for financing the delivery of vaccines throughout the country.
• Despite failed past attempts at healthcare reform, discussions on introducing a National Health Insurance (NHI) scheme have slowed but continue after decades of debate.