06/04/2026

MONDAY | APR 6, 2026

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Rising oil prices do not just affect transport at the consumer level; they raise operational costs across the health system. – AFPPIC Mideast crisis impacts medical costs T HE effects of escalating hos tilities in the Middle East fol lowing the military strikes in Iran in February are already filtering into the systems we rely on every day. medical and food supply chains. Left unmanaged, these pressures will not be evenly felt, with B40 households, the urban poor and migrant communities facing the greatest risk of being priced out of essential needs. Ű BY DR HOOMASHINI, DR SEAN THUM AND ASSOC PROF DR THARANI LOGANATHAN

One immediate pathway is healthcare inflation. Rising oil prices do not just affect transport at the consumer level; they raise operational costs across the health system, from logistics and supply distribution to electricity for running facilities. Over time, these costs are absorbed into the cost of service delivery. In a system where public healthcare is heavily subsidised, higher operating costs increase fiscal strain and may limit how much capacity can be expanded. For patients, this can mean longer waiting times, tighter access or a gradual shift towards out-of-pocket spending. The second pathway is supply chain disruption, particularly for medicines and critical equipment. Malaysia remains a net importer of pharmaceuticals, with imports reaching RM11.3 billion in 2023. Current stockpiles provide a buffer of roughly one to three months, but they are not indefinite. Prolonged disruption to shipping routes, especially through the Strait of Hormuz, will push up the cost of active pharmaceutical ingredients and essential consumables. This may not result in immediate shortages, but it will increase procurement costs in an already stretched system. Less visible, but potentially more acute, is the dependence on liquid helium. It is essential for MRI machines to function, yet global supply is highly concentrated. Disruptions to production and export routes have already tightened availability to Asia. Hospitals cannot store helium indefinitely. Even under optimal conditions, it evaporates within 45 days. Prolonged supply constraints may eventually force facilities to scale back MRI services, quietly delaying critical diagnoses for conditions like cancer where early detection is vital. The third pathway runs through nutrition and broader public health risks. Malaysia’s food system is closely tied to imported inputs, particularly fertilisers. Around 60% of mineral fertiliser needs are sourced from abroad, with the Middle East supplying key nitrogen-based products like urea. At the same time, export restrictions from major suppliers such as China, which accounts for roughly a third of Malaysia’s fertiliser imports, have further tightened global supply. The result is an upward pressure on fertiliser prices, which leads to

While Malaysia is not directly involved, the indirect effects are both real and immediate, largely transmitted through fuel prices, trade disruptions and broader economic channels. In a highly interconnected global economy, supply chain disruptions, energy price volatility and shipping bottlenecks rarely stay contained. Across Asia Pacific, countries are already responding, with the Philippines declaring a national energy emergency and others drawing down reserves to manage rising costs. Overlaying all of this is the broader economic adjustment driven by higher oil prices. Brent crude has moved from around US$70 in late February to above US$100, with peaks near US$126. For a country that subsidises fuel, this has immediate fiscal implications. The monthly subsidy bill has risen sharply, prompting recalibration. Beginning this month, the subsidised RON95 quota under the Budi95 programme will be reduced from 300 litres to 200 litres per month. The subsidised price remains, but consumption beyond that threshold shifts to higher market rates. From a policy standpoint, this is a containment measure rather than a withdrawal, highlighting the need to balance household support with fiscal sustainability. In Malaysia, the impact is being felt through the cost of living. Higher oil prices are feeding into transport, food and electricity costs, placing added pressure on households, particularly those with limited financial buffers. The government has responded with a series of measures, including rationalising subsidies and scaling back non-essential spending. Prime Minister Datuk Seri Anwar Ibrahim signalled the need for tighter fiscal measures early on, followed by a special Cabinet meeting to assess the situation, and subsequent adjustments to petrol subsidies. While official messaging remains cautiously optimistic, the more important question is how these external shocks will translate into pressures within our healthcare system. At its core, the escalating conflict presents a dual threat of heightened fiscal volatility driven by global oil prices and simultaneous disruption to

difference. And just as important – giving kids the confidence to say no when something doesn’t feel right. This isn’t something schools, parents or the government can solve alone. It takes all of us. Schools can talk openly about the risks. Teachers and staff can also be trained to spot early warning signs. Parents can create safe spaces for honest conversations, without fear or judgement. Sometimes, just asking “Have you ever been offered something like this?” opens the door. these resources could support the public health budget and cushion essential food prices via existing Sumbangan Asas Rahmah initiatives. Both public and private healthcare sectors are likely be affected by the rising costs. However, public-private collaboration can help ease congestion to the public healthcare facilities. For example, the current outsourcing of medical services to private healthcare providers. The Hospital Services Programme has improved healthcare accessibility and quality by reducing patient load in public healthcare sector, shortening waiting times for specialised care and enhancing overall service quality. Malaysia has taken measures to strengthen pharmaceutical buffers through the introduction of the National Generic Medicine Framework as part of the Malaysian National Medicines Policy. This initiative aims to improve the affordability of medicines, ensure quality standards of active ingredients and increase access to essential medicines. During these challenging times, local pharmaceutical companies can play a critical role in mitigating medical inflation and reducing dependence on international market monopolies. In the medium term, sustained fiscal pressure may constrain the pace of health system reform if left unaddressed. This is where structural adjustments become necessary. Advancing healthcare financing reform, including forms of national health insurance, can reduce reliance on annual fiscal allocations and improve system sustainability during economic shocks. At the same time, building domestic capacity matters. Incentivising local production of

authorities have even found vapes mixed with drugs or anaesthetics. That sweet scent? It can be a mask for something truly dangerous. Teens are especially vulnerable. The bright colours, sweet smells and pressure to fit in can make it incredibly hard to say no. Sometimes, the signs are easy to miss: > Unusual tiredness or dizziness > Sudden mood changes or secretive behaviour > Declining school performance Catching it early makes a huge increased production costs. In Cameron Highlands, vegetable farmers are already reporting input cost hikes of 15% to 20% for crops such as tomatoes and sawi . These figures tend to pass through quickly to retail prices. Meanwhile, the poultry sector is feeling the strain. As accessible protein sources, chicken and eggs rely on imported feed like corn and soybean meal. Rising energy and freight costs have hiked feed prices, and because poultry production cycles are short, these increases reach consumers within weeks. Rice, for now, remains relatively stable. Malaysia imported about 1.7 million tonnes of rice in 2024, accounting for roughly 30% of total supply. The Agriculture and Food Security Ministry has indicated that current stocks are sufficient until at least mid-year. However, the global rice market is showing signs of strain. India has seen significant exports volumes delayed, and although Malaysia sources primarily from Thailand and Vietnam, global price movements tend to align over time. Sustained pressure in the international market will eventually narrow the buffer we currently have, making it harder to shield domestic prices from external shocks. In the short term, these pressures are likely to increase demand on subsidised public healthcare services as households seek more affordable care, while also intensifying calls for broader subsidy support. Immediate stabilisation measures will need to go beyond across-the board subsidies. More targeted realignment, specifically shifting from blanket fuel subsidies towards B40 focused support, can help free up fiscal space. Channelled into a dedicated resilience mechanism,

Government tighten regulations on vape products and make sure clear, accurate information reaches families before the dangers do. This is a national issue and the innocence of youth is being targeted in ways that feel playful but carry lifelong consequences. We need to get the message out there:“Strawberry doesn’t always mean sweet. Sometimes, it means dangerous.” can critical and agricultural inputs would reduce exposure to external volatility. Existing frameworks such as the National Action Plan for Health Security can be more actively leveraged to manage rising costs, secure supply chains and coordinate cross-sector responses. The objective extends beyond continuity to prevent widening gaps in access, particularly among populations already at higher socio economic risks. Overall, the system is likely to remain functional, but the distribution of impact will become more uneven. Access may tighten at the margins and existing inequities may widen if left unaddressed. Malaysia does have buffers, including energy revenues and existing subsidy frameworks, but these alone are not sufficient. What is needed is a more anticipatory approach that protects access to healthcare and nutrition while strengthening system resilience. The conflict may be geographically distant, but its effects are already embedded in how our systems operate. The adjustments are gradual rather than abrupt, which makes it easier to overlook. That is precisely why policy responses need to move early before these pressures become harder to reverse. Dr Hoomashini is a medical officer in the private healthcare sector, Dr Sean Thum is a policy officer at the Communications Ministry, and Assoc Prof Dr Tharani Loganathan is a public health medical specialist with a specialisation in Health Economics and a lecturer at the Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya. Comments: letters@thesundaily.com medical supplies

Sweet strawberry, hidden danger: What teens are really tasting

LETTERS letters@thesundaily.com

The truth is, even one try can do real harm. Experts warn that these substances can cause dizziness, confusion, and long-term damage to a still-developing teenage brain. Most fruity vapes contain high levels of nicotine – strong enough to rewire a young brain, increase the risk of addiction and cloud judgement. In neighbouring countries,

IT looks like candy. It smells like strawberries. But in schools across Malaysia, these sweet little treats – fruity vape pods, candy-like packs – are hiding something far more serious. What seems like harmless fun is often laced with nicotine, and in some cases, even drugs. And it’s finding its way into the hands of kids who are curious, pressured or simply unaware.

K.T. Maran Seremban