In celebration of the 20th anniversary of the Jeffrey Cheah School of Medicine and Health Sciences (JCSMHS), the school hosted the Building Resilient Health Systems: Collaborative Pathways to Equity and Access symposium on 18 November 2024. The event gathered key stakeholders, including government officials, civil society representatives, healthcare professionals, academics and community members, to explore strategies for promoting health equity and accessibility in Malaysia. Notably, the event embraced an inclusive spirit, with participants from the deaf and disabled communities.

Opening the event, Professor Mohamed Shajahan Bin Mohamed Yasin, Professor and Head of JCSMHS, emphasised the importance of collaboration and multi-sectoral involvement in strengthening healthcare systems.

The first presentation, Strengthening Malaysia’s Healthcare Foundations: Strategic Goals for Financial Sustainability and System Resilience, was delivered by Dr Yap Wei Aun, Chief Executive Officer of the Health Transformation Unit, Ministry of Health. Dr Yap detailed how Malaysia’s healthcare system faces significant challenges due to rapid urbanisation, demographic shifts, and inequality. He highlighted the need for a financially sustainable and resilient approach, particularly in underserved areas. He called for public-private partnerships to bridge gaps in service delivery while maintaining equitable access. “We need to ensure that our limited resources are optimally utilised to achieve equitable and high-quality healthcare outcomes,” Dr Yap stated.

Ms Ranjit Kaur, a patient advocate and member of the Asia Pacific Oncology Alliance, followed with her presentation, Bridging Gaps in Healthcare Access: A Community Perspective on Overcoming Barriers and Building Partnerships. Drawing on her experience, she highlighted the success of the City Cancer Challenge program in transforming breast cancer care in Greater Petaling through community engagement and multi-sector collaboration. “We must engage with communities to understand their needs and ensure healthcare is accessible and inclusive for all,” she emphasised.

Professor Dr David McCoy, Professor of Global Public Health at the United Nations University, delivered the third presentation, Addressing Structural Barriers and Advancing Health Equity in Malaysia’s Healthcare System. He analysed the structural determinants of health inequity, including social, political, and economic influences. While critiquing market-driven policies that worsen inequality, Professor McCoy emphasised that “good government needs good governance”. Effective governance requires a healthy civil society, independent media, and robust educational institutions to ensure accountability and challenge power structures. He also advocated redistributing resources and empowering marginalised communities to reduce systemic health inequities.

The final keynote, Global Strategies for Health Equity: Addressing the Social Determinants of Health to Build Resilient Health Systems, was delivered by Professor Sir Michael G. Marmot, Director of the University College London Institute of Health Equity. Professor Marmot shared global insights from his work in the UK and Norway, illustrating the profound impact of social determinants on health outcomes. He discussed the significant differences in public spending on early childhood development, noting that Norway invests $12,000 per child annually compared to $4,000 in the UK and $3,000 in the US. “The greater the deprivation, the greater the frequency of adverse childhood experiences, which damage development and impact mental and physical health throughout life,” he explained. Professor Marmot also discussed the success of the Marmot principles, which have guided systemic action on health inequities in cities like Coventry and Manchester.

The event also featured a Q&A session moderated by Professor Dato’ Dr Adeeba Kamarulzaman, President and Pro Vice-Chancellor of Monash University Malaysia. Attendees raised critical questions about urbanisation, mental health, and the role of NGOs in complementing government efforts. Professor Marmot mentioned that civil society organisations are vital in addressing gaps, particularly when governments fail to address health inequities. Professor McCoy added, “While NGOs are crucial, the struggle for equity must include a fight for good governance. Only governments can implement large-scale systemic changes necessary for health equity.” When asked about addressing systemic inequality, Professor McCoy remarked with a well-known quote, “It’s easier to imagine the end of the world than the end of capitalism.” He elaborated on the need to challenge entrenched power dynamics and focus on structural changes that enable equitable access to healthcare.

In response to concerns about malnutrition and undernutrition in children, Professor Marmot stressed the need for poverty reduction and interventions like Brazil’s conditional cash transfer program, which has successfully improved childhood health and development. Urbanisation poses certain challenges to healthcare accessibility, with families in urban centres often facing higher costs and fewer support systems, leaving children vulnerable to poor nutrition and chronic illnesses.

This symposium, part of the Jeffrey Cheah School of Medicine and Health Sciences’ 20th anniversary celebrations, highlighted the need for multi-sectoral collaboration, innovative thinking, and community involvement to create a more equitable and accessible healthcare system for all.