The Minister of Health is committed to table the amendment of The Control of Smoking Product for Public Heath Bill 2023, which also includes the Generational End Game Policy that restricts tobacco products to people born after 2007.
From the very beginning of her appointment, the media and anti-smoking groups have been reminding her of that message over and over and over again – get the GEG Bill passed.
Isn’t it odd that despite all the shortcomings in our healthcare appearing and exposed now and during the MCO and the Minister prioritizing period poverty over most issues, the Minister is now prioritizing the passing of the GEG Bill against other more urgent needs?
A tobacco endgame needs to address systems issues to a greater degree than individual behaviour.
The answer is that this choice is not so much of her own but she is probably trying to ride on the coattails of her predecessor – presiding and overseeing the country’s ascension into the record books of being the 1st country in the world to pass a GEG bill, something which eluded countries in the developed world until today despite these countries talking earlier about introducing such a bill in their respective countries.
Hopefully, the Minister is not trapped by the Malaysia Boleh slogan.
The rush to table the amendment for her probably gives her a sense of achievement and will earn her the title Malaysia’s First Female Health Minister laid the groundwork and spark for a tobacco-free world’ and to make rich those who would be behind the implementation of the operating and enforcement framework.
With all the economic uncertainty the country is facing today, this is a time when we need to be supported by the government in terms of ease of doing business and not laden with burdensome procedures.
Critical to the success of the GEG Bill if it is passed means a lot of monies needs to be budgeted and allocated for the implementation and enforcement of the GEG Bill e.g investment in communication initiatives to explain the policy and the benefits that will accrue to future generations, investments for retailer compliance monitoring and enforcement, investments to help those socioeconomically disadvantaged people – admittedly there is a demographical disparities in tobacco use in this country - the largest group of potential smokers coming of age, investments to curb the expected increase in illicit trade in normal-strength tobacco and organised crime, additional investments and resources to strengthen the Customs Department for the detection of smuggled tobacco products and the establishment of a monitoring programme to track illicit use as the new policies take effect.
With a debt of RM1.5 trillion and with a possible cut in the budget for most expenditure for the country, it appears that the country can ill afford to rush through this legislation in the present climate.
Given this situation, it is highly likely that designated funds, if any, will be limited and with limited funding and a lack of public health services designated by the government for Tobacco-Free Malaysia 2040, the country will not have sufficient resources to reach the 2040 goal.
Waste of resources and catastrophic expenditures are potential economic side effects of the passing of the GEG Bill if the government is not prepared and committed to provide adequate or sufficient funding for its implementation, enforcement and monitoring.
Are there any keys to accountability, improvement, scalability and sustainability of this initiative in the latest draft of the GEG Bill?
E.g steps to develop the evidence base for action, a technical package of a limited number of high-priority, evidence-based interventions that together will have a major impact, effective performance management, especially through rigorous, real-time monitoring, evaluation, and program improvement, the type of partnerships and coalitions with public- and private-sector organizations, communication of accurate and timely information to the health care community, decision makers, and the public to effect behavior change and engage civil society, and the political commitment to obtain resources and support for effective action.
If it does not capture many of the processes and outcomes that matter most to people, such as competent implementation and enforcement measures and health outcomes, confidence in the GEG Bill will go up in smoke as fast as it is being introduced.
Is the government prepared to guarantee a minimum level of achievable output within a specific time frame if the lawmakers decide to pass through the GEG Bill?
Otherwise, all these efforts to date are wasteful and unethical.
There is probably more going on than we can see or understand on why the rush, twice, once with her predecessor and now with the present Minister of Health to push through the GEG Bill.
Do not put sharp knives in their hands.
If this fails, the ramifications could be worse than what it was intended to do.
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