Affirming Malaysia’s commitment towards Universal Health Coverage – Titiwangsa Declaration 2019

The Malaysian Medical Association invites all medical associations, health organisations and members of the public to be a signatory to the Titiwangsa Declaration 2019 – a gesture to express the willingness of all to work together with the Ministry of Health (MOH) to achieve Universal Health Coverage (UHC) in Malaysia.


THE TITIWANGSA DECLARATION 2019:
TOWARDS UNIVERSAL HEALTH COVERAGE

We, leaders and representatives of professional societies, scientific associations, civil society organizations, governmental agencies and departments, private for-profit entities, non-governmental non-profit organizations, and citizens of Malaysia and common citizens of our planetary commons.

CONSIDERING the over-arching and foundational themes expressed in the Constitution of the World Health Organization in 1946 and updated in 2014,

INSPIRED BY the seventeen aspirational and lofty Sustainable Development Goals of Agenda 2030 for Sustainable Development of the United Nations resolved in 2015,

REAFFIRMING the principles and commitments expressed in the ambitious and visionary Astana Declaration of 2018,

ENVISIONING a whole-of-society healthcare system in Malaysia that prioritizes, promotes and protects the health and well-being of all human beings; is humane, comprehensive, high-quality, easy-to-access, affordable and sustainable; is provided with compassion, respect and dignity by healthcare professionals who are well-trained and well-motivated; and sustains an enabling environment where all human beings and communities are actively empowered and engaged in enhancing their health and well-being, and

IN PURSUIT of Universal Health Coverage, hereby Declare:

  • That we strongly affirm our eternal commitment to the fundamental human right of every human being in Malaysia to the highest attainable standard of health and well-being, without any impediment or distinction of any kind, described in the values and principles enshrined in the sovereign Constitution of the Federation of Malaysia and the Universal Declaration of Human Rights of 1948, in particular healthcare justice and solidarity,
  • That we are convinced that health is beyond just complete physical, mental and social well-being for an individual; it also leads to Health Capital that is crucial for society- and nation-building in Malaysia, alongside the universal principles of Justice, Solidarity and Prosperity. We hold that Universal Health Coverage achieves not only bio-psycho-social good for individuals, but a more holistic public good that extends to Social Harmony and Resilience, and
  • That despite the remarkable progress in Malaysia’s health outcomes since Independence in 1957, there remains unaddressed health needs particularly among the poor (urban and rural) and people in vulnerable situations. For ethical, humanistic, political, social and economic reasons, we hold that it is unacceptable that inequity in access and disparity in outcomes persist, and increasing numbers among us are not free from impoverishing payments for health, living precariously under the threat of financial ruin due to ill-health.

With these Declarations in mind, we commit to:

  • ACHIEVING UNIVERSAL HEALTH COVERAGE (UHC), by reinforcing our primary healthcare system through appropriate infrastructure and incentives; by visibly promoting public, promotive, preventive, rehabilitative and palliative care, not just curative care; by removing barriers to access, be they physical, mental, cultural, institutional or emotional barriers; by extending physical, infrastructural and financial coverage to the entire population for the right high-quality and cost-effective health services at the right time; that any changes to achieve UHC must be soundly based on practical and sustainable science, which therefore requires deep, sincere and meaningful consultation with the healthcare providers at all levels and in all sectors; and by thoughtfully re-designing healthcare access charges to simultaneously prevent financial hardship, ensure appropriate self-reliance on health and long-term national fiscal health, leading to a healthy and resilient population with no one left behind on any part of our continuum of care,
  • EMPOWERING INDIVIDUALS AND COMMUNITIES, by continuing to support individuals, families, communities and the broader society to participate in decision-making and governance for their healthcare needs; by actively and passively promoting the health literacy especially in under-served populations, that is needed to enhance their health or the health of those for whom they care; by inspiring a sense of personal and community ownership for their health and well-being, guided by warm-hearted and knowledgeable healthcare professionals; and by encouraging a sense of self-reliance for health and yet equal solidarity with our community, as health is too inter-linked to be atomized to an individual, and
  • HEALTHCARE AND SOCIAL JUSTICE, by continuing to secure and sustain adequate resources through greater investment in healthcare from state and non-state actors; by ruthlessly reducing leakages in the form of inefficiencies, corruption, wastage, fraud and abuse; by bringing health and finance decision-makers together around the shared goal of “Health as Investment” and appropriate resource allocation; by appropriately enacting cost-effective and evidence-based decision-making at all levels of government; by focusing not only on the challenges in the present like non-communicable diseases, but also casting an eye to future challenges like aged care, climate change and technological disruption.

Holding these Commitments in mind, we reaffirm the timeless responsibility of all levels of our Government in protecting and advancing the right of everyone to enjoy the highest attainable standards of health. We deeply understand that Universal Health Coverage requires addressing not only bio-psycho-social determinants of health, but also economic and environmental ones. Thus, we acknowledge the need for bold political choices using a whole-of-society approach, in order that Universal Health Coverage policies becomes embedded in all state and non-state actors in a truly multi-sectoral and trans-disciplinary setting.

We call on all stakeholders to join us in achieving the Commitments expressed in this Declaration, in a spirit of partnership, generosity and ambition.

Together, we can and we will achieve Health and Well-Being for All, leaving no one behind.