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White Paper
Chronic Obstructive Pulmonary Disease (COPD) in Malaysia
Mar 11, 2025

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Chronic obstructive pulmonary disease (COPD), a progressive respiratory condition characterized by airflow limitation, represents a critical public health challenge in Malaysia. With an estimated prevalence of 6.1%, representing approximately 548,000 affected individuals, and an annual economic burden of RM 2.8 billion, COPD has emerged as the seventh leading cause of death in the country. The impact extends beyond direct healthcare costs, with affected individuals experiencing an average of 12-18 days of work absenteeism annually and a 22-35% reduction in work capacity, translating to individual productivity losses of RM 7,020 per year. Recent evaluation reveals significant systemic challenges, underscoring the need for reforms.

Analysis suggest that most primary care providers often adopt a reactive approach to diagnosis. Importantly, healthcare professionals demonstrate limited proficiency in early detection and workplace hazard recognition. Public awareness is particularly concerning, with 80% of patients unaware of COPD before diagnosis. Patient education remains inadequate, resulting in poor inhaler technique and suboptimal treatment outcomes.

Analysis also suggests that there are critical infrastructure limitations which hamper effective COPD care. This coupled with limited diagnostic capabilities, availability of spirometry equipment and shortage of trained personnel severely impacts COPD care delivery. Treatment accessibility is compromised by limited availability of long-acting bronchodilators in primary care facilities and budget constraints preventing recommended dual or triple therapy. This results in high emergency department visits (31%) and hospital admissions (42%). The scarcity of pulmonary rehabilitation facilities also creates substantial gaps in comprehensive care delivery.

Despite COPD being the seventh leading cause of death in Malaysia, there is no comprehensive national strategic plan for its management. The current National Strategic Plan for Non-Communicable Disease (2016-2025) inadequately addresses COPD. Care integration is poor, with only 20% of patients being referred from primary to specialist care. Clinical practice guidelines have not been updated since 2009, leaving significant gaps between local and international standards.

To address these challenges, a comprehensive, collaborative, and multi-pronged approach is needed, involving various stakeholders from the government, healthcare providers, patients, and the private sector. Some key recommendations are:

  • Enhancement of healthcare professional training and capability building
  • Expansion of diagnostic and rehabilitation infrastructure through public-private partnerships
  • Development of a comprehensive national COPD strategy aligned with international standards
  • Implementation of a hub-and-spoke healthcare delivery model
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