Letter To DG, Ministry Of Health

Date : 19th June, 2019

YBhg. Datuk Dr. Noor Hisham Bin Abdullah
Director General
Ministry of Health Malaysia
Level 12, Block E7 Kompleks E,
Pusat Pentadbiran Kerajaan Persekutuan
62590 Putrajaya, Malaysia

E-mail : anhisham@moh.gov.my

Tel : 603 8883 2545

YBhg Datuk Dr,

RE: Civil Society Organizations Recommendations Towards Meeting The WHO 2030 HCV Elimination Targets.

Several civil society members attended the recently concluded 4th National Hepatitis Conference and we would like to congratulate Ministry of Health, especially Hospital Ampang for organizing a very successful national discussion. We would also like to express our gratitude to Datuk Dr Mohammad Radzi Abu Hassan, Head of Gastroenterology Services, MOH and Dr Anita Suleiman, Head of HIV/STI/Hep C Sector, MOH for having a roundtable meeting with the civil society representatives during the conference to discuss about the future hepatitis management for the country.

During the discussion, it was mentioned that the Ministry of Health has formulated a National Viral Hepatitis Strategy Plan, pending for approval. At the time of formulating the strategy plan, it is unclear whether civil society and patient groups have been involved in the process. Thus, we the representatives of hepatitis C advocacy organizations, hepatitis patients and individuals would like to express our recommendations based on the WHO Global Strategy:

1. To have active structured engagement and dialogue with relevant stakeholders such as ministry of health, service providers, patients and civil society where discussions on the challenges and high impact interventions can take place.

2. Scale up testing among high-risk groups. We applaud the ministry’s move to collaborate with FIND to formulate a simplified diagnostic algorithm. Besides providing the HCV rapid test kit at the 25 family medicine specialist clinics, the testing could be further expanded at 728 needle and syringe exchange programme (NSEP) outreach points1,incarcerated and prisons setting throughout Malaysia to target the missed opportunities among the high-risk groups.

3. Increase capacity of outreach workers by training them to perform HCV
rapid test. This move is essential as it integrates and links the HCV
services with other health services such as family medicine specialist
clinics and methadone clinics that will increase savings, reach and
efficiency.

4. Decentralisation of HCV services to overcome the limited capacity of
hepatologists as HCV diagnostics 2 and treatment regimes can be
administered and monitored with less organisational support at the
family medicine specialist clinics and methadone clinics. This will
reduce the number of loss to follow up cases and shorter waiting period
for patients.

5. Eliminate the model of warehousing HCV patients (holding off patients
from treatment). The upcoming HCV guideline should focus on
equitable access for all regardless of the severity of disease as it
increases savings, efficiency and the HCV patients’ overall quality of
life. It will also accelerates the country’s progress towards achieving
WHO’s targets by 2030.

6. Ministry of Health to register more generic direct acting antivirals
(DAAs) without compromising safety, efficacy and quality of the
products because they offer a great opportunity for substantial savings
and increase the number of treatment.

The opportunity to eliminate hepatitis is one, which we cannot let pass us by
since the government’s strong commitment in WHO to eliminate hepatitis by
2030. We would like to call upon Ministry of Health to have fully invested
National Viral Hepatitis Strategy Plan for Hepatitis C, to lend your support to
these recommendations and establish a dedicated channel at Ministry of
Health for continuous engagement with community groups.

Thank you.

1 Boo SL. Malaysia is ‘world leader’ in battling HIV spread with needles, says UK Report. Malay Mail [Internet]. 2015
Feb 17 [cited Apr 5 2019]. Available from: http://www.themalaymailonline.com/malaysia/article/malaysia-is-worldleader-
in-battling-hiv-spread-with-needles-says-uk-report

2 Status paper on availability & accessibility of diagnosis and follow up with MoH to remediate to the issues
highlighted in the paper. https://drive.google.com/file/d/1OQa83TDIGb4_39dFDlkt6oq_vbTcDL92/view

Cc Dr Anita Sulaiman
Ketua
Sektor HIV/STI/Hep C
Bahagian Kawalan Penyakit
Kementerian Kesihatan Malaysia
Aras 4, Blok E10, Kompleks E
Pusat Pentadbiran Kerajaan Persekutuan
62590 Putrajaya, Malaysia

YBhg. Dato’ Dr Muhamad Radzi Abu Hassan
Consultant Gastroenterologist & Hepatologist
Hospital Sultanah Bahiyah
KM 6, Jalan Langgar
05460 Alor Setar, Kedah

Signed by,

Organizations:
1. Crisis Home
2. Beyond Borders
3. Pengasih Malaysia
4. Persatuan Kebajikan Komuniti Ikhlas Malaysia
5. Persatuan Cahaya Harapan Negeri Kedah/Perlis
6. Persatuan Insaf Murni Malaysia
7. Pertubuhan Islah Movement
8. Perantaraan Pesakit Kelantan (Sahabat)
9. Pertubuhan Kebajikan Intan Zon Kehidupan
10. Positive Malaysian Treatment Access & Advocacy Group (MTAAG+)
11. SEED Malaysia
12. Treatment Action Group. N.Y.
.
Individuals:
1. Adzrin Mumin
2. Ahmad Kamar Pilos Abd Jalil
3. Azuan Az
4. Badrul Haffiz Yob
5. Dr Nason Tan Day Seng
6. Henry Koh
7. Haryati Jonet
8. Jaafar Daud.
9. Kartini Salmah
10. Kwan Wing Kien
11. Manis Chen
12. Md Rusli Md Ali
13. Md Khairu Che Imran
14. Mohd Afiq Mohd Khairi
15. Mohd Amirul Ikram
16. Mohd Azaha Hamid
17. Mohd Hafiz Abd Rahman
18. Mohd Rashid Hashim
19. Muhammad Aiman Mohd Nor
20. Norfaizal Mhd Asokomaran
21. Razali Ayub
22. Rosli
23. Sulastri Ariffin
24. Suzana Ahmad
25. Syariana Jane Kassim
26. Tan Wan Leong
27. Wan Kamariah Daud
28. Zainudin Amin

For further info contact Mr Edward Low

Address:
E-33A-02, 3 Two Square, No.2, Jalan 19/1, Petaling Jaya, Selangor.
Tel & Fax: 03-7931 2066
Email: mtaagplus@gmail.com

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