Malaysia Society for Harm Reduction

06/11/2025

🌊 Bringing Health Closer to the Shores of Omadal Island

Over the past few years, our journey at Omadal Island, Sabah, has been nothing short of transformative. Under the Seaweed Cultivation and Health Awareness Project, supported by Yayasan Hasanah and the Kementerian Kewangan, we have worked hand-in-hand with the local community to strengthen healthcare access for one of Malaysia’s most remote and underserved island populations. Health Team’s final scheduled visit led by Assoc. Prof. Dr. Vivien How marked a significant milestone in our ongoing effort to bring health education, medical screenings, and capacity-building into community life.

Through this initiative, more than 300 residents have received direct health screenings and consultations — many for the first time — improving healthcare access and fostering lasting community health awareness. The highlight of this journey has been the empowerment of local residents trained as Community Health Helpers (CHHs) — individuals who now serve as the community’s first line of health support. Together, they’ve established a functional Community Health Hub, equipped with telemedicine capability, medication management training, and health education modules that continue to serve families across the island.

Special appreciation goes to ISKUL Sama DiLaut Omadal for their steadfast partnership and contribution in making this initiative truly meaningful. Their local knowledge and commitment to the children and families of Omadal have amplified the impact of our efforts in ways that numbers alone cannot describe.

As we move forward, we remain committed to sustaining and transitioning this model toward community-led healthcare — ensuring that even in the most distant corners, healthcare remains a right, not a privilege.

06/11/2025

Diabetes in the Malaysian Workplace

For millions of employees around the world, diabetes is a daily reality and for many in Malaysia, it’s a growing challenge that affects our workplaces every day.

One in six Malaysian adults (15.6%) lives with diabetes (NHMS 2023), and the number continues to rise, including among those under 40 years old. Many are of working age, juggling demanding schedules, long hours, and limited opportunities to manage their condition properly.

Unfortunately, stigma, lack of awareness, and inadequate workplace support often make things harder, leading to stress, absenteeism, or even medical complications that can be prevented.

Protective frameworks in Malaysia
- The Department of Occupational Safety and Health (DOSH) encourages workplace health surveillance and preventive occupational health services.
- PERKESO’s Health Screening Programme (HSP 3.0) provides free screening for non-communicable diseases, including diabetes, for eligible employees.
- The Ministry of Health (MOH) and its partners run nationwide NCD programs and maintain registries to improve disease control and prevention.
- Many NGOs — including the Malaysia Society for Harm Reduction (MSHR) — together with various universities, actively collaborate on health education and screening initiatives across the country.

These are good foundations but they require active engagement from both employers and employees.

What more can we do in the workplace?
- Make health screening a routine part of employment, not an afterthought.
- Introduce diabetes-friendly policies such as micro-breaks for glucose testing, flexible scheduling, access to healthy meals, and proper storage for insulin.
- Build awareness programs that reduce stigma and normalise conversations around diabetes and chronic disease.
- Encourage participation in PERKESO and MOH initiatives, and strengthen partnerships with local NGOs for preventive health activities.

Diabetes is manageable, but it requires understanding, flexibility, and shared responsibility. Let’s make our workplaces part of the solution — a place that supports health, inclusion, and well-being for everyone.

27/10/2025

Why Quitting Smoking Is Harder Than You Think

We don’t often talk about smoking in medical terms but we should.

Ni****ne addiction is a chronic, relapsing condition. Just like diabetes or hypertension, it requires management, monitoring, and ongoing support.
Telling someone with high blood pressure to “just think positively and stop having hypertension” would be absurd yet this is how we often treat smokers.

During the early years of Malaysia’s HIV epidemic, the message was simple: “Just stop risky behaviour.” But real life proved more complex. Telling people not to inject drugs or to simply avoid unsafe s*x didn’t make the problem disappear - honest, compassionate, evidence-based approaches did.
The same principle applies to to***co.

For many smokers, quitting cold turkey is not realistic. That’s why health experts worldwide now advocate phased approaches, combining:
• Behavioural counselling to manage triggers
• Ni****ne replacement therapies (patches, gums)
• Prescription medications that reduce cravings
• Harm reduction tools such as e-ci******es or heated to***co, which dramatically cut exposure to harmful smoke

Not every tool works for everyone. Some succeed through counselling. Others with medications. And many long-term smokers benefit from harm reduction as a bridge to eventual abstinence.

Smoking is not just a matter of willpower — it’s a matter of biology, psychology, and support.

When we begin to view smoking through that lens, we open the door to saving thousands of Malaysian lives every year.

Dr Anita Suleiman - founder and president of Harm Reduction Action Network (HaRAN).

For many people who have never smoked, quitting might look like a straightforward choice.

09/10/2025

World Mental Health Day 2025 | October 10

In Malaysia, mental health remains one of the most overlooked aspects of our well-being. According to the NHMS 2023, over 1,000,000 Malaysians aged 16 years and above are living with depression, a number that has doubled since 2019. Even more alarming, half of them have had thoughts of self-harm or of being better off dead.

Our younger generation is particularly vulnerable. One in six children in Malaysia experiences mental health problems:
- 46% have peer problems
- 25% have conduct problems
- 17% struggle with emotional difficulties
The rise in bullying, depression, and su***de among adolescents reported in the news is a painful reminder of how fragile the human mind can be and how urgently early intervention and empathy are needed.

Work-related stress have also become major contributors to declining mental health. Long working hours, constant performance pressure, and financial constraints leave many feeling overwhelmed, anxious and burnt out.

Beyond personal struggles, we are increasingly confronted by racial and community divides, irresponsible rhetoric, and the toxic amplification of hate on social media. Irresponsible voices often exploit sensitive issues, stirring emotions, provoking anger, and deepening divisions within our society. What begins as a difference of opinion can quickly spiral into hostility fueled by sensationalism, misinformation, and incensed commentary designed to provoke rather than unite. These manufactured tensions not only fracture our communities but also add to the stress, anxiety, and emotional exhaustion.

Across the world, wars and acts of cruelty continue to inflict unimaginable suffering, tearing families apart and shattering communities. It is deeply distressing, even unbearable at times, to witness such inhumanity born of reckless, senseless decisions. For many, simply watching these atrocities unfold feels mentally and emotionally overwhelming.

In this challenging world, perhaps the simplest yet most powerful thing we can do is to be there for someone. A small act, listening without judgment, offering a shoulder, or checking in on a friend can make a world of difference to someone silently struggling. Seeking help is never a sign of weakness!

What may seem small to us can feel overwhelming to someone living through it. As parents, partners, friends, and colleagues, let’s choose to be more perceptive, compassionate, and kind because sometimes, our presence alone can help someone find the strength to keep going.

A crisis is not defined by its size, but by the pain it brings to the one enduring it.

This World Mental Health Day, let’s start by being there for our loved ones by listening, understanding, and reminding each other that none of us have to go through life’s storms alone. Our strength as humans lies in our collective compassion. Let’s build a kinder, more supportive world, one conversation at a time.

05/09/2025

Hepatitis and Mental Health: A Call for Integrated Care

As we intensify global efforts to eliminate viral hepatitis by 2030, one crucial dimension remains under-addressed: the mental health of those affected.

A Bidirectional Impact
People living with Hepatitis B or C are at heightened risk of experiencing:
-Depression and anxiety
-Cognitive impairment from liver-related toxin accumulation
-Social isolation and reduced quality of life

This stems not only from physiological effects (the liver–brain axis) but also from the emotional burden of stigma, fear of discrimination, and inadequate psychosocial support.

Conversely, individuals with mental health conditions such as schizophrenia, bipolar disorder, or depression are more likely to contract hepatitis, particularly Hepatitis C, due to:
-Unsafe injecting practices
-High-risk s*xual behaviors
-Systemic neglect in prevention services
-Limited access to diagnosis and treatment

Despite this two-way relationship, hepatitis and mental health services continue to be delivered in silos. This fragmented approach leads to:
-Missed diagnoses
-Lower treatment adherence
-Worsened health outcomes
-Deepened stigma and isolation

The Way Forward: Integration & Inclusion
The World Hepatitis Alliance (WHA) calls for immediate reforms including:
✅ Routine hepatitis testing in mental health facilities
✅ Mental health screening and support in hepatitis clinics
✅ Peer support and destigmatization programs
✅ Integrated primary care strategies
✅ Cross-training of healthcare providers
✅ Accessible information for patients and caregivers
✅ Inclusion of people with lived experience in program design
✅ Research investments to close data and service gaps
✅ Civil society support to deliver outreach and frontline care

Malaysia has made commendable progress but to truly uphold the goals of equity and health for all, we must embed mental health support into every stage of hepatitis care, from testing and diagnosis to treatment and aftercare. This is especially vital for key populations such as:
-People Who Inject Drugs (PWID)
-Incarcerated populations
-Migrants and stateless persons
-Youth in vulnerable communities

People with lived experiences of hepatitis and mental health challenges bring crucial perspectives. Their stories illuminate the path toward more compassionate, inclusive, and human-centered care systems.

Let us not forget: hepatitis is more than a liver disease. It’s a public health, social justice, and mental health issue and our response must reflect that.

30/08/2025

🌿 Progress from the Sea: Empowering Omadal Island Through Seaweed Farming

Our seaweed farm on Omadal Island is beginning to take meaningful strides, slowly but surely.

Despite early challenges and some unexpected delays, the hard work of our seaweed experts, Dr. Nurleena Wong Wai Sin and Prof. Muta Harah Zakaria, along with the unwavering determination of the Omadal Island community, is now bearing fruit. The community has been trained in sustainable seaweed farming techniques and is receiving continuous coaching on managing the farm. The farm infrastructure is now fully established including a dedicated drying platform and cultivation has commenced on a considerable number of seaweed lines, large enough to sustain livelihoods for a significant number of community members.

Under the guidance of Dr. Illisriyani and Puan Syahneemn, locals have also been equipped with skills in marketing, commercialization, and financial management. They are now empowered to take charge of their own sales, maintain proper records, and ensure fair pricing through early-stage sales channels minimizing the role of middlemen and helping eliminate exploitative practices.

Our first harvest is expected between mid and late September. With ongoing support from local government agencies, university experts, and the strong will of the community, we hope this farm evolves into a cornerstone of sustainable income, while also creating pathways for seaweed-based product development and eco/agro-tourism opportunities.

This initiative stands as a quiet but powerful example of how science, partnership, and community resilience can create long-term change.

The Seaweed Cultivation and Health Awareness Program at Omadal Island, Sabah is a collaborative initiative between the Malaysia Society for Harm Reduction (MSHR) and Universiti Putra Malaysia (UPM), generously supported by Yayasan Hasanah and the Kementerian Kewangan.

30/08/2025

Selamat Hari Kebangsaan 2025 from MSHR!

Malaysia MADANI: Rakyat Disantuni – A theme that beautifully captures the true soul of our nation.

This Merdeka, we are reminded that independence is not merely freedom from colonisation, it is the celebration of our diverse cultures, identities, and dreams, flourishing side by side in unity.

Malaysia is at its best when every voice is valued, every community is respected, and every citizen is uplifted. The strength of our country lies in its vibrant tapestry of people different in language, faith, and origin, but united by shared hope and compassion.

Let this year’s theme not remain just a slogan, but a living promise where every rakyat is truly disantuni, embraced with dignity, and empowered to thrive. May this Merdeka be a celebration of inclusion, justice, and the freedom to live fully.

Selamat Hari Kemerdekaan ke-68!

03/08/2025

I don't feel sick, could I have hepatitis?

Get the Facts. Take Action.

03/08/2025

Hepatitis A – Preventable, But Not Yet Forgotten

While much attention is given to chronic hepatitis B and C, Hepatitis A (HAV) remains a public health concern, especially in communities with limited access to clean water, sanitation, and hygiene education.

Malaysia’s Landscape:
Hepatitis A is a self-limiting viral infection spread via the faecal-oral route, commonly through contaminated food or water. Thanks to improvements in public sanitation and health infrastructure, Malaysia has seen a significant decline in Hepatitis A cases from 2.24 per 100,000 in 2000 to 0.41 per 100,000 in 2013. However, outbreaks still occur, particularly in densely populated, underserved, or disaster-affected areas.

Who’s at Risk?
-Communities with inadequate sanitation or poor access to safe water
-Individuals consuming unhygienic or raw food
-Travellers to areas with high HAV endemicity
-Frontline workers, including food handlers, healthcare providers, and sanitation workers

What Can Be Done?
✅Promote personal hygiene, especially regular handwashing
✅Ensure safe food handling and clean water access
✅Improve WASH (Water, Sanitation & Hygiene) conditions in rural and high-risk areas
✅Vaccination is available and recommended for at-risk populations, travellers, and during outbreak response

Although Hepatitis A does not cause chronic infection, it can result in severe illness particularly in older adults or people with underlying liver disease. Sustained attention to food safety, environmental health, and targeted vaccination can help Malaysia eliminate Hepatitis A as a public health threat.

The Hepatitis A vaccine is a safe and highly effective inactivated vaccine given in two doses, six months apart. It offers over 95% protection and long-term immunity, often lasting decades. It is recommended for travelers, people with chronic liver conditions, healthcare and food workers, and communities with poor sanitation. While not part of Malaysia’s routine childhood immunization, it is available in private clinics and used during outbreak responses. Minor side effects are rare. Hepatitis A is fully preventable, speak to your doctor about getting vaccinated.

📚 Learn more:
WHO Hepatitis Overview - https://www.who.int/health-topics/hepatitis =tab_1
World Hepatitis Alliance – What is Viral Hepatitis? - https://www.worldhepatitisalliance.org/what-is-viral.../
Malaysia Ministry of Health – Hepatitis Case Study Report (PDF) -https://www.moh.gov.my/.../Umum/CaseStudy-HEPATITIS.pdf
MOH Malaysia – Hepatitis Educational Content - https://infosihat.moh.gov.my/mul.../flyer/tag/Hepatitis.html

Together, let’s help Malaysia eliminate Hepatitis C by 2030.

01/08/2025

Understanding the Unintended Consequences of Banning To***co Harm Reduction Tools in Malaysia

While the intention behind banning products like vapes or ni****ne alternatives is often to protect public health, it's important to reflect on the broader implications such policies may have especially in the Malaysian context.

According to recent studies, over 55% of ci******es sold in Malaysia in 2024 were illicit. In some regions like Sabah and Sarawak, this figure climbs as high as 80%. These illicit products are often significantly cheaper, lack safety oversight, and contribute to an estimated RM5 billion in annual tax revenue loss.

When safer, regulated ni****ne alternatives are banned or restricted:
- Consumers may still seek ni****ne through unregulated, black-market sources
- Health risks increase, as illicit products may contain unknown or harmful substances
- Enforcement becomes more complex, stretching limited resources
- Public health goals may be undermined, despite good intentions

What’s clear is that an evidence-based, balanced regulatory approach is needed. One that:
- Ensures product safety through proper regulation
- Informs and empowers consumers with safer options
- Supports enforcement efforts against illicit trade
- Protects both public health and national revenue

Let’s shift the conversation from bans to better regulation, aligning public health priorities with practical realities on the ground.

NielsenIQ Illicit Ci******es Study – May 2024
Illicit ci******es made up 54.8% of the market share in Malaysia in 2024.
https://www.batmalaysia.com/content/dam/endmarkets/my/en/download/sustainability-and-responsibility/Illicit-Ci******es-Study--ICS--In-Malaysia--May-2024-Report.pdf

To***co Reporter (June 2025)
Malaysia loses RM5 billion annually in tax revenue due to illicit cigarette trade.
https://to***coreporter.com/2025/06/16/malaysia-losing-1-2b-to-illicit-ci******es/

Free Malaysia Today (February 2025)
Illicit cigarette sales account for 80% in some parts of East Malaysia (Sabah & Sarawak).
https://www.freemalaysiatoday.com/category/nation/2025/02/26/80-of-ci******es-sold-in-east-malaysia-illicit-says-to***co-firm

BMJ To***co Control (2024)
A peer-reviewed study found illicit ci******es made up 41.1% (2011), 52.7% (2015), and 70% (2019) of Malaysia’s market—highlighting how tax policy and weak enforcement fuel black market growth.
BMJ To***co Control – https://to***cocontrol.bmj.com/content/34/2/242

IEA UK (2025)
Over-regulating or banning safer ni****ne alternatives can push consumers toward illicit markets, increasing health risks and revenue loss. Balanced regulation is essential.
IEA UK – The Black Market for To***co is Out of Control
https://iea.org.uk/the-black-market-for-to***co-is-out-of-control

***coControl

This article was first published on the Institute of Economic Affairs Substack. Official figures recently published by HMRC indicate a huge … Continue reading "The black market for to***co is out of control"

01/08/2025

Could I pass hepatitis on to my baby?

Get the Facts. Take Action.

01/08/2025

🧬 Hepatitis C (HCV) – A Curable Yet Underdiagnosed Public Health Challenge in Malaysia

Hepatitis C is a viral infection that attacks the liver, and if left untreated, can lead to chronic liver disease, cirrhosis, liver failure, and liver cancer. While it is one of the most curable infections in modern medicine, it remains largely undetected and untreated, especially in Malaysia.

-An estimated 400,000–453,700 Malaysians (≈ 2–2.5% of adults) are living with chronic Hepatitis C
-The majority were infected via unsafe injection practices, particularly among people who inject drugs (PWID)
-Case notifications rose steadily from 2010, peaking in 2016, but many infections still go undiagnosed due to lack of symptoms
-Infections are often discovered only after serious liver damage has occurred
-Most Malaysians infected with HCV are unaware of their condition, and only a small fraction have received treatment

HCV is primarily spread through blood-to-blood contact. Common routes include:
-Sharing contaminated needles or syringes (especially among PWID)
-Receiving unscreened blood transfusions (especially before the 1990s)
-Exposure to unsterile medical, dental, or tattoo equipment
-Less commonly, through unprotected s*x or mother-to-child transmission

Most people with Hepatitis C experience no symptoms for years. When symptoms do appear, they may include fatigue, abdominal pain, dark urine, or jaundice.

A simple blood test (anti-HCV antibody) can detect exposure. Confirmatory RNA testing is needed to assess active infection.

Hepatitis C Is Curable
-Thanks to Direct-Acting Antivirals (DAAs), Hepatitis C is now curable in over 95% of cases, with a treatment duration of just 8–12 weeks.
-Treatment is available through public healthcare facilities
-Malaysia issued a compulsory license for sofosbuvir in 2017, making treatment more affordable
-In collaboration with WHO, FIND, DNDi, and MAC, Malaysia has piloted HCV self-testing and expanded decentralized care through primary health clinics
-Launched pilot self-testing programs to expand community-based detection
-Advocated inclusion of ravidasvir, a regional innovation, into the WHO Essential Medicines List in 2023

✅ What You Can Do
-Get tested — especially if you belong to a high-risk group
-Encourage friends and family to talk to their healthcare providers
-Support access to care and reduce stigma by sharing accurate information

📚 Learn more:
WHO Hepatitis Overview - https://www.who.int/health-topics/hepatitis =tab_1
World Hepatitis Alliance – What is Viral Hepatitis? - https://www.worldhepatitisalliance.org/what-is-viral.../
Malaysia Ministry of Health – Hepatitis Case Study Report (PDF) -https://www.moh.gov.my/.../Umum/CaseStudy-HEPATITIS.pdf
MOH Malaysia – Hepatitis Educational Content - https://infosihat.moh.gov.my/mul.../flyer/tag/Hepatitis.html
Together, let’s help Malaysia eliminate Hepatitis C by 2030.

Get the Facts. Take Action.