ABSTRACT
IntroductionAs of 3rd June 2021, Malaysia is experiencing a resurgence of COVID-19 cases. In response, the federal government has implemented various non-pharmaceutical interventions (NPIs) under a series of Movement Control Orders and, more recently, a vaccination campaign to regain epidemic control. In this study, we assessed the potential for the vaccination campaign to control the epidemic in Malaysia and four high-burden regions of interest, under various public health response scenarios. MethodsA modified susceptible-exposed-infectious-recovered compartmental model was developed that included two sequential incubation and infectious periods, with stratification by clinical state. The model was further stratified by age and incorporated population mobility to capture NPIs and micro-distancing (behaviour changes not captured through population mobility). Emerging variants of concern (VoC) were included as an additional strain competing with the existing wild-type strain. Several scenarios that included different vaccination strategies (i.e. vaccines that reduce disease severity and/or prevent infection, vaccination coverage) and mobility restrictions were implemented. ResultsThe national model and the regional models all fit well to notification data but underestimated ICU occupancy and deaths in recent weeks, which may be attributable to increased severity of VoC or saturation of case detection. However, the true case detection proportion showed wide credible intervals, highlighting incomplete understanding of the true epidemic size. The scenario projections suggested that under current vaccination rates complete relaxation of all NPIs would trigger a major epidemic. The results emphasise the importance of micro-distancing, maintaining mobility restrictions during vaccination roll-out and accelerating the pace of vaccination for future control. Malaysia is particularly susceptible to a major COVID-19 resurgence resulting from its limited population immunity due to the countrys historical success in maintaining control throughout much of 2020.
ABSTRACT
OBJECTIVES: The aim of this study was to provide a comprehensive overview of the evolution of health technology assessment (HTA) in Malaysia over the past decade. METHODS: We described the evolution of HTA program in Malaysia based on review of administrative data, publicly available information and quantitative description of impact evaluation. RESULTS: Health Technology Assessment HTA was formalized in Malaysia in 1995 as a central structure within the Ministry of Health, Malaysia in 1995. Expansion of activities demonstrated over the years including Horizon Scanning of health technologies and implementation of evidence-based Clinical Practice Guidelines. Improvement on the processes in terms of types of report, quality, monitoring, and impact evaluation as well as accessibility was also carried out. Examples of impact/influence of the reports have also been demonstrated. CONCLUSIONS: HTA program in Malaysia has evolved over the past decades. Its role in policy formulation and decision making of health technologies has become more significant over the years and is foreseen to be bigger in the future. As a trusted source of evidence, HTA in Malaysia will continue to strengthen the health system by advocating informed decision making and value-based medicine. As other countries in this region is trying to establish their own HTA processes and procedures, this review on the evolution of the HTA program in Malaysia might give some insights on developing a sustainable HTA program.
