Medical products confer enormous benefit to health but also have potential harmful effects, either through their inherent properties or through misuse and abuse. This chapter analyses the role of medical products in the Malaysian healthcare system over a 60-year period. It covers issues of access and affordability alongside those of safety and quality. The initial period focused on ensuring a reliable supply of medicines and vaccines through import, storage, distribution and dispensing. Concerns about safety led to the evolution of national registration of medicines and human resource and governance issues around building capacity for monitoring and enforcement. Subsequent development of the health system experienced growing capacity for local manufacture, appearance of counterfeit medicines in the marketplace, and required strengthening of regulatory systems through international collaboration. Also included are purchase effectiveness, cost of medicines and pricing mechanisms. Systems analysis highlights the conflict between cost of medicines and the advancement of Universal Health Care and illustrates the use of Right to Government use to reduce inequities in access.

Within the first 30 years since independence, Malaysia successfully eradicated or drastically reduced the occurrence of several serious communicable disease. During the second 30 years, Malaysia had some success as well as limited or no progress in dealing with non-communicable diseases, re-emerging diseases such as dengue, and other new and emerging diseases such as influenza H1N1. This chapter analyses the development and evolution in order to identify key features that contributed to the success or limited the progress of control efforts. The discussion covers issues such as design of surveillance and control programmes, the role of ‘vertical’ and integrated approaches, and the limitations faced by the health system in trying to adapt from controlling communicable to non-communicable diseases. The influence of interactions between components of the healthcare system such as the workforce, primary and secondary care, environmental health services, medical products and vaccines is illustrated.