AT the start of the year, I wrote that the Prevention and Control of Infectious Diseases Act 1988 (Act 342) is “much outdated and antiquated”.

Act 342 is the principal legislation that provides for the prevention and control of infectious diseases in Malaysia. Enacted in 1988, it has remained much the same since.

It was enacted arguably at a time when public health was thought to have conquered infectious diseases. But the reemergence of infectious diseases – emerging infectious diseases (EID) – such as Severe Acute Respiratory Syndrome (2003), Ebola (2013) Middle East Respiratory Syndrome Coronavirus Infection (2014) and Zika (2016) in the last two decades as major public health concerns has called into prominence law as “an intervention tool to achieve particular public health goals. (see Scott Burris et al, Making the Case for Laws That Improve Health: A Framework for Public Health Law, The Milbank Quarterly, Vol. 88, No. 2, 2010 pp. 169-210).

The ongoing global Covid-19, caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is the worst EID of the century. This is in terms of incidence and number of deaths. Only the “Spanish flu” (1918-1919) had much higher case-fatality rates and far higher absolute number of deaths.

SAR-CoV-2 shares about 86% homology with the SARS virus from the SARS outbreak in 2003. The clinical and radiological manifestations of SARS and Covid-19 are very similar. But Covid-19 is much worse than SARS because of its higher reproductive number, and a high proportion of asymptomatic infections that amplify the outbreak through silent spread.

Therefore, although the infection fatality rate is lower than for SARS, the overall number of deaths is exponentially higher than SARS. (see Annelies Wilder-Smith and Sarah Osman, Public Health Emergencies of International Concern: A Historic Overview, Journal of Travel Medicine, 2020, pp. 1-13)

SARS was effectively eradicated in 2003 as a result of rigorous top-down pandemic responses, with about 8,000 cases and 800 deaths. Covid-19 is – well, how else to describe it – ongoing.

If law is an important intervention tool, then Act 342 of 1988 is – well, how else to describe it – outdated.

Health director-general Dr Noor Hisham Abdullah, alas, has said it too.

“This is an old Act, which has been in use for around 32 years now,” said Noor Hisham said at a press conference yesterday.

“Based on our experience during the Covid-19 outbreak, we feel that Act 342 has to be improved in order for it to be relevant to the current situation and also to technological enhancement,” he added.

Act 342 needs not only improvement, but a transformation – a reform – to become an essential intervention tool for creating the conditions for people to be healthy.

It should reflect at least three principles – duty, power, and restraint. First, it should impose duties on the government to promote health and wellbeing within the population. 

Second, it should afford public health authorities ample power to regulate individuals and businesses to achieve the communal benefits of health and security. 

Third, it should restrain the government from overreaching in the name of public health. (see Lawrence O. Gostin, Public Health Law Reform, Am J Public Health, 91(9), 2001, pp. 1365-1368)

Act 342 needs a wholesome revision, and not just in the form of the Prevention and Control of Infectious Diseases (Amendment) Bill 2021, which was tabled for its first reading in Parliament yesterday. The bill can be seen here.

This is not to say that the bill is not needed. It is, and necessary, because as Noor Hisham said, the provisions – taken from the Emergency (Prevention and Control of Infectious Diseases) Ordinance 2020, which has been annulled, have proven to be effective in curbing the spread of Covid-19 affecting more than 2.6 million Malaysians.

But more than that, our public health law needs to be strengthened to be robust, to deal with existing and reemerging infectious diseases, as well as to safeguard public health against new and emerging infectious diseases. – December 15, 2021.

* Hafiz Hassan reads The Malaysian Insight.

* This is the opinion of the writer or publication and does not necessarily represent the views of The Malaysian Insight. Article may be edited for brevity and clarity.