Malaysia’s Health Czar Under Fire

Critics charge mismanagement, authoritarian behavior

A widening chorus of critics charges that Malaysia’s Director-General for Health, Noor Hisham Abdullah, has badly mishandled the country’s approach to the Covid-19 virus while fostering a cult of personality around him and aggrandizing his importance, almost rendering him out of control.

The pandemic has now affected at least 5,532 victims and caused 93 deaths although the critics charge that delays and miscues in testing and tracking, which are crucial to reining in the virus, have made the numbers meaningless. Tests now are being conducted on 3,515 subjects per million of population, compared to 16,203 per million in Singapore, for instance, with more than 1,000 cases per day currently being discovered in the city-state compared to only double figures in the whole of Malaysia.

Noor, who is also the chairman of the Malaysian Medical Council (MMC), has become the frontman for the campaign, a budding public star who exhibits a thoughtful demeanor and a deadpan delivery as he describes the developments in the campaign against the virus. But the critics charge the ministry’s complacency borders on negligence.

Last year, Noor was associated with allegations reported by Asia Sentinel of a cover-up of systemic corruption in MMC disciplinary hearings which allowed doctors accused of gross professional misconduct to go free of sanctions.

Malaysia’s first cases were confirmed on January 25 in visitors from Guangdong and Wuhan (case number 4) in China, which most experts agree was the source of the original outbreak. Only two days before, on January 23, Wuhan had been placed into full lockdown affecting 11 million people following the Chinese government’s acknowledgment that a life-threatening epidemic was underway. Other local cases emerged slowly from unknown sources, suggesting that the virus had found other entry points and community transmission pathways. Nonetheless, critics say, despite having identified cases directly from the source city and with evidence of localized infection and transmission, Noor and his team at the health ministry made few if any emergency preparations.

This lack of prior preparation between the first outbreak and the national lockdown, formally known as the Movement Control Order, which wasn’t issued until March 18 – 53 days later – resulted in shortages of personal protective equipment (PPE), ventilators, beds and above all testing and tracking equipment, which many claim may have cost the lives of dozens of people.  

Indeed, as late at April 17, Noor had only just sourced and ordered rapid test kits from Korea almost three months after the first cases and one month into the national lockdown. During this period of inactivity, on February 12, by which time the WHO was reporting 45,171 cases globally, the then-Health Minister, Dzulkifly Ahmad announced in direct contradiction to WHO advice issued the previous day that public gatherings in Malaysia would not be banned. Noor appears to have played a central role in delivering advice to go ahead with the event, a religious affair that focuses on persuading Muslims to return to practicing their religion.

That decision was to prove a disaster for the management and spread of Covid-19, leading to thousands more cases and at least 20 deaths.

The Tabligh disaster

On the same day that Dzulkifly announced the ministry's decision to allow mass gatherings, approval was given to the international religious convention of up to 16,000 people at a mosque in Sri Petaling in Kuala Lumpur from February 27 to March 3.

That was to be the source of the largest single outbreak of the disease with 1,963 people testing positive and 20 dead. In total 27,522 people were tested as the participants came into contact with others in the wider community. A huge expense of scarce resources was wasted involving the police in tracking down thousands of participants, some of whom have still not been identified. The number of tests took up almost 30 percent of the total number across the whole population.

Multiple other clusters were linked to the Tabligh including a wedding in which 135 guests tested positive, 44 of whom were health workers. Many of the clusters involve tahfiz religious schools – schools specializing in memorizing the Quran – requiring additional testing of 9,842 students.

Post-Tabligh panic

Public and political commentators found a ready group of politicians to blame for the Tabligh disaster, which took place around the same time as the collapse of the Pakatan Harapan government and ended Dzulkifly’s tenure as health minister.

The later revelation that the approval had been given two weeks earlier has exposed a different story in which Noor takes a central but so far unexplained role. Dzulkifly immediately pointed the finger at the then-Home Minister, now Prime Minister, Muhyiddin Yassin although his deputy Lee Boon Chye contradicted that. Lee acknowledged that the health ministry had known of the event but had not banned it or issued any public health warnings because they did not know of any foreign participants, claiming further that there was no local community transmission among Malaysians to raise any concerns.

In truth, the Tabligh is an annual international event well known to the government.  Carriers of the Covid-19 virus with no travel history had already been identified. The then-federal territories minister Khalid Samad, whose department had issued the road closure permits, said his department would not have done so if they had known the government was going to collapse.

All three appeared reluctant to discuss the director general’s role in these decisions or to cite Noor as the source of the advice that the mass gatherings could go ahead. Local media in turn have notably refrained from asking Noor for clarification on the issue of whether he advised that the event could proceed.

Cult of personality

Part of the reason for that appears to be Noor’s surprising public popularity, with local, seasoned journalists writing uncritical valentines to him. Reports have appeared of children sending him gifts. There was a public celebration of his 57th birthday. Even veteran politician Lim Kit Siang, leading figure of the opposition Democratic Action Party, called for him to be named Health Minister. He has been given the same accolades as Anthony Fauci, the central figure in the US campaign against the virus.

However, in early April, that started to come apart. A private-sector physician accused him of “living in an ivory tower” and his ministry of failing to protect medical front-liners following reports that lack of personal protective clothing had left 30 healthcare workers testing positive.

Public attacks exploded against his detractor, calling for him to be sacked from his job. On April 14, however, Noor was forced to acknowledge that there was only personal protective equipment to last for 14 days. He offered no apology, with critics complaining that cyberbullies were protecting him. One social media critic adopted the moniker “Anonymous – for fear of persecution.”

Power grab and humiliation

Noor was given unprecedented control over managing the lockdown. On March 16, he was criticized for advising the lockdown in the first place. On April 9, he rejected a call by 14 former presidents of the Malaysian Medical Association for a staged wind-down of the first phase of the MCO. Instead, it was extended with even greater powers granted to him without referral to political leaders.

On April 17, the Malaysian Attorney General, Idrus Harun, intervened following the revelation that Noor had been granted power under the second phase of the MCO to circumvent the judiciary by issuing fines without trial to people alleged but not proven to have breached the lockdown. Idrus summarily revoked those powers the following day.

Multiple ministers in the new ruling Perikatan Nasional government, which took power on March 2, have been humiliated for attempting to rein in Noor. Adham Baba, the Health Minister and his immediate superior, has been effectively sidelined and ridiculed, although largely of his own making, allowing Noor unfettered power.

The Senior Minister in the Prime Minister’s Office and effective Deputy Prime Minister, Azmin Ali, was forced to announce that “all MCO-related economic decisions went through the Health Ministry” in areas previously under his sole authority. Noor, for instance, summarily dismissed an appeal by the Higher Education Minister to allow 80,000 healthy students confined in university hostels to be allowed home.

Even Muhyiddin has seen government policy rescinded or effectively sabotaged by Noor’s rulings. After the premier had announced on national television that the Movement Control Order (MCO) would be eased, Noor publicly contradicted him, disagreeing with the decision. Later, he effectively sabotaged a Health Ministry order requiring prior testing of all employees for firms opening up under the prime minister’s new regulations, delaying the reopening for two weeks pending the testing process. Former ministers have also not escaped humiliation as the spat around his former boss Dzulkifly has shown.

Noor now appears to be untouchable, a growing chorus of critics say. Former ministers fumble for excuses to cover up his failure to advise them to ban the Tabligh, which caused thousands of infections and dozens of deaths. Almost every day he identifies new, previously ignored at-risk groups which are used to justify the lockdown for weeks or months to come.