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By Dr Yolanda Augustin and Professor Sanjeev Krishna
The Global Health Crisis
Safeguarding a nation’s health and quality of life is putting a rapidly growing burden on public finances especially when daily scientific discoveries are delivering new answers for many diseases.
These discoveries are often made in high income countries but even there not all their citizens benefit equally.
Health remains a privilege for the few and recedes even further for many in the Global South.
The main barriers to wider access are the costs of diagnosis and treatments.
The World Health Organisation’s Council on the ‘Economics of Health for All’ calls for a radical shift: placing health at the heart of economic and social policy, not as a byproduct but as a central goal.
This means that the “Physical and mental wellbeing for all people must be a central goal of economies, not just a stepping stone to other objectives.”
How can the Global South deliver on the importance of maintaining health as a key pillar of economic growth?
Mariana Mazzucato’s ‘Entrepreneurial state: Debunking public vs. private sector myths’ dispels the fallacy that government should only regulate and leave innovation to the private sector.
She argues that it is time to move beyond the false dichotomy of public versus private, regulation versus innovation.
Instead, we must build ecosystems where governments, academia, industry, and civil society co-create solutions that are affordable, accessible, and sustainable for all.
Nowhere is this approach needed more urgently than for the health sector.
An Ecosystem for Health Innovation
What limits access to innovative therapeutics and diagnostics in Low-and-Middle-Income-Countries (LMICs)?
There is currently an almost inevitable domination of research and development agendas, and corresponding funding streams by nations with higher incomes.
Decolonizing healthcare means empowering countries in the Global South to set and lead their own research priorities.
These will reflect the patterns of endemic disease and their management pathways, often not fully understood from afar.
To accelerate equitable access for the sick, countries like Malaysia are pursuing bold policy reforms.
These include a strategic focus on sectors such as pharmaceuticals, medical devices, and digital health as part of Malaysia’s New Industrial Masterplan 2030.
Malaysia is also building capacity by investing in the next generation of scientists, clinicians, and innovators through targeted training and career pathways, ensuring sustainability, resilience and local development.
As part of the larger ASEAN community, Malaysia is fostering greater South-South collaborations and strengthening regional alliances for resource sharing, training and medical research.
Malaysia Leading Clinical Research in ASEAN
Clinical Research Malaysia (CRM), the Institute of Clinical Research (ICR) and the Institute of Medical Research (IMR) have been at the forefront of building a robust and leading clinical research ecosystem.
In 10 years, Malaysia has delivered over 2,500 clinical trials in oncology, infectious disease and non-communicable diseases.
This has expanded patient access to innovative therapies. It has also delivered over RM1.5 billion revenue for the economy.
Malaysia now has two First-in-Human (FIH) Phase 1 units at Sarawak General Hospital and Hospital Ampang.
These are world class facilities run by Malaysian doctors, nurses and pharmacists, delivering cutting edge research.
To date, 5 oncology FIH drug trials have been delivered at Sarawak General Hospital, a testament to the excellence of our clinical research teams.
International Affordable Diagnostics and Therapeutics Alliance
Prime Minister Daruk Seri Anwar Ibrahim delivered the opening address at Clinical Research Malaysia Trial Connect recently that saw over 1,000 delegates attend from all over Southeast Asia.
Noting the impressive achievements of Malaysia in clinical research to date, he called on all sectors to work together, to ensure equitable access to therapeutics and to enhance regional collaboration in ASEAN.
The International Affordable Diagnostics and Therapeutics Alliance (IA-DATA) was established to respond to this mandate.
IA-DATA is building strong inter-sectoral partnerships within government, academia, responsible industry and Civil Society Organisations (CSOs) to deliver affordable diagnostic and therapeutic solutions for neglected diseases, cancer and rare diseases that afflict ASEAN and the Global South. The Global North may benefit too.
Three main pillars of IA-DATA are affordable point-of-care diagnostics for neglected and threat diseases and affordable therapeutics through strategies such as drug repurposing and plant molecular farming.
Universiti Malaya together with Ministry of Health is working on diagnostics as part of a regional hub for pandemic preparedness.
These include diagnostics for neglected infections such as dengue, monkey malaria, leptospirosis and melioidosis that are an unmet need in rural communities especially in Sabah and Sarawak.
Malaysia has also established a South-South Diagnostics Alliance, working with partners from Thailand, Vietnam, Sri Lanka and Brazil.
Drug repurposing is the process of finding new therapeutic uses for existing or investigational drugs beyond their original, approved indications.
A consortium that includes academic teams from Universiti Malaya and Universiti Malaysia Sarawak will initially focus on repurposing a widely used and inexpensive antimalarial called artesunate for treating colorectal cancer, nasopharyngeal cancer and preventing cervical cancer.
Two Phase 2 clinical trials to repurpose artesunate are opening to recruitment at UM and Ministry of Health Hospitals across Malaysia in June 2025.
IA-DATA is also developing Plant Molecular Farming (PMF) to reduce the cost of cancer drugs. PMF is a cutting-edge bioproduction platform that uses genetically engineered plants to produce high-value therapeutics.
IA-DATA together with scientists at UM, UNIMAS and City St George’s University of London are making monoclonal antibody treatments affordable, thereby expanding patient access. Local industry will also benefit from these innovations.
Thailand already has their own Plant Molecular Farming facility, Baiya Pytopharm at Mahidol University.
It was set up to focus on rabies antibodies but during the pandemic it pivoted to vaccines and developed one of Thailand’s COVID-19 vaccines.
This is a great example of how innovate solutions can be developed in the Global South not just in the UK,US or Europe, which have typically been bastions of drug and biotech development.
Building Public-Private Partnerships in the Global South
Building synergistic alliances that share ideas, take risks and reap rewards, ensures that public investment translates into impacts for the public by providing greater access to lifesaving interventions.
Global South stands at a crossroads. Self-reliance inspired by local leadership, fostered through regional collaborations, and developing in a framework of bold policy reforms means that countries like Malaysia can lead a new era of health innovation.
Bridging the gap between discovery and delivery will ensure that no one is left behind. Although the challenge is formidable the path is clear: health for all is not only possible - it is an imperative. – May 11, 2025
Dr Yolanda Augustin is a Malaysian Clinical Oncologist at City St George’s University of London.
