The Galen Centre for Health & Social Policy, an independent public policy research and advocacy organisation based in Kuala Lumpur, is strongly concerned over the amendments proposed by the Government for the Prevention and Control of Infectious Diseases Act (PCIDA) 1988 (Act 342), also known as RUU 342.
“These punitive measures may potentially create double standards, victimise vulnerable groups, and lead to poor public health outcomes,” said Chief Executive Azrul Mohd Khalib.
The proposed amendments currently include increasing the maximum compound from RM1,000 to RM 5,000 currently on individuals violating this law. It also empowers an officer to order an individual infected or believed to be infected with a disease or any close contact to wear or use a tracking device, while significantly increasing the powers and authority of the Director General of Health during a public health emergency.
"Punitive measures would disproportionately hit the most vulnerable members of society, particularly those from lower-income households and other disadvantaged socioeconomic backgrounds. This could exacerbate corruption, lead to criminalisation, double standards, and discrimination against the affected," he said.
He also cited the COVID-19 crisis as an example of such disastrous effects and said that increased penalties would work against managing contagious diseases, instead of enforcing health guidelines.
The National Health and Morbidity Survey 2019 revealed that one out of three Malaysians possessed low health literacy. Based on this, Azrul pointed out that people were unlikely to understand disease prevention activities, health promotion, or healthy lifestyle practices.
"People should not be punished for something they do not fully understand," he said, adding there must be increased investment in health education and promotion.
"Unfortunately, people are being treated differently when it comes to SOP compliance. Government officials and politicians are usually fined lightly or escape penalties due to non-compliance altogether. Imposing heavy fines as big as RM5,000, which is more than three times the minimum wage, would be sending many into prisons for failure to pay," he said, adding that smaller fines and short detention periods were enough of a deterrent without being overly punitive.
"Even with the penalties under the existing laws, general adherence and compliance among the Malaysian public were very high and were seen with admiration by many countries, particularly in the West," he said.
Azrul said that fines, imprisonment, or quarantine measures within limits, and the harsh legislations often curtail public health in most public health emergencies by acting as a deterrent to people coming in for testing, and concur with SOPs barriers, care, prevention, testing, and treatment. "They end up doing more harm than good," he said.
He added that harsh penalties could also serve to discourage people from seeking the medical attention they need, out of fear of what may happen to them in turn. "Studies and our own experiences show that the use of fear, intimidation and threats of punitive penalties during a public health emergency creates stigma, discrimination and victim-blaming. Rather than coming forward for treatment, people may hide their illnesses," said Azrul, encouraging a more humane approach.
"Hard-earned lessons from previous pandemics have shown that good information, cooperation, empathy, and compassion reduce suffering, protect public health, and save lives,” he said.