Independent writing on medicine, public health and health policy — with a Malaysian and regional perspective.
Researched from primary sources and written by Dr Muruga Vadivale,
who has been writing about medicine online since 1995.
About Kerbside Consult and how I work →
All articles — 2026
48/2026 · 10 October 2026Artificial intelligence is moving beyond answering questions to producing mathematical results, proposing scientific hypotheses and designing potential medicines, but generating a promising result and establishing a discovery are not the same thing. In October 2026 OpenAI released a collection of mathematical results from an internal frontier model, with Lean formalisations of many of the proofs, and Biohub announced an approximately US$1.8 billion expansion of its Virtual Biology Initiative. This article asks whether AI can contribute genuinely new scientific knowledge. It starts with a 1998 Vertex neural-network paper to show that computational discovery is decades old, then looks at why a checked proof is not the same as an important one, how AlphaFold 3 and rentosertib, an AI-discovered drug for idiopathic pulmonary fibrosis, show the distance between a prediction and a treatment, and who is actually paying for the virtual-cell effort: about US$300 million of the total comes from Google DeepMind, Isomorphic Labs and Meta. It then turns to what this could mean for Malaysia, from disease registries and trial feasibility to local data and governance, and why the scientist remains in the laboratory. It is careful about the difference between a hypothesis and a fact, and between a result generated by AI and one that survives independent scrutiny.
AI may help us discover what we did not know. Science must still establish whether what we have discovered is true.
47/2026 · 10 October 2026Medical AI can now answer examination questions, draft differential diagnoses and explain a pathology report with impressive fluency, so how good is it, really? A new initiative, the Medical AI Superintelligence Test (MAST), tries to answer that by scoring models across diagnostic reasoning, management reasoning, safety, radiology and medical images instead of setting yet another examination. On its general leaderboard, last updated on 8 October 2026, the leading general-purpose models cluster around 60%, with the highest composite at 60.2%. This article asks what that number does and does not mean: why an equal-weight harmonic mean punishes uneven performance, why one model can score 75.7% for diagnostic reasoning and 43.3% for medical images, and why a composite score is not a clinical error rate and not a measure of how safely an AI would practise medicine. It looks at why diagnosis is only the beginning of managing a patient, why the benchmark is not the bedside, and why “which AI is best?” may be the wrong question when the better one is how good it is at the particular task you are asking it to do. It is careful about the difference between answering structured questions, performing clinically relevant benchmark tasks and improving outcomes in real patients, and notes that the leaderboard is still in preview and its scores may change.
Medicine is not a single cognitive task—and intelligence is not a single score.
46/2026 · 10 October 2026How did a company founded in Pune in 1966 become so important to global immunisation, and what can Malaysia learn from its experience? I first heard of the Serum Institute of India (SII) during my Aventis years and met it again as a regional partner at Novavax, and my one regret is that I never visited its plant in Pune. This article follows SII from antitoxins and antivenoms to routine childhood vaccines, and looks at why affordability and quality-assured supply matter, MenAfriVac and MenFive in meningitis, the company-reported donations, its COVID-19 role through Covishield and Covovax, and the R21/Matrix-M malaria vaccine developed with Oxford and Novavax. It then turns to the economics of vaccine manufacturing and what Malaysia and ASEAN can realistically take from a capability built over decades, including the difference between fill-and-finish and end-to-end development. It is careful about the difference between company-reported figures and independently verified ones, and about the difference between developing, manufacturing and distributing a vaccine. It carries an editorial independence and disclosure statement.
The real measure is not simply the number of doses produced. It is whether safe, effective, quality-assured vaccines reach the people who need them.
45/2026 · 9 October 2026When a child is obese, is it the child, the parents, the environment, or has obesity itself become the disease? On 7 October 2026 the World Health Organization released its first global guidelines on the integrated management of obesity in children and adolescents, and NHMS 2024 found that more than one in four Malaysian children and adolescents aged 5–19 were overweight (14.4%) or obese (13.6%). This article looks at how childhood obesity is defined, why blame is such a poor treatment, the part played by biology, families, schools and the wider environment, the growth-chart clues that should prompt a search for another cause, the complications and stigma that come with it, and what structured, family-based care involves at different ages. It then turns to the new obesity medicines, including why an overseas approval is not a Malaysian indication, their side effects, and the narrow place of bariatric surgery in severe adolescent obesity. It is careful about the difference between WHO’s international guidance and what Malaysian product information and the 2023 national guideline actually say.
Treat the disease. Support the family. Change the environment. Protect the child.
44/2026 · 8 October 2026The 2026 Nobel Prize in Physiology or Medicine recognised optogenetics, and I admit my own tube light did not quite go on at first. This article follows the story from a single-celled green alga to channelrhodopsin, the light-gated channel that Nagel and Hegemann helped establish, and then to the 2005 experiment that put it into mammalian neurons. It explains what optogenetics is, why it changed neuroscience, and what it has taught us, and looks at the one clear human proof-of-concept, partial visual recovery in a patient with advanced retinitis pigmentosa. It asks why the eye came first, why treating the brain is so much harder, and why the larger legacy may be indirect, with discoveries made with light guiding other treatments. It is careful about the difference between understanding a disease circuit and treating a patient.
Optogenetics does not necessarily have to become the treatment to change the treatment.
43/2026 · 8 October 2026A British newspaper has described an “American COVID” variant spreading in the United Kingdom, with a list of symptoms attached. The label is misleading, and the more interesting story lies elsewhere: SARS-CoV-2 continues to evolve, vaccine manufacturers can update their products to circulating lineages, and yet the surveillance that should inform those decisions has become less comprehensive. This article looks at the XFG lineage and what a share of submitted sequences can and cannot show, why a variant is not a nationality, how WHO’s retention of LP.8.1 sits beside the XFG choices of the US FDA and the European Medicines Agency for 2026–2027, what antigen selection means for the manufacturers who must plan around it, how mRNA and recombinant protein platforms compare, and what all of this means for Malaysia. It is careful about the difference between a share of sequences and a share of infections.
We are getting better at updating vaccines. Are we becoming less certain about what the virus is doing?
42/2026 · 7 October 2026Scams and online abuse in Malaysia, set out as a practical guide. Bank, government and family impersonation, phishing and malware, investment, shopping and job scams, love scams, sextortion and AI-fabricated images, and cyberbullying: for each, what to do before it happens and what to do after. The first minutes after money is sent (the bank, its Kill Switch, NSRC 997 and a police report), the checks that help, how families can respond without humiliation, a safety plan for older people and those living alone, a contacts table, and where Malaysian law stands. It is careful about the difference between a law that has passed Parliament and a law in force: at 7 October 2026 a gazetted commencement date for the Cybercrimes Bill 2026 could not be verified.
Before you press send, make one independent call.
41/2026 · 7 October 2026 · Updated 10 October 2026A 28-year-old laboratory worker at the Irkutsk Anti-Plague Research Institute died on 2 October after developing pneumonia of unknown aetiology. WHO is looking at possible pneumonic plague; Russia has told WHO that no plague cases have been recorded in Irkutsk. Plague was being considered. It had not been confirmed. This article is about the stage before the diagnosis: what “unknown origin” means, how clinical assessment, exposure history, laboratory testing and contact tracing fit together, why precautions and treatment may begin before confirmation, and why nearly 200 contacts were placed under observation. It also looks at Wu Lien-Teh, the Penang-born doctor who confronted the Manchurian pneumonic plague epidemic of 1910–11, Malaysia’s own plague history and notification rules, and what we still need to know. It is careful about the difference between a signal, an investigation and a diagnosis.
The absence of a detected outbreak and the absence of an explanation are different findings.
40/2026 · 5 October 2026In July 2006 I wrote about medical research and the Ninth Malaysia Plan. Twenty years later, this article asks three questions: what did we build, what did we learn, and what did it change? It traces the foundations, from the first Malaysian Good Clinical Practice guideline in 1999 to the national research register, Clinical Research Malaysia and the Institute for Clinical Research, then sets that machinery beside what the national health surveys show: overweight and obesity, diabetes and hypertension are still with us. It looks at the distance between research and better health, what COVID-19 and the vaccine ambition tested, and Malaysia’s move upstream into early-phase research. It is careful about what study counts and survey figures can and cannot show.
What are we doing with what we know?
39/2026 · 5 October 2026A bottle, a shirt and a car tyre belong to the same story: plastic that fragments or sheds into particles and travels through water, food and air. Particles have been reported in human blood, brain tissue and arterial plaque, and a 2024 study linked plaque plastics with later heart attack, stroke or death. This article sets out what those studies show and what they cannot, with Malaysian bottled-water and semen studies, the seafood question, why there is no clinical test and what a doctor should say, and then returns upstream to what households, industry and government can prevent. It is careful about the difference between a policy target and a result.
How much of it needed to get there in the first place?
38/2026 · 4 October 2026Vads Corner went online on 12 October 1995, Cybermed began in Berita MMA in March 1997 and Kerbside Consult in August 2026. Asked how much I have actually written, I counted — and found that reading the old pages was more interesting than counting them. A personal retrospective on getting online when that was itself a task, on building a one-stop site for medical resources, on columns that aged better or worse than others, and on why the question has moved from finding information to deciding what it means. It is careful about what the counts do and do not include: indexed columns and pieces, not a complete lifetime bibliography.
There is probably another article in that.
37/2026 · 4 October 2026Twenty billion ringgit is large enough to become almost meaningless. On 9 July 2026 the Government told Parliament that, after RM31.3 billion in recoveries and assuming no further recoveries, the remaining net burden of 1MDB-related obligations is about RM20.1 billion. This article translates that figure into the scale of Malaysian healthcare and of an ordinary household: about 43% of one year's Ministry of Health allocation, almost three times its development budget, the equivalent of some 428 clinics the size of the one planned for Rantau, and roughly RM584 for every person in Malaysia. It is just as careful about what the comparison is not: there is no evidence this money was ever earmarked for healthcare, and the figures illustrate scale, not loss.
At the kerbside, it is opportunity. And opportunity has a cost when it is lost.
36/2026 · 4 October 2026In December 1997 I wrote about a bird virus that had crossed into humans in Hong Kong. Since then there have been two pandemics, and neither was the H5N1 we were watching: the first was a swine-origin H1N1, the second was not influenza at all. Today H5N1 is still with us, and an October 2026 paper in Emerging Infectious Diseases points to reassortment in older Asian lineages as a possible, but unproven, driver of spillover. This article asks what reassortment is, why most of it goes nowhere, what the evidence does and does not show, and whether Malaysia's animal, environmental and human surveillance connects quickly enough.
We do not need to predict the next pandemic perfectly. We need to be ready when the virus reveals itself.
35/2026 · 4 October 2026Reports of medical officers not reporting for permanent postings in Sabah and Sarawak invite blame, but the figures are still provisional until the 7 October reporting deadline. This article asks a better question: how do we make doctors want to go, and make it worthwhile for them to stay? It looks at the family, postgraduate training, connectivity, the cost of an empty post and what a rural medical officer offer worth accepting might look like.
Compulsion may get the doctor to report. Opportunity, support and belonging may make the doctor stay.
34/2026 · 3 October 2026Malaysia’s Fifth Edition of Good Clinical Practice is a reason to look back. From ICH E6 and Malaysia’s first national guideline in 1999, through E6(R2)’s focus on risk, to E6(R3)’s quality by design, this article traces how GCP changed what researchers are expected to plan and oversee in a trial, and why the purpose has not changed: protecting participants and producing trustworthy evidence.
Good Clinical Practice was never meant to mean more paperwork. It was meant to mean better research.
33/2026 · 3 October 2026Twenty years after Yamanaka showed that an adult cell could be reprogrammed, iPS-derived cells are being used to make heart muscle, replace dopamine-producing neurons, manufacture platelets and engineer immune cells to attack cancer. This article looks at what has reached patients, what Japan's 2026 conditional approvals do and do not establish, and why making the right cell, consistently and safely, is the real challenge.
The future of medicine may not only be about finding the right drug. It may also be about manufacturing the right cell.
32/2026 · 1 October 2026El Niño is forecast to return, and Malaysia has been here before. The 1997–98 and 2015–16 events brought drought, haze, heat and water stress, and the health consequences extended well beyond the weather itself. This article looks at what those episodes taught us about heat illness, dengue and other vector-borne disease, haze, water and food security, and what households, clinicians and health services can do to prepare.
The climate hazard may be natural. The size of the health disaster is not predetermined.
31/2026 · 1 October 2026West Nile virus is making news in Italy again, with more than 1,500 locally acquired human infections reported across 16 European countries. Twenty-seven years after the 1999 New York outbreak, the question for Malaysia is closer to home: researchers have reported viral RNA in our birds, mosquitoes, bats and horses, but what that means for human illness is much less certain. Why the animal, mosquito and patient findings need connecting, and what clinicians and laboratories can do before an outbreak.
Do not wait for the outbreak. Connect the animal, mosquito and patient findings, and test what is suspected.
30/2026 · 29 September 2026Consumer genetic testing can illuminate ancestry, reconnect families and reveal medically important information. It can also contradict the documentary family tree, uncover relationships no one expected and allow an untested person to be narrowed to a likely identity through relatives. This article examines autosomal DNA, Y-DNA, mitochondrial DNA and SNPs — and the questions they raise about health prediction, consent, ownership, security and genetic privacy.
Your genome may be uniquely yours. The information contained within it has never belonged to you alone.
29/2026 · 29 September 2026A 31-year-old man from Kubang Pasu was reportedly bitten by a stray dog in August, did not receive post-exposure prophylaxis, and died of rabies — the first human case in Kedah since 1998. This article sets the case against Malaysia’s rabies history and Sarawak’s continuing outbreak, and explains the first consultation, vaccine and immunoglobulin, the window after exposure, and what prevention needs from health services, veterinarians and communities.
Every bite deserves an assessment. Every community deserves prevention.
28/2026 · 25 September 2026The science and business of longevity — what biological clocks, experimental medicines and supplements can tell us, what human trials have actually shown, and which established measures help protect health and independence. An examination of healthspan, lifespan and the evidence behind the promise of more healthy years.
A longer life is valuable largely because of what can still be done with it.
27/2026 · 25 September 2026Memory may change with age. Dementia is different: it causes an acquired decline that interferes with independent everyday life. This article explains the warning signs, treatable mimics, assessment and treatment, sundowning, caregiver support, care choices and advance planning — with Malaysian services and practical guides for families.
A diagnosis may explain the behaviour, but it must never erase the person.
26/2026 · 24 September 2026Hearing loss in later life can mimic memory trouble, deepen isolation and increase risk. This article examines when hearing loss needs urgent assessment, how tinnitus and hearing aids fit into the picture, what devices cost in Malaysia, what financial help may be available, and what families can do today.
Sometimes restoring connection begins with four ordinary words: Can you hear me?
25/2026 · 23 September 2026Malaysia’s concessions begin at 60; its demographic statistics turn at 65. Neither threshold is a clinical finding. What actually separates a manageable later life from dependence — savings, family, surroundings — and why clinicians and policy alike should treat the person in front of them, not the birthday on the file.
It is an age — not an answer, a retirement from relevance, or a diagnosis. 24/2026 · 23 September 2026On 15 September 2026, Fiji declared HIV a national emergency — an estimated 9,100 people living with it, only 39% aware of their status and 22% on treatment, and new diagnoses up 27% in a year. What accelerated a preventable epidemic, what it says about mother-to-child transmission, prevention and access to treatment, and what Malaysia and the region should take from a warning that has no national boundary.
HIV never left. We should not wait for a national emergency to notice it again. 23/2026 · 19 September 2026Malaysia has legislation, national guidelines, surveillance and an action plan on antimicrobial resistance. The unresolved question is whether these reach the consultation room and pharmacy counter — and whether anyone measures what happens there. The evidence, the implementation gap, and what clinicians and pharmacists can do.
The laboratory report may say “resistant”. What it is really telling us is that choices made before this patient arrived now matter. 22/2026 · 18 September 2026Medicine needs hierarchy, but hierarchy also creates power. This piece examines Malaysian evidence on workplace bullying, protected reporting, due process, the role of witnesses and the hidden curriculum through which one generation teaches the next what medicine will tolerate.
Authority is not immunity. A good hierarchy uses the knowledge of the senior person while protecting the dignity of the junior one. 21/2026 · 18 September 2026In 1999, an unfamiliar mosquito-borne illness appeared in Port Klang and I asked whether we were doing enough to control vector-borne diseases. Twenty-seven years later, chikungunya has spread through Asia and the Americas, vaccines have arrived and been suspended, and the mosquito looks very familiar. The challenge is no longer finding the tools. It is using them together.
The challenge is no longer finding the tools. It is using them together. A Kerbside Reflection · 20/2026 · 17 September 2026In late 1998, Malaysia thought it knew what was killing the pig farmers. It was Japanese encephalitis — until the patients, the epidemiology and the pigs themselves stopped fitting the diagnosis. How Malaysian clinicians, scientists and veterinarians recognised that a reasonable diagnosis had accumulated too many unreasonable exceptions, and what they found when they looked harder. The discovery of Nipah virus, told through contemporaneous DOBBS and Cybermed archives.
When the facts stop fitting the diagnosis, question the diagnosis — not the facts. A Kerbside Reflection · 19/2026 · 17 September 2026Sarawak, Taiwan and what outbreaks taught us about information, uncertainty and trust — from the early medical Internet, when reliable information was scarce, to a world where information is instantaneous and certainty can travel faster than evidence.
We solved the problem of getting information quickly. We did not solve the harder problem of knowing how much confidence that information deserves.
18/2026 · 16 September 2026
Workplace violence in Malaysian healthcare — what local studies reveal about abuse and under-reporting, where compassion and staff safety meet, and what healthcare professionals, patients and relatives can do before anger becomes violence.
You can challenge the care without threatening the caregiver.
17/2026 · 16 September 2026
Two of the world’s largest measles outbreaks in 2026 arrived by entirely different routes — one through disrupted immunisation systems and widening coverage gaps, the other substantially through declining vaccine acceptance. Malaysia, with neither crisis, had 231 outbreaks in 2024 anyway. As of 14 September 2026: Bangladesh has recorded more than 172,000 suspected cases and 1,030 deaths; the United States has recorded 3,294 confirmed cases, its highest annual total since eliminating measles in 2000. The article asks how three very different settings ended up in the same place, and what that means for Malaysia specifically. With acknowledgement to Prof Lam Sai Kit for review and suggested additions.
Coverage numbers are averages, and measles does not respect averages. It finds the unprotected fraction.
17a/2026 · 16 September 2026
A practical one-page guide for patients, parents, and anyone who needs to act now — from isolating immediately and recognising Koplik’s spots, to vitamin A dosing, urgent warning symptoms, household contact management, and notifiable disease reporting. Companion to Eliminated, Until It Wasn’t.
Do not walk into a clinic or emergency department without calling ahead.
17b/2026 · 16 September 2026
A pre-travel MMR checklist for Malaysian families — vaccination status by birth cohort, what to do with infants aged six to eleven months, the concluded 2025 MOH supplementary campaign, post-exposure steps abroad, and why Malaysia itself is on the CDC’s global measles advisory list. Companion to Eliminated, Until It Wasn’t.
In 2026, there is no low-risk itinerary for an unvaccinated traveller.
A Kerbside Reflection · 16/2026 · 15 September 2026
Twenty-six years ago, medicine stood at the edge of a genetic revolution. Reading back the genome project optimism of 2000, David Quek’s ethics editorial and Ronald McCoy’s Sandosham Lecture from 2026: some predictions proved remarkably prescient, others never happened, and the ethical questions behind them have become more pressing as gene therapy, CRISPR and genetically edited pig kidneys move from speculation into regulated medicine. Malaysia is now sequencing its own population. The problem is rarely whether science will advance.
It is whether our judgement can keep up.
A Kerbside Reflection · 15/2026 · 14 September 2026
From traditional medicine to wellness technology — how do we know whether a treatment really works? Artemisinin showed that traditional knowledge can supply a real clue to a real medicine. The RM17,000 electrostatic machine showed that an impressive-sounding explanation is not the same as evidence. Acupuncture sits somewhere in between — better than sham for chronic pain in some well-conducted trials, insufficient evidence for most of the conditions it is marketed for. The 1997 editorial that started this piece, the 2005 column that prompted it, and nearly thirty years of the same question: does it work, is it safe, and where is the evidence?
The packaging is different. The yardstick is not.
14/2026 · 13 September 2026
The traditional consultation was built around an enormous imbalance of information. The Internet disrupted that hierarchy. Patients could suddenly read about their illnesses before seeing their doctors. Social media changed the quality of what came through the pipe. Defensive medicine added an invisible participant to every encounter. And now generative AI has entered the room too — not as a tool the doctor chose, but as something the patient brings in. Thirty years of watching one part of this transformation, from Vads Corner in October 1995 to the consultation as it stands today.
The information gap is narrowing. The judgement gap may be much harder to close.
13/2026 · 12 September 2026
From Nipah and West Nile to H5N1 and antimicrobial resistance — thirty years of warnings, and the lessons we keep relearning. Each outbreak taught something different: about spillover, ecological surveillance, watching transmission change, healthcare amplification, system resilience, and threats that advance without an obvious starting gun. The question is not which pathogen comes next. It is whether the systems to detect and respond to it are in place when the warning arrives.
We cannot know what comes next. But after nearly thirty years of warnings, we should know what to do when it comes.
12/2026 · 11 September 2026
The patient may still see the doctor. Increasingly, the consultation begins somewhere else. Generative AI has moved from novelty to clinical adjacency faster than medicine has moved to understand it. This piece examines what AI can do well, where it fails in ways that matter, what the clinical trials actually show, and what both patients and doctors should do when the machine has already had its say.
The information revolution has become an interpretation revolution. The question is not whether AI belongs in the consulting room. It is already there. The question is where it should sit.
11/2026 · 10 September 2026
Malaysia has demonstrated through RESET that it can build high-level political machinery — a joint ministerial committee, named insurers, a live pilot, regular progress reporting — around a difficult healthcare problem. The government’s Health White Paper, passed by Parliament with bipartisan support in 2023, is a comprehensive 15-year reform blueprint for the public healthcare system. It has not received comparable machinery. This piece asks why, and what the evidence from eight sections of primary sources looks like when placed alongside that question.
67% of hospital admissions and 83% of outpatient visits go through the public system. That is the system the Health White Paper is for. That is the system this piece is about.
10/2026 · 8 September 2026
Malaysia measures hourly PM2.5 concentrations at 68 stations. It publishes a composite index. It does not publish the underlying concentration in the unit that WHO guidelines, commercial apps, and Singapore’s own system use — and the gap between those two things has a clinical cost that is measurable in hours, not days. This argument has been made from this column since 1999. The previous version of it was eventually won.
The question is whether the next step takes another decade, or whether someone finds the courage this season.
9/2026 · 7 September 2026
Malaysia’s proposed Senior Citizens Bill is delayed again — now expected in early 2027. But the delay is the least of the problem. A law that passes without funding, enforcement machinery, community detection and care infrastructure will not protect elderly Malaysians. It will offer them rights on paper. Four million people aged 60 and above, at least five ASEAN neighbours with dedicated legislation already in force, and an Act that has been on the books since 2018 and has never once been brought into force.
The law is the beginning of the answer, not the answer itself.
8/2026 · 6 September 2026
Malaysia’s new government-backed base medical insurance product has a design problem. It is described by ministers as protection for people the private market fails. It is built, in its actual terms, as a fully underwritten voluntary insurance product. A comparison of six countries across the Asia-Pacific shows that the choice Malaysia has made in MediAsas is not the only available one — and a nationwide survey of 855 specialists reveals what happens when a guarantee letter exists on paper but not at the point of need.
A promise made at the point of sale — protection, if you need it — is not the same as protection delivered at the point of need.
6 September 2026
A practical one-page guide to disputing a denied, delayed or revoked health insurance claim in Malaysia — from getting the reason in writing to filing a free dispute with FMOS. Plain, practical, and printable.
A free, independent dispute body has existed since January 2025. Most patients still do not know to use it.
A Kerbside Reflection · 5 September 2026
Thirty years of building this without a budget, an institution, or anyone asking me to — and the question that Kerbside Consult has finally made it hard to avoid asking directly.
Whether the next ten years justify the same verdict is not mine to decide.
7/2026 · 4 September 2026
GP consultation fees frozen since 1992. Hospital non-professional charges unregulated. A public alternative running short of the workforce needed to deliver it. Malaysia regulates most tightly where costs are already lowest, leaves pricing freedom where bills are largest, and is underinvesting in retaining the doctors the low-cost option depends on.
The RM80 regulatory ceiling and the RM34 consultation rate a GP actually receives are not in conflict with each other. They coexist.
A Kerbside Reflection · 3 September 2026
What thirty years of guestbook correspondence actually recorded — who was using the site, why they had come, and what they did with what they found there.
People wrote back. That seems as good a measure as any of whether it was worth doing.
6/2026 · 31 August 2026
In 1997 I wrote about the computer a doctor would need to get online, and about a law that would let doctors practise medicine down a telephone line. The computer became obsolete on schedule. The law never started. What the evidence actually says about telehealth today, what already exists scattered across six different systems nobody has joined up, and what it would take to finish what was promised twenty-nine years ago.
Malaysia rebuilt a 1997 cyber law from scratch this year. Its sibling, passed the same year to enable telemedicine, has simply never been switched on.
5/2026 · 30 August 2026
The Bill has now missed five tabling dates, the carbon tax is under review, and the standard we are measured against is not law. What the evidence now says about heat and dengue, what the government has and has not done about it, and what the profession could do that it is not doing.
The consultation on the Climate Change Bill drew submissions from lawyers, business networks and think tanks. None that I can find came from a medical body.
4/2026 · 28 August 2026
What to do about dengue: mosquito control that actually works, the warning signs that mean see a doctor, the ones that mean go to hospital now, and one common home-treatment mistake that makes bleeding worse. One screen long, and printable.
The dangerous phase isn't while the fever is high. It's the day or two after it breaks — exactly when people stop paying attention.
3/2026 · 28 August 2026
A dengue vaccine is registered, available, and being bought privately in Malaysia. The question was never whether it works. It is what a cost-benefit analysis actually assumes, who decides, and why the same regulatory meeting can be reported two entirely different ways by two professional bodies who each took what they wanted from it.
Two doses run at RM400 to RM500 in private clinics. A family that can find that much is protected this month. A family that cannot waits for an analysis whose assumptions are not published.
2/2026 · 26 August 2026
What to do about the haze. Which mask actually works and which is theatre, why closing the windows beats wearing one, who in your household is really at risk, and when to stop managing it at home. One screen long, and printable.
Only an N95 or better does anything. Fit matters more than the rating. And the bad chest arrives three days after the smoke clears.
1/2026 · 26 August 2026
The same haze, the same diplomacy, and a surveillance system that registers its own success as an absence of disease. Twenty years after I wrote HAZE-OC, the sequel writes itself — and that is rather the point.
Malaysia's ambient air quality standard turns out not to be law. The Ministry reported no rise in illness on a day nine Sarawak districts sat in the unhealthy band.