KUALA LUMPUR (Sept 19): Malaysia is ready to reform its healthcare system to be more sustainable, equitable, and future-ready, according to the Health Minister Datuk Seri Dr Dzulkefly Ahmad. In 2023, 36% of the 2,445 nurses who applied for work overseas were from the public sector. Last August, the minister also reported that 705 medical officers and 1,394 nurses who had served more than five years had resigned from their posts between 2022 and 2024. These healthcare reforms are therefore timely, especially for health practitioners, as they help address brain drain, long shift hours, and the risk of losing talent to the private sector or overseas opportunities. Reforms can also ease the high costs of insurance premiums, which have pushed even higher-income patients to public hospitals, stretching their already limited capacity.
The reforms include enhancing the Ministry of Health (MOH) hospitals and clinics through the Rakan KKM initiative, implementing the Diagnosis-Related Group (DRG) payment system to tackle runaway medical inflation, restructuring basic Medical and Health Insurance/Takaful (MHIT) in providing better coverage for the M40 (Middle 40% income) group, and digitalising healthcare programmes. Despite this, many other challenges still remain, such as the rise in dual disease burdens, ageing population, and increase in medical costs. Thus, alongside these reforms, waqf can play a crucial role in complementing the healthcare system. While these initiatives are commendable, sustainable healthcare financing also requires complementary models rooted in our own tradition. One such model is waqf.
Waqf, a sacred trust in Islam, has historically shaped the landscape of public welfare. While many associate it with mosques or cemeteries, its contribution to healthcare has been both enduring and profound from endowing hospitals in the Ottoman Empire to sustaining community clinics in earlier Muslim societies. Today, healthcare waqf remains an underutilised gem. In the face of rising medical costs and overburdened public systems, waqf offers a long-term solution rooted in shariah, ethics, and social solidarity. With careful design, particularly one built on income-generating assets, waqf can help sustain operations, fund equipment, and pay staff salaries without compromising spiritual or legal integrity.
From a shariah point of view, the strategic allocation of waqf funds to cover both preventive and chronic care is encouraged. While free medical check-ups allow early diagnosis and are ideal for community outreach, subsidising long-term treatments such as dialysis or cancer care fulfills the deeper maqasid of protecting life (hifz al-nafs) and restoring dignity. When balanced correctly, this ensures not only immediate relief but also long-term societal transformation.
However, there are still barriers. Many continue to assume waqf is only for mosques or burials. Healthcare waqf does not yet enjoy the same visibility or structured campaigns as educational or religious projects. Governance can also be further strengthened, particularly in communicating impact to the public. There’s also some debate about using waqf funds to pay salaries. Yet from the shariah tradition, it is entirely consistent with maslahah ammah (welfare of society at large). Historical waqf institutions paid doctors, nurses, and even cooks through profits that were made from endowed funds. Waqf was never just about buildings, it was about ensuring the continuity of beneficial service. To sustain this today, institutions must shift from passive waqf models to strategic ones. Rental properties, shariah-compliant investments, and reinvested returns can be structured to build reserve funds. These reserves then cushion staff salaries and equipment costs even in leaner years. To illustrate, India, too, holds immense untapped potential. The Mughal era saw robust waqf institutions supporting madrasahs and hospitals. Today, greater digitisation, clearer legal frameworks, and stronger public-private partnerships are needed to revive this potential.
If waqf institutions wish to strengthen public trust, they should adopt transparency mechanisms. Dashboards, independent audits, and community-based shariah oversight are not luxuries, but necessary tools to uphold amanah and adl. And while hospitals funded by donations such as Lam Wah Ee in Penang are remarkable, waqf offers a sustainability advantage: a donation ends when the money runs out, but a waqf keeps giving, sadaqah jariyah in action.
More importantly, the community’s attitude is evolving. Increasingly, Muslims view healthcare waqf not just as a good deed, but as a collective duty. This aligns beautifully with the Islamic vision of society, where the benefit of one becomes the responsibility of all. Healthcare waqf is not only feasible, but necessary. It reflects not just faith, but foresight.
Mohamed Aslam Akbar is an associate professor of shariah sciences and deputy dean of postgraduate research and innovation at IIUM, specialising in Fiqh al-Mu'amalat, Islamic economics and finance. Azidah Ahmad Zaki is a PhD candidate studying at IIUM, taking the doctor of philosophy (economics) programme and focusing on the area of Islamic economics.