A presentation for the subject 'Development and Public Policy', Master of Public Policy, University Malaya. The subject was taught by Dr Derrick L. Cogburn, a Visiting Associate Professor from the American University, Washington DC Caution: while the official designation of the stated audience was accurate at the time of presentation, the official designation of the author stated herein was altered to suit the context of this presentation.

1. DEVELOPMENT & PUBLIC POLICY
BRIEFING MEMO
To: H.E. Datuk Farida Mohd Ali, Chief Secretary to the
Ministry of Health
From: Mohd Hasim Ujang, Head of Policy & International
Relations Division, Ministry of Health
Date: November 7, 2014
Re: Proposal to set up Malaysian Research and Application
Initiatives for Exoskeleton and Advanced Prosthetic Limbs
1

2. WHAT ARE THE PROPOSALS?
2
• The Government need to set up a Malaysian Research and
Application Initiatives for Exoskeleton and Advanced
Prosthetic Limbs.
• A specific government program should be set up to organize
and permanently fund the research initiative.
• The program can be placed under existing public universities
with medical expertise and facilities; the UM, UKM or USM;
OR
• Alternatively, a National Institute of Biomedical Robotics and
Biomechanical Research & Application should be created to
cater for this purpose. However this may entail higher costs.
• Need Comparative Feasibility Study with CBA.

3. STATISTICAL BACKGROUND
3
Year 2008 2009 2010 2011 2012 2013Total
Number of
Physically
Disabled 83,070 94,331 105,020 123,346 148,461 162,215 716,443
Average per
year 119,407
Source: Malaysian Statistics Department

4. WHAT ARE ADVANCED
EXOSKELETONS?
4
• External robotic or biomechanical support that assist
a paralyzed person to walk. Can be motorized or non-
motorized.
• Can be used to assist permanently paralyzed person
or to train a temporarily paralyzed person to regain
walking ability.
• Custom-built with proper calculations and
measurements for individual patients/users.

5. EXAMPLES OF ADVANCED
EXOSKELETONS
5

6. EXAMPLES OF ADVANCED
EXOSKELETONS
6

7. EXAMPLES OF ADVANCED
EXOSKELETONS
7

8. EXAMPLES OF ADVANCED
EXOSKELETONS
8

9. WHAT ARE ADVANCED
PROSTHETIC LIMBS?
9
• Custom-built prosthetics that match the
natural limbs as closely as possible in terms of
functionality, agility and ease of use.
• Employs high technology characterized by the
application of advanced bio-mechanical
engineering and human kinetics.
• Applied in combination with natural
orthopedic and psychomotor treatments to
produce the most desired results.

10. EXAMPLES OF
PROSTHETIC LIMBS
10

11. EXAMPLES OF
PROSTHETIC LIMBS
11

12. EXAMPLES OF
PROSTHETIC LIMBS
12

13. EXAMPLES OF
PROSTHETIC LIMBS
13

14. EXAMPLES OF
PROSTHETIC LIMBS
14

15. WHAT’S THE IMPORTANCE?
15
• Use of outmoded prosthetic and ambulation methods
(wheelchairs, crutches etc) severely limits mobility and
independence of physically disabled persons.
• Physically disabled persons do not just want to move. They
want to be agile, independent and outgoing just like normal
persons.
• Advanced exoskeleton and prosthetic limbs can fulfil these
needs.
• To comply with Paragraph 1(f), 1(g), 1(h) and 1(i) Article 4 of
the CRPD which Malaysia has already ratified and committed
to.

16. WHAT’S THE IMPORTANCE?
16
Article 4 of the CRPD
“1. States Parties undertake to ensure and promote the full
realization of all human rights and fundamental freedoms for all
persons with disabilities without discrimination of any kind on the
basis of disability. To this end, States Parties undertake:
f. To undertake or promote research and development of
universally designed goods, services, equipment and facilities, as
defined in article 2 of the present Convention, which should
require the minimum possible adaptation and the least cost to
meet the specific needs of a person with disabilities, to promote
their availability and use, and to promote universal design in the
development of standards and guidelines;”

17. WHAT’S THE IMPORTANCE?
17
Paragraph 1(g) & 1(h), Article 4 of the CRPD
• “To undertake or promote research and development of, and to
promote the availability and use of new technologies, including
information and communications technologies, mobility aids,
devices and assistive technologies, suitable for persons with
disabilities, giving priority to technologies at an affordable
cost;”
• “To provide accessible information to persons with disabilities
about mobility aids, devices and assistive technologies,
including new technologies, as well as other forms of
assistance, support services and facilities;”

18. WHAT’S THE IMPORTANCE?
18
Paragraph 1(i) Article 4 of the CRPD
• “To promote the training of professionals and staff working with
persons with disabilities in the rights recognized in this
Convention so as to better provide the assistance and services
guaranteed by those rights.”
• Moreover, current supply of advanced exoskeleton and
prosthetic limbs is very limited, expensive and has to be
procured overseas with long waiting time.
• This program is pivotal to make advanced exoskeleton and
prosthetic limbs to become more affordable, locally available
and more user-friendly for local population.

19. FURTHER BENEFITS
19
• Provide prospects for greater agility and independence not
just for disabled persons in Malaysia but in other Southeast
Asian countries as well – Vietnam & Cambodia.
• Generate positive externalities by creating new jobs and new
industry – researchers, physiotherapists, biomechanical
specialists, suppliers and so on. Malaysia possibly become
regional hub for this new industry.
• Eliminate the need for traditional forms of assistance –
specialized ramps and lanes for wheelchairs will no longer
necessary.
• Improve overall quality of life.

20. References
20
• The UN Convention on the Rights of Persons with Disabilities
(CRPD): http://www.un.org/disabilities/convention/conventionfull.shtml
• Hugh Herr (MIT): ‘Exoskeletons and orthoses: classification, design
challenges and future directions’
http://www.jneuroengrehab.com/content/pdf/1743-0003-6-21.pdf
• Anneli Nilsson, Katarina Skough Vreede, Vera Häglund, Hiroaki Kawamoto,
Yoshiyuki Sankai and Jörgen Borg (Dandeyard University Hospital,
Sweden): ‘Gait training early after stroke with a new exoskeleton – the
hybrid assistive limb: a study of safety and feasibility’
(http://www.jneuroengrehab.com/content/pdf/1743-0003-11-92.pdf)