KUALA LUMPUR - Malaysia's relative success in managing the Covid-19 pandemic has led to a gradual reopening of its borders to medical tourism, as the country prepares to make a comeback as the world's top spot for such travellers.

The country's governing body for medical tourism, the Malaysia Healthcare Travel Council (MHTC), previously mooted allowing patients from specified nations to arrive on commercial flights and enter via green zones, but subject to clearance and permission from their own governments.

However, the plan has since been put on hold indefinitely as the country extended its movement control curbs until the end of the year.

Instead, MHTC is now looking to strengthen its medical travel bubble, where patients from anywhere in the world are allowed to come into Malaysia provided they travel in private aircrafts and are not exposed to the community during the course of their treatment.

"While medical tourists are slowly coming back, the numbers are still far from pre-Covid days, said the senior resident medical officer of Pantai Hospital Kuala Lumpur's (PHKL) Emergency Department, Dr Mohd Ridzuan Abdul Razak.

Situated in the heart of Kuala Lumpur, PHKL is a prime destination for medical tourists drawn especially by the country's medical expertise and lower costs.

"We are on par with world standard. Doctors in Malaysia are mostly trained in western countries. So, patients know there is quality.

"Now, they also know it is safe and we have the support of the government," Dr Ridzuan told The Straits Times.

Before the pandemic, PHKL treated about 120 international patients a day, including medical travellers. Now, there are fewer than 10 such patients a day.

Part of the reason for the steep drop is the country's strict standard operating procedure (SOP) for medical tourism.

Since June 19, only foreign patients with serious illnesses are allowed into the country to receive treatment.

Also, they must fly in on private charter or medical evacuation flights and are confined to the hospital during the duration of their stay. And they are not allowed to be a tourist after their treatment.

Most of these "high-yield patients" are cancer sufferers, Ms Sherene Azli, MHTC's chief executive officer told The Straits Times.

Malaysia positioned itself as a medical tourism destination about 10 years ago when it launched MHTC under the health ministry.

It has since grown exponentially, at a compound annual growth of 15 per cent since 2011.

Malaysia's medical tourist arrivals is almost three times that of its South-east Asian neighbours.

And in the last two years, it is ranked No. 1 globally for having the highest volume of medical tourist arrivals: 900,000 in 2018 and 1.3 million in 2019. Thailand is in the No 2 spot.

The vast majority of these patients are from the region, and they tend to suffer from cancer or cardiovascular diseases.

Medical tourism has also bolstered Malaysia's tourism industry, which is now its third-largest GDP contributor.

Before the pandemic, it was contributing nearly 10 per cent to the tourism economy, MHTC had said.

Healthcare travel revenue - from hospital receipts alone- more than tripled in a decade, hitting RM 1.7 billion (S$550 million) in 2019, and contributing RM8 billion to the economy.

For 2020, MHTC is aiming for RM500 million in hospital receipts and RM2 billion in contributions to the economy.

But the progressive opening up of the medical tourism industry has caused some concern in Malaysian states like Penang.

In August, the state said it will no longer allow medical tourists to enter.

The decision was prompted by new Covid-19 cases in the state after almost three months of not having even a single case. The new infected cases coincided with the arrival of three medical tourists from Indonesia, where most of the medical tourist are from .

Ms Sherene, however, is confident these tourists pose the lowest risk, given the strict SOP of the MHTC.

"With the SOP we have put in place, they are the lowest risk (in terms of breaking quarantine orders)," she said, pointing out that medical tourists will be brought directly to their hospitals where they will undergo quarantine with their treatment.

Dr Ridzuan agreed.

"We don't need to worry, we are not letting them in freely. All our guidelines are based on clinical evidence, and health ministry directives," he added.