BRACING FOR an UNCERTAIN FUTURE ANNUAL REPORT 2020
Periwinkle flower or Kemunting Cina is MAKNA’s official logo. Periwinkle is synonym for cancer treatment as it produces 2 potent alkaloids (Vinblastine and Vincristine) used in Chemotherapy. The logo symbolizes our effort in supporting cancer patients throughout their journey towards recovery. MAKNA stands for Majlis Kanser Nasional. The word MAKNA translates as ‘meaning’ in Malay. It aptly conveys our spirit and aspirations as an organization that strives to create a meaningful impact. This is further expressed in our tagline "A Meaning to Life".
Logo rasmi MAKNA ialah bunga Kemunting Cina atau Periwinkle. Ia sinonim dengan rawatan kanser kerana menghasilkan 2 alkaloid penting (Vinblastine dan Vincristine) yang digunakan dalam Kemoterapi. Justeru, logo tersebut melambangkan usaha untuk membantu pesakit kanser dalam perjalanan mereka kembali pulih. MAKNA ialah akronim untuk Majlis Kanser Nasional. Ia menunjukkan semangat dan aspirasi MAKNA sebagai sebuah organisasi yang berusaha untuk memberi impak yang bermakna. Kenyataan ini disokong dengan slogan “A meaning to life” yang bermaksud “Menghayati MAKNA kehidupan”.
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02
03
MISSION AND OBJECTIVE
MESSAGE FROM FOUNDER & PRESIDENT
FOREWORD BY THE GENERAL MANAGER
04
05
06
BOARD OF TRUSTEES
EXECUTIVE COMMITTEE
BURSARY PROGRAMME
14
18
20
DONATION PLEDGES
MAKNA ON THE MAP
PEOPLE OF MAKNA
22
40
41
FINANCIAL STATEMENT
AWARD & RECOGNITION
MARC
MISSION To mobilise resources in order to provide curative, preventive, research and support services to cancer patients and families, high-risk groups and the general public.
OBJECTIVE To pool and utilise all efforts, expertise and finance from all sectors of the society to fight cancer and reduce related pain, morbidity and the suffering that cancer patients undergo.
MAKNA is a not-for-profit social enterprise registered under the registrar of societies in 1994.Lembaga Hasil Dalam Negeri: Seksyen 44(6) Akta Cukai Pendapatan 1967. RUJ: LHDN.01/35/42/52/179-6.4232 Nombor Warta Kerajaan 2153 bertarikh 30 Mac 1995.
MAKNA is aligned with four (4) of the United Nations’ Sustainable Development Goals (SDGs)
MAKNA is a member of the Union for International Cancer Control (UICC).
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MESSAGE FROM FOUNDER & PRESIDENT 2020 has allowed us to unwind, taking a little step back from our fast-paced lives. We get to spend our time at home with our loved ones, develop new hobbies and so much more. For MAKNA, it was a whole new experience. The pandemic may have slowed things down, with death announcements taking place almost every day, people losing their family and friends – all happening in the blink of an eye. It is hard to witness this situation, especially when you are responsible for those who have a higher risk of catching the virus due to a weak immune system, aside from being financially challenged and have no means to survive when restrictions were enforced by the government to protect us.
DATO’ MOHD FARID ARIFFIN
For the past 26 years, our services have been focusing mainly on underprivileged cancer patients. In 2020, our humanitarian work goes beyond our commitment. As a former health minister, I understand how frustrating it could be to have to endure through an outbreak. This is why we decided to donate personal protective equipment (PPE) to the Ministry of Health, after seeing a shortage of supplies during the first wave of the COVID-19 pandemic. Later, we extended our efforts to distribute food packs to our cancer patients. I am grateful to be able to do all this, with the help of our dedicated staff and volunteers at MAKNA. But none of this would be possible without you – our incredible donors. I may not be able to personally thank each and every one of you but know that I will always cherish the trust and support given to us throughout the years. All of you have made it possible for us to be where we are today. I pray and hope for a better world – may all the sickness go away and we will be able to live together in peace and harmony, Insha-Allah.
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FOREWORD BY THE GENERAL MANAGER 2020 was an unusual year – it caused us to develop anguish, fear, and uncertainty. COVID-19 may have put the world on pause, but our assistance persisted. When my father, Dato’ Mohd Farid Ariffin, founded the organisation in 1994, a lot of people doubted his effort. But watching his late son, my beloved brother, battling leukemia, he asked himself, “what if poor cancer patients had to face this disease and not have the chance of surviving it because they couldn’t afford the treatment?” His determination was greater than anything else. The journey towards all of our accomplishments today was not easy. In fact, it was very long and required strenuous effort. In 2020, we are happy to share the following news:
FARAHIDA MOHD FARID
•We have successfully provided financial support to 6,764 cancer patients which comprised of 6,312 adults and 452 children through our Bursary Programme. •Our home visit team reached out to 5,382 patients in 13 states across the country. •We have opened yet another halfway house, Villa Farul in Putrajaya for patients receiving treatment at the National Cancer Institute. •Our MAKNA – HCTM Cancer Institute operated as usual during the pandemic with its ward capacity reduced by 50% and the Bone Marrow Transplant (BMT) ward put on standby as a COVID-19 ward.
Our humanitarian work did not stop there. In the same year, we had the opportunity to support our frontliners and patients during the pandemic: •We donated 70,000 pieces of personal protective equipment (PPE) to the Ministry of Health, consisting of 10,000 pieces each of KN95 mask, face shield, boot covers, disposable head covers, long-sleeved isolation gowns with cuffs, long-sleeved plastic aprons with thumb hook and protective coveralls or jumpsuits. •We delivered 1,118 food packs to cancer patients and schools affected by the pandemic under the Food Packs Assistance Programme. Each recipient received 3 boxes containing essential food items such as rice, flour, salt, sugar and many more.
On top of that, we are proud to share that MAKNA has been selected as a recipient of the prestigious Merdeka Award under the Education and Community Category. Additionally, we were also assessed by the Malaysian Rating Corporation Berhad (MARC) and received a “Gold” rating. We are the first nonprofit to receive such rating from MARC. The success we are proud of today is only made possible with the support of our dedicated staff, donors, and the public, along with the blessing of the Almighty Allah, enabling us to put in all the efforts, allowing us to reach where we are today. Our efforts in caring for our fellow humans will not deter as we keep on working towards normalcy, even when we are not sure if we will have what we’ve known to be normal again. But if nothing else, the pandemic has taught us to remain committed to our goals.
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BOARD OF TRUSTEES
YAM Tengku Puteri Seri Lela Wangsa, Tengku Tan Sri Hajjah Meriam binti Al-Marhum Sultan Haji Ahmad Shah Al-Musta’in Billah PSM.,SIMP., JP.
YBhg Emeritus Professor Tan Sri Dato’ Dzulkifli Abdul Razak Chairperson, Rector, International Islamic University Malaysia
EXECUTIVE COMMITTEE
Vice President Emeritus Professor Dr Cheong Soon Keng Dean, Faculty of Medicine & Health Sciences UTAR & Emeritus Professor, Hospital Canselor Tuanku Muhriz
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Honorary Secretary Dr Imran Abdul Khalid Hon. Lecturer, Penang Medical College & Pengerusi Badan Sokongan Pesakit Kanser Seberang Perai
Honorary Treasurer Rosleem Haji Nordin @ Bohari Senior Accountant, Accountant General’s Department of Malaysia
Member Prof Datin Paduka Setia Dato Dr Aini Ideris Pro-Chancellor, International Medical University
Member Dr Teoh Hoon Koon Assistant Professor, Faculty of Medicine & Health Sciences UTAR
Assistant Honorary Treasurer Douglas Tan Hock Kee Group Managing Director, Asian Business Solutions Group of Companies
Member Professor Abdul Aziz Baba Vice-Chancellor, Professor of Medicine, International Medical University Malaysia
Member Zainol Bahari Talib Vice Chairman, Takaful National Board, NAMLIFA
Assistant Honorary Secretary Farahida Mohd Farid General Manager, Majlis Kanser Nasional
Member Professor Dato’ Dr Hj Jafri Malin Datuk Hj Abdullah Director, Centre for Neuroscience Services and Research, Universiti Sains Malaysia Kampus Kesihatan & Professor of Neurosciences and Senior Consultant Neurosurgeon Hospital Universiti Sains Malaysia Kubang Kerian, Kelantan
Member Rohaizad Ismail CEO of KAF Investment Bank Berhad
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“Thank you MAKNA for providing the best assistance and care throughout my journey in fighting cancer. I was constantly worried about the cost I had to pay for my treatment until I found out and applied for MAKNA’s bursary assistance”. Mr. Rosli Bin Mohd Atan, renal cell carcinomacancer patient
BURSARY (FINANCIAL ASSISTANCE)
MAKNA's Bursary Programme is intended for cancer patients in the lower income groups who are undergoing treatment at government hospitals. They can apply via their respective hospital's Medical Social Welfare Department. Our financial aid is provided for purchasing necessities which include non-formulary drugs, milk supplements, surgical equipment, prostheses, colostomy bags as well as financial assistance for those who need them. There was a 20% increase in application for assistance during the pandemic as applications were made online, resulting in faster and more convenient approval.
Total Patients
Year 2020
Cancer patient has to be undergoing or seeking treatment at any government hospitals.
ADULT CASES
PAEDIATRIC CASES
6312
452
The Medical Officer will refer financially-challenged patients to the Medical Social Work Department for assistance. The officer will then refer eligible cancer patients’ application to MAKNA through online MAKNA Bursary Online System-(MBOS). Received application via MBOS will be verified by MAKNA Officer.
TOTAL CASES
6764
Application will be processed within 14 working days upon management’s approval.
AMOUNT DISBURSED
2020 : RM15,688,766.00
The status of the approval then can be accessed via MBOS by Medical Social Worker for further action.
2019 : RM10,782,762.00
Types of Assistance :
FINANCIAL ASSISTANCE
06
APPLIANCES
PROSTHESES
NON-FORMULARY DRUGS
SURGICAL EQUIPMENT
“Jururawat MAKNA yang bertugas sangat peramah dan membuatkan saya berasa selesa apabila perlu menginap di wad selama beberapa hari.” Puan Kasturi, pesakit kanser darah
MAKNA - HCTM CANCER INSTITUTE 1991 Year 2020
The cancer institute, established in 1999 in collaboration with Hospital Canselor Tuanku Muhriz UKM (HCTM), provides comprehensive and state-of-the-art facilities to cancer patients of all financial backgrounds. The cancer institute comprises an oncology ward, radiotherapy services centre and a stem cell transplant ward. Due to the global health crisis of Covid-19 pandemic, MAKNA-HCTM ward functioned as usual with 50% ward capacity put on standby as COVID-19 ward.
Total Patients
2020 : 941
2020 : 9
2019 : 984
2019 : 92 STEM CELL TRANSPLANT WARD
ONCOLOGY WARD
2020 : 58
2020 : 91
2019 : 62
2019 : 12
RADIOTHERAPY
BONE MARROW TRANSPLANT
2020 : 163
2020 : 49
2019 : 238
2019 : 42 PALLIATIVE
CHEMOTHERAPY
2020 : 14 BRACHYTHERAPY
2019 : 25
2020 : 550 SYMPTOMATIC
2019 : 559
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“Saya berasa amat bersyukur dengan bantuan yang telah diberikan oleh MAKNA selama ini. MAKNA bukan sahaja menanggung kos perubatan, tetapi juga membuat lawatan ke rumah untuk melihat keadaan saya. Saya amat menghargai usaha MAKNA.”
HOME VISIT
Encik Abu Bakar, pesakit kanser tekak
HOME VISIT
Year 2020
All patients under the Bursary Programme are visited by the Home Visit team to ensure that donations are channeled to the recipients. The team plays an essential role as well as in providing emotional support and encouragement for patients to continue with their treatment or follow-ups. Due to the SOPs and restrictions on interstate travel applied during the Movement Control Order (MCO), our Home Visit team were unable to visit the patients personally at home. However, the team managed to stay connected with the patients through phone calls for their updates. Once the travel ban was relaxed or lifted, home visit activities were resumed as per usual.
Total Visits
HOME VISIT TEAM
ADULT PATIENTS
5070
PAEDIATRIC PATIENTS
312
LATEST STATUS
APPROVED BURSARY APPLICATIONS
TOTAL PATIENTS
2020 : 5382 3368 2019 : 3277
VISITED : 3,368 CALLED : 2,014 HOSPITALS
BURSARY DEPARTMENT
Home Visit Roles:
08
Assess and verify patient details, prognosis, treatment and socio-economy status
Ensure patient receives the approved aid and are continuing their treatment
Help patients and family gain better knowledge on MAKNA services
"Saya amat gembira apabila menerima lawatan khas daripada jururawat MAKNA. Mereka telah sedikit sebanyak mengajar saya dan anak saya dalam penjagaan luka dan cara penukaran bag kolostomi agar kami dapat melakukannya sendiri dengn mudah." Encik Iqram Ahmad, pesakit kanser usus
HOME CARE NURSING Year 2020
MAKNA Homecare Nursing is a clinical team, handled by six trained nurses and a Health Care Assistant to provide help for underprivileged cancer patients in receiving treatments at home after being discharged from the hospital. Caretakers will be trained to take care of the patient's needs such as changing a colostomy bag, cleaning wounds, etc.
Total Visits
TOTAL CASES MALE
239
FEMALE
329
2020 2020: :3368 564
Home Care Visit Roles: Roles:
Reach out to bedridden and stage 3 and 4 cancer patients.
Help patients and caretaker to perform necessary care such as dressing wounds, changing colostomy bags and inserting or extracting urinary chatheter.
Provide appropriate nursing care as well as psychosocial support for the patients after their treatment.
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“I am grateful for MAKNA’s free mammogram screening. I was able to detect my breast cancer at an early stage thanks to their wonderful faciliity, especially during an event near my hometown.” Puan Norhazniza Jalil, breast cancer patient
DIGITAL MOBILE MAMMOGRAM UNIT (DMMU) Year 2020
We believe that early detection and prevention are crucial factors in reducing cancer morbidity and mortality. With this in mind, MAKNA introduced the Digital Mobile Mammogram Unit Programme in 2011 to deliver breast cancer screening services to locations all over Malaysia, from districts to cities, from rural to urban areas, for those who come from poor dwellings and are unable unable to afford or have access to such facilities. Apart from mammogram scans, Clinical Breast Examinations (CBE) are also conducted.
Progress on MAKNA Digital Mobile Mammogram Unit
Due to the pandemic, our DMMU were unable to deploy its services especially with travel restrictions and government lockdowns.
DMMU TRAILER WEST MALAYSIA (EXISTING)
DMMU TRAILER SABAH Applied for CKAPS license 3
Completed refurbishment works on trailer body Purchased new mammogram machine and prime mover
Trailer sent to Kota Kinabalu
DMMU TRAILER WEST MALAYSIA (UPCOMING)
Setting up of MAKNA Kota Kinabalu satellite office
DMMU TRAILER SARAWAK
Completed tender process
First teaser program on 7-11 April 2021 – conducted 34 CBE
Completed panel reviewing process
Completed renovations on the MAKNA Sibu satellite office
Trailer and DMMU staff has been reassigned to assist the Pusat Pemberian Vaksin (PPV) Bergerak initiative.
Purchased prime mover and mammogram machine *In June 2021. in response to the government's call for volunteers in their nationwide COVID-19 vaccination program, MAKNA has set up Pusat Pemberian Vaksin (PPV) Bergerak, a Vaccination Program initiative. Consequently, MAKNA has reassigned DMMU staff for this purpose.
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“MAKNA has helped me jumpstart my career in cancer research, thanks to the MAKNA Cancer Research Award (MCRA) programme. I hope the effort will continue to help young researchers in Malaysia.” Dr Siti Amalina Zainal Abidin, Universiti Malaya
CANCER RESEARCH
For the past 19 years, we have been committed towards advancing cancer research in providing research funds and grants to make life-changing scientific discoveries. During the pandemic, the research team took the opportunity to complete the Human Leukocyte Antigen (HLA) typing backlog samples under the Malaysian Stem Cell Registry (MSCR) project.
Malaysian Stem Cell Registry
34.9% MALE
2020 : 708
65.1%
2019 : 2047
New registered stem cell donors
FEMALE
No. of Search, Match and Transplants 181 176
176
Search
163
158
Match Transplant
157
YEAR 2020 TOTAL
140
SEARCH
111
181
90
MATCH 46
40
33
7
39
31 0
2012
3
2013
26 1
3
2014
2015
4
2016
23 0
2017
23 0
2018
TRANSPLANT 0
2019
7
2
2020
2
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“I began to see how important the role is – it is having the ability to provide much needed assistance to patients, helping them to ease their journey and keeping their faith alive while showing them possibilities of survival.” Puan Azlina Abdullah@Mama Lina, Volunteer Leader
VOLUNTEERS
Our volunteers are the key driving force helping us to cast a wider net and extend support to a larger group of cancer patients as they undergo treatment; encompassing communities from all parts of the country. Effective actions were made on the ground by the volunteers in the states to deliver food aid under our Food Packs Assistance Programme to cancer patients who were affected by the pandemic. The team also managed to give away breast prostheses to our breast cancer patients.
Year 2020
Total Volunteers POTENTIAL LEADERS
LEADERS
97
32
ACTIVE
2020 : 350 2019 : 430
TOTAL ACTIVITIES CONDUCTED
2020 : 408 2019 : 566
Main Functions:
VOLUNTEER TRAININGS
12
HOME & HOSPITAL VISITS
VOLUNTEER SUPPORT GROUPS
CANCER AWARENESS
COMMUNITY OUTREACH PROGRAMME
FUNDRAISING
“Staying at MAKNA’s halfway house has given me a great sense of relief as it saves me so much time and energy after receiving treatment at the cancer center. The stay was comfortable and I get to rest after a long day.” Mr. Merican Anak Sanggaw, cancer patient at MAKNA Villa Kenyalang
HALFWAY HOUSE
Our halfway houses provide short-term accommodation for patients and their caregivers travelling away from home for treatment. Patients can have a comfortable place to rest after undergoing the treatment without having to worry about the cost of travel. Our halfway house remain open during the pandemic to enable patients with prior appointments to receive their scheduled treatment.
Year 2020
Total Patients
VILLA KILATAN (KELANTAN)
30
VILLA MUTIARA (PULAU PINANG)
22 Total patients assisted
VILLA GAUHAR (JOHOR)
6
2020 : 129 2019 : 125
VILLA FARUL (PUTRAJAYA)
21
VILLA KENYALANG (SARAWAK)
32
VILLA BAYU (SABAH)
18
We are partnering with Grab to help bring patients to and from the hospitals.
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“Sebagai seorang yang mempunyai ahli keluarga yang juga menghidap kanser, saya amat memahami kesusahan yang dihadapi terutamanya dari segi pembayaran kos perubatan. Saya berharap sumbangan yang diberikan dapat membantu pesakit kanser untuk meneruskan pejuangan hidup." Encik Razak Salleh, penderma tahunan MAKNA
DONATION PLEDGES Year 2020
As donors, your support and generosity made it possible for us to stay true to our mission to reduce the burden of cancer patients. Despite current circumstances, we received an increase of 4.7% in donation amount, thanks to online sign-ups and an upgrade of monthly contributions by our recurring donors.
My Pledge Against Cancer
This fundraising project has been the main income generator for MAKNA since 2002. Each donor commits to MAKNA a monthly commitment of RM38, RM58 & RM88 to MAKNA via credit cards, debit cards or online banking.
Monthly Commitment
Auto Debit
RM38/RM58/RM88
New Donors
7,632 14
Anniversary Donors
99,797
Amount Collected
2020 : RM44.26 million 2019 : RM42.27 million
DONATION PLEDGES Year 2020
With the latest implementation of QR code and additional locations of boxes placement, the Sen Saves Lives and Donation Boxes programme managed to raise an increase of 65% in donation. Meanwhile, there were an 8.1% increase in donation amount for e-Charity programme.
Sen Saves Lives
The initiatives under this programme include Kempen Kutip Syiling and donation boxes. The programme is supported by the Ministry of Education and Bank Negara Malaysia to encourage participation of the younger generation and donation boxes are located in selected premises for the public.
Amount Collected
2020 : RM 257,593.00 2019 : RM 155,778.00
Year 2020
e-Charity:
Donations can be made online via credit card or online banking payment to www.makna.org.my or to crowdfund channel via simplygiving.com.
MAKNA's e-charity accounts: Maybank : 014075326343 : 514075617955 CIMB : 8001183431 RHB : 26412400012200
Amount Collected Bank Rakyat : 220621275301 Billplz (CIMB) : 8001183431 PayPal (CIMB) : 8001183431 SimplyGiving (Maybank) : 514075001920
2020 : RM384,927.00 2019 : RM356,007.00
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“I learned a few important knowledge about cancer thanks to their Exhibition team. Their exhibition gallery was very impactful, with anatomies and visuals to learn from for a better understanding.” Mr. Awang Halim, Head Master SMK Berseri Perlis
CANCER AWARENESS
Another key objective of MAKNA is to help reduce cancer incidences in Malaysia through continuous education to drive awareness and encourage positive health behaviour changes. The MAKNA Exhibition team organises numerous talks and exhibitions across Malaysia. In 2020, on-ground talks were conducted online with respective audiences as physical activities could not take place during the MCO.
Year 2020
Total Exhibition
GOVERNMENT AGENCIES
12
UNIVERSITIES
12
CORPORATES
21
COMMUNITIES
14 TOTAL
16
2020 : 59
online talks & exhibitons
2019 : 85
on-ground talks & exhibitons
CANCER HELPLINE
CANCER SUPPORT GROUP
We are always here to listen and give support, not only to cancer patients, but also their families, caregivers and the general public. Our personnel who are trained in oncology will attend to the helpline and emails seeking information, guidance and emotional support. In 2020, we've received large enquiries relating to health and cancer relating to COVID-19 pandemic through calls, emails and social media direct messages.
Battling with cancer is already hard; dealing with the emotional toll of cancer can also be overwhelming. Our support group headed by trained staff members and volunteers will give counsel to cancer patients, their family members or caregivers to ease their cancer journey. Sharing sessions: 50 sessions Visits to patients at home and hospitals: 105 visits
Calls attended: 1079 Emails replied: 353 Social Media queries : 1432
YOUNG CANCER SURVIVOR SCHOLARSHIP
INTERNATIONAL DIVISION
For young cancer patients/survivors, their studies might be affected as a lot of resources are allocated for their treatment. To help them in completing their education, we provide financial assistance through this scholarship programme.
The MAKNA International Division is in charge of external relations and partnerships as well as resources mobilisation on an international level. We also focus on creating impact in international communities within Malaysia or overseas. Ultimately we also contribute to the brand positioning of MAKNA internationally, through publications, collaborative work, events participation and more.
Total amount: RM33,338.00 Total application: 27 applications
Total patients assisted: 10
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WE ARE READY TO SERVE YOU
Kubang Kerian, Kelantan Kepala Batas, Penang
HALFWAY HOUSE PENANG
HALFWAY HOUSE KELANTAN
Klang Valley
Johor Bahru, Johor
HEADQUARTERS
HALFWAY HOUSE PUTRAJAYA
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HALFWAY HOUSE JOHOR
MAKNA IN HANOI, VIETNAM
Partners:
Address: Room 1003, Ford Thang Long building, 105 Lang Ha Street, Dong Da District, Hanoi, Vietnam. Email: international@makna.org.my
Bright Future Fund, Ministry of Health, Vietnam Hung Viet Oncology Hospital National Cancer Hospital (K Hospital) Hanoi Oncology Hospital
Community outreach projects:
Supporters & Volunteers:
Homecare visit Emotional support for cancer patients in Hanoi K hospital Cancer awareness and education events
Hanoi Medical University Electric Power University Centre for Research – Consulting and Support of Community Health (RCSCH) Cancer Survivor Groups
HALFWAY HOUSE SABAH
Likas, Sabah
KOTA KINABALU SABAH OFFICE
Kuching, Sarawak DIGITAL MOBILE MAMMOGRAM UNIT (DMMU) Our MAKNA Digital Mobile Mammogram Unit (DMMU) is available across the state to deliver free breast screening services.
SIBU SARAWAK OFFICE HALFWAY HOUSE SARAWAK
MAKNA EXHIBITION TRUCK The MAKNA Exhibition Truck is equipped with advanced equipment that uses Virtual Reality (VR) technology as a means of conveying information on cancer. By using such technology in this new innovation, we believe it will improve our efforts to increase awareness and knowledge on cancer among the general public.
ACTING TOGETHER, BETTER TOGETHER
MAKNA Hari Raya Aidilfitri 2020 Group Photo
MAKNA Food Packs Assistance Programme, in collaborations with Pos Malaysia.
MAKNA Periwinkle Project 2020 at Sekolah Kebangsaan Gombang in Muar, Johor.
Donation of Personal Protective Equipment (PPE) for the Ministry of Health in April 2020.
The launching of MAKNA's sixth halfway house, Villa Farul in Putrajaya. Also present was National Cancer Institute (NCI) Deputy Director, Dr. Muhamad Azrin Omar and the team.
FINANCIAL STATEMENTS 2020
EXPENDITURE
RM 40,692,703
INCOME
RM 51,745,913
CONTENT 23
STATEMENT BY EXECUTIVE COMMITTEE MEMBERS
24
REPORT ON THE AUDIT OF THE FINANCIAL STATEMENTS
26
STATEMENT OF INCOME AND EXPENDITURE
27
STATEMENT OF ASSETS, LIABILITIES AND FUND BALANCES
28
STATEMENT OF CHANGES IN ACCUMULATED FUND
29
STATEMENT OF CASH FLOWS
31
NOTES TO THE FINANCIAL STATEMENTS
STATEMENT BY EXECUTIVE COMMITTEE MEMBERS We, Dato’ Mohd Farid Ariffin and Rosleem Nordin @ Bohari, two of the Executive Committee members of Majlis Kanser Nasional (“MAKNA”), state that, in the opinion of the Executive Committee, the financial statements set out on pages 23 to 39 are drawn up so as to give a fair presentation of the financial position of MAKNA as at 31 December 2020 and of the financial performance and cash flows of MAKNA for the financial year ended on that date in accordance with the accounting policies set out in Note 2 to the financial statements.
DATO’ MOHD FARID ARIFFIN PRESIDENT
ROSLEEM NORDIN @ BOHARI HONORARY TREASURER
Kuala Lumpur
MAKNA Hari Raya Aidilfitri 2020 Group Photo
23
REPORT ON THE AUDIT OF THE FINANCIAL STATEMENTS Our opinion In our opinion, the financial statements of Majlis Kanser Nasional (“MAKNA”) give a true and fair view of the financial position of MAKNA as at 31 December 2020, and of its financial performance and its cash flows for the financial year then ended in accordance with the accounting policies set out in Note 2 to the financial statements. What we have audited We have audited the financial statements of MAKNA, which comprise the statement of assets, liabilities and fund balances as at 31 December 2020, and the statement of income and expenditure, statement of changes in accumulated fund and statement of cash flows for the financial year then ended, and notes to the financial statements, including a summary of significant accounting policies, as set out on pages 23 to 39. Basis for opinion We conducted our audit in accordance with approved standards on auditing in Malaysia and International Standards on Auditing. Our responsibilities under those standards are further described in the “Auditors’ responsibilities for the audit of the financial statements” section of our report. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion. Independence and other ethical responsibilities We are independent of MAKNA in accordance with the By-Laws (on Professional Ethics, Conduct and Practice) of the Malaysian Institute of Accountants (“By-Laws”) and the International Ethics Standards Board for Accountants’ International Code of Ethics for Professional Accountants (including International Independence Standards) (“IESBA Code”), and we have fulfilled our other ethical responsibilities in accordance with the By-Laws and the IESBA Code. Responsibilities of the Executive Committee Members for the financial statements The Committee of MAKNA is responsible for the preparation of the financial statements of MAKNA that give a true and fair view in accordance with the accounting policies set out in Note 2 to the financial statements. The Committee is also responsible for such internal control as the Committee determines is necessary to enable the preparation of financial statements of MAKNA that are free from material misstatement, whether due to fraud or error. In preparing the financial statements of MAKNA, the Committee is responsible for assessing MAKNA’s ability to continue as a going concern, disclosing, as applicable, matters related to going concern and using the going concern basis of accounting unless the Committee either intends to liquidate MAKNA or to cease operations, or have no realistic alternative but to do so. Auditors’ responsibilities for the audit of the financial statements Our objectives are to obtain reasonable assurance about whether the financial statements of MAKNA as a whole are free from material misstatement, whether due to fraud or error, and to issue an auditors’ report that includes our opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with approved standards on auditing in Malaysia and International Standards on Auditing will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of these financial statements.
24
REPORT ON THE AUDIT OF THE FINANCIAL STATEMENTS
(CONTINUED)
Auditors’ responsibilities for the audit of the financial statements (CONTINUED) As part of an audit in accordance with approved standards on auditing in Malaysia and International Standards on Auditing, we exercise professional judgement and maintain professional scepticism throughout the audit. We also: (a) Identify and assess the risks of material misstatement of the financial statements of MAKNA, whether due to fraud or error, design and perform audit procedures responsive to those risks, and obtain audit evidence that is sufficient and appropriate to provide a basis for our opinion. The risk of not detecting a material misstatement resulting from fraud is higher than for one resulting from error, as fraud may involve collusion, forgery, intentional omissions, misrepresentations, or the override of internal control. Auditors’ responsibilities for the audit of the financial statements (continued) (b) Obtain an understanding of internal control relevant to the audit in order to design audit procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion on the effectiveness of MAKNA’s internal control. (c) Evaluate the appropriateness of accounting policies used and the reasonableness of accounting estimates and related disclosures made by the Committee. (d) Conclude on the appropriateness of the Committee’s use of the going concern basis of accounting and, based on the audit evidence obtained, whether a material uncertainty exists related to events or conditions that may cast significant doubt on MAKNA’s ability to continue as a going concern. If we conclude that a material uncertainty exists, we are required to draw attention in our auditors’ report to the related disclosures in the financial statements of MAKNA or, if such disclosures are inadequate, to modify our opinion. Our conclusions are based on the audit evidence obtained up to the date of our auditors’ report. However, future events or conditions may cause MAKNA to cease to continue as a going concern. (e) Evaluate the overall presentation, structure and content of the financial statements of MAKNA, including the disclosures, and whether the financial statements of MAKNA represent the underlying transactions and events in a manner that achieves fair presentation. We communicate with the Committee regarding, among other matters, the planned scope and timing of the audit and significant audit findings, including any significant deficiencies in internal control that we identify during our audit. OTHER MATTERS This report is made solely to the members of MAKNA and for no other purpose. We do not assume responsibility to any other person for the content of this report.
PRICEWATERHOUSECOOPERS PLT LLP0014401-LCA & AF 1146 Chartered Accountants
AZIZAN BIN ZAKARIA 02930/05/2022 J Chartered Accountant
Kuala Lumpur 8 June 2021
25
STATEMENT OF INCOME AND EXPENDITURE FOR THE FINANCIAL YEAR ENDED 31 DECEMBER 2020 NOTES INCOME Receipts from projects Donation received from individuals, societies and corporations Interest from deposits Dividend income Annual subscriptions Other income
3
2020
2019
RM
RM
47,042,415
44,982,583
183,117 4,331,135 186,766 2,480 51,745,913
361,697 4,534,314 175,103 2,780 300 50,056,777
15,688,766 11,969,739 10,520,333 915,595 1,222,683 935,745 31,738 (591,896)
10,782,762 11,946,915 11,386,540 816,280 569,108 239,727 13,362 (467,584)
40,692,703
35,287,110
11,053,210
14,769,667
(11)
(25)
11,053,199
14,769,642
LESS: EXPENDITURE Bursary Salaries and related costs Activities costs Administrative costs Depreciation of property, plant and equipment Consumables, cleaning and utilities Scholarship granted (Reversal of)/provision for impairment of investments
4 SURPLUS OF INCOME OVER EXPENDITURE BEFORE TAXATION TAXATION SURPLUS OF INCOME OVER EXPENDITURE AFTER TAXATION
26
5
STATEMENT OF ASSETS, LIABILITIES AND FUND BALANCES AS AT 31 DECEMBER 2020
NOTES
2020
2019
RM
RM
6
10,539,631
9,899,393
7 8
8,585,286 2,572,200 9,674 122,044,576 6,327,093
7,808,092 2,059,411 20,275 110,527,104 9,069,402
139,538,829
129,484,284
3,053,914
3,412,330
136,484,915
126,071,954
147,024,546
135,971,347
147,024,546
135,971,347
NON-CURRENT ASSETS Property, plant and equipment CURRENT ASSETS Investments Receivables Tax recoverable Fixed deposits with licensed banks Cash and bank balances
9 9
CURRENT LIABILITIES Trade and other payables NET CURRENT ASSETS NET ASSETS Financed by:
10
ACCUMULATED FUND Accumulated surplus of income over expenditure
27
STATEMENT OF CHANGES IN ACCUMULATED FUND
FOR THE FINANCIAL YEAR ENDED 31 DECEMBER 2020
TOTAL 2020
RM
Balance at 1 January 2020 Surplus of income over expenditure
135,971,347 11,053,199
Balance at 31 December 2020
147,024,546
2019
28
Balance at 1 January 2019 Surplus of income over expenditure
121,201,705 14,769,642
Balance at 31 December 2019
135,971,347
STATEMENT OF CASH FLOWS
FOR THE FINANCIAL YEAR ENDED 31 DECEMBER 2020 2020
2019
RM
RM
CASH FLOWS FROM OPERATING ACTIVITIES Surplus of income over expenditure after taxation
11,053,199
14,769,642
Adjustment for: Depreciation of property, plant and equipment Interest income Dividend income Tax expense Reversal of impairment of investments
1,222,683 (4,331,135) (186,766) 11 (591,896)
569,108 (4,534,314) (175,103) 25 (467,584)
Surplus before working capital changes
7,166,096
10,161,774
Changes in working capital: Receivables Trade and other payables
(255,630) (358,416)
(277,692) (277,950)
Cash generated from operating activities
6,552,050
9,606,132
Interest received Tax paid Tax refund
4,075,444 (1,468) 12,058
4,164,480 (1,806) -
10,638,084
13,768,806
(1,862,921)
(1,206,963)
(11,517,472) 185,298
(9,831,649) 173,297
(185,298)
(173,297)
(13,380,393)
(11,038,612)
Net cash flows generated from operating activities CASH FLOWS FROM INVESTING ACTIVITIES Purchase of property, plant and equipment Net movement in fixed deposits with licensed banks with maturity of more than 3 months Dividend received Reinvestment of dividend income into investments in unit trusts Net cash flows used in investing activities
29
STATEMENT OF CASH FLOWS
FOR THE FINANCIAL YEAR ENDED 31 DECEMBER 2020 (CONTINUED) NOTES
Net increase/(decrease) in cash and cash equivalents Cash and cash equivalents at beginning of the financial year Cash and cash equivalents at end of the financial year
9
2020
2019
RM
RM
(2,742,309)
2,730,194
9,069,402
6,339,208
6,327,093
9,069,402
Non-cash transactions: During the financial year, dividend income of RM185,298 (2019: RM173,297) had been reinvested in investments in unit trusts and tax payment of RM1,468 (2019: RM1,806) had been deducted from the gross dividend income.
30
NOTES TO THE FINANCIAL STATEMENTS
FOR THE FINANCIAL YEAR ENDED 31 DECEMBER 2020 1. CONSTITUTION Majlis Kanser Nasional ("MAKNA") was registered on 10 November 1994 and officially launched on 30 March 1995 and was approved by the Department of Inland Revenue for the purposes of Section 44(6) of the Income Tax Act, 1967. The objectives of MAKNA are to work towards the attainment of a better health care system for all Malaysians especially in terms of the prevention and control of cancer; to develop and formulate policies for cancer prevention and intervention; to strengthen and generate services and programmes on cancer and to strengthen support services for cancer patients and affected persons. MAKNA has 211 (2019: 211) employees at the end of the financial year. The address of the principal place of activity is as follows: BG 03A & 05, Ground Floor Megan Ambassy, 225, Jalan Ampang 50450, Kuala Lumpur. 2. SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (a) Property, plant and equipment Property, plant and equipment are stated at cost, with the amount of sales and services tax (“SST”) included, less accumulated depreciation and impairment losses. Property, plant and equipment are depreciated on a straight line basis to write-off the cost of each asset over its expected useful life. The principal annual rates of depreciation used are as follows:
Building Office renovation Hospital renovation Office equipment Hospital equipment Computer equipment Exhibition equipment Furniture and fittings Mobile trailer Motor vehicle
2.0% 20.0% - 33.3% 20.0% 20.0% 20.0% 20.0% 20.0% 20.0% 20.0% 20.0%
Property, plant and equipment received on donation are not capitalised. At each balance sheet date, an assessment is made for any indication of impairment. If such indications exist, an analysis is performed to assess whether the carrying amount of the asset is fully recoverable. A write down is made if the carrying amount exceeds the recoverable amount. See accounting policy Note 2(e) on impairment of assets.
31
NOTES TO THE FINANCIAL STATEMENTS
FOR THE FINANCIAL YEAR ENDED 31 DECEMBER 2020 (CONTINUED) 2 SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (CONTINUED) (b) Cash and cash equivalents Cash and cash equivalents consist of cash in hand, cash at bank and fixed deposits with licensed banks with original maturities of 3 months or less that are readily convertible to known amounts of cash which are subject to an insignificant risk of change in value. (c) Income and expenditure Income is recognised when it is probable that the economic benefits associated with the transaction will flow to the organisation and the amount of income can be measured reliably. Receipts from projects Receipts from projects relate to donations raised from projects and are recognised on a receipt basis. Donations received from individuals, societies and corporations Donations received from individuals, societies and corporations are recognised on a receipt basis. Interest from deposits with licensed banks Interest from deposits with licensed banks is recognised on an accrual basis based on the principal outstanding and the rates applicable. Interest from investment Interest from investment is recognised on an accrual basis based on the principal outstanding and the rates applicable. Dividend income Dividend income is recognised when the right to receive payment is established. Expenditure is recognised on an accrual basis. (d) Investments Investments are stated at lower of cost or market value on an aggregate portfolio basis. On disposal of an investment, the difference between the net disposal proceeds and its carrying amount is charged or credited to the statement of income and expenditure. Investments are classified as current assets if maturity is due within one year or less. If not, they are presented as non-current assets.
32
NOTES TO THE FINANCIAL STATEMENTS
FOR THE FINANCIAL YEAR ENDED 31 DECEMBER 2020 (CONTINUED) 2. SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (CONTINUED) (e) Impairment of assets Property, plant and equipment are reviewed for impairment losses whenever events or changes in circumstances indicate that the carrying amount may not be recoverable. Impairment loss is recognised for the amount by which the carrying amount of the asset exceeds its recoverable amount. The recoverable amount is the higher of an asset’s net selling price and value in use. For the purpose of assessing impairment, assets are grouped at the lowest level for which there is separately identifiable cash flows. The impairment loss is charged to the statement of income and expenditure and any subsequent increase is recognised in the statement of income and expenditure. (f) Receivables Receivables are measured initially at cost, with the amount of sales and service tax (“SST”) included, less provision for impairment. The provision is established when there is objective evidence that MAKNA will not be able to collect the amounts due according to the original terms of receivables. Cash flows are included in the statement of cash flows on a gross basis. (g) Payables Payables are obligations to pay for goods and services that have been acquired in the ordinary course of operation from suppliers. Payables are recognised at cost, with the amount of sales and service tax (“SST”) included. Cash flows are included in the statement of cash flows on a gross basis. (h) Income taxes Current tax expense is determined according to the tax laws of each jurisdiction in which MAKNA operates and include all taxes based upon the taxable income.
33
NOTES TO THE FINANCIAL STATEMENTS
FOR THE FINANCIAL YEAR ENDED 31 DECEMBER 2020 (CONTINUED)
3. RECEIPTS FROM PROJECTS Donation received from projects: - Direct Debit Donor System - MAKNA Pledge against Cancer - Zakat - E-Charity - Sens Saves Lives - Direct Mail - Ad-hoc - Payroll Giving - Volunteers - Exhibition/Pameran - International donors - Merchandise & Home Visit - Telemarketing - Mobile Project - Lifeline Clothing - Klimb for Kanser - Movember - AirAsia - JomBotak - Others
4. EXPENDITURE
2020
2019
RM
RM
37,545,341 6,716,197 1,575,340 384,927 257,593 176,618 129,413 76,733 51,348 43,520 29,206 26,315 17,164 12,700 -
35,954,527 6,320,851 1,467,500 356,007 155,778 74,352 79,232 87,197 113,316 12,362 27,485 18,286 124,900 104,392 82,518 1,661 926 432 861
47,042,415
44,982,583
2020
2019
RM
RM
11,969,739 30,000 4,590
11,946,915 30,000 15,370
9,407,147 1,142,634 1,419,958
8,954,060 1,062,662 1,930,193
11,969,739
11,946,915
Included in expenditure are: Salaries and related costs Audit remuneration Legal fees The employee information is as follow: Salaries and wages Contribution to Employees’ Provident Fund Other employee benefits
34
NOTES TO THE FINANCIAL STATEMENTS
FOR THE FINANCIAL YEAR ENDED 31 DECEMBER 2020 (CONTINUED)
5. TAXATION MAKNA has been given exemption on income, other than dividend income, under Paragraph 13 of Schedule 6 of the Income Tax Act, 1967 with effect from 1 March 1995 to 31 December 2024. The taxation charge for the financial year is in respect of dividend income. There is no taxation charge on the income of MAKNA arising from its operations which is exempted from taxation under the mutuality concept. 2020 2019 RM
RM
11
25
Additions Reclassification
Cost at 31.12.2020
4,575,849 453,072 171,032 190,155 161,850 516,229 643,869 2,637,920 4,797,592 891,394
31,500 35,342 1,003 454,612 54,939 356,700 715,380 213,445
2,775,219 (2,775,219) -
4,575,849 484,572 206,374 191,158 161,850 970,841 698,808 5,769,839 2,737,753 1,104,839
15,038,962
1,862,921
-
16,901,883
Charge for the year Reclassification
Accumulated depreciation 31.12.2020
Tax expense: Current year 6. PROPERTY, PLANT AND EQUIPMENT Cost at 1.1.2020
RM Building Office renovation Office equipment Hospital equipment Exhibition Equipment Computer equipment Furniture and fittings Mobile trailer Capital work in progress Motor vehicle
Accumulated depreciation 1.1.2020
RM Building Office renovation Office equipment Hospital equipment Exhibition Equipment Computer equipment Furniture and fittings Mobile trailer Motor vehicle
Net book value
RM
RM
RM
RM
RM
RM
665,046 181,313 99,501 110,527 63,646 313,271 418,521 2,552,499 735,245
91,517 93,456 29,047 31,366 32,370 116,805 101,506 612,453 114,163
-
756,563 274,769 128,548 141,893 96,016 430,076 520,027 3,164,952 849,408
5,139,569
1,222,683
-
6,362,252 10,539,631
35
NOTES TO THE FINANCIAL STATEMENTS
FOR THE FINANCIAL YEAR ENDED 31 DECEMBER 2020 (CONTINUED)
6. PROPERTY, PLANT AND EQUIPMENT (CONTINUED) Cost at 1.1.2019
Additions
Disposals
Cost at 31.12.2019
RM
RM
4,575,849 410,425 134,547 190,155 134,650 390,378 608,123 2,631,470 3,865,008 891,394
42,647 36,485 27,200 125,851 35,746 6,450 932,584 -
-
4,575,849 453,072 171,032 190,155 161,850 516,229 643,869 2,637,920 4,797,592 891,394
13,831,999
1,206,963
-
15,038,962
Accumulated depreciation 1.1.2020
Charge for the year
Disposals
Accumulated depreciation 31.12.2020
573,529 95,258 74,377 79,261 34,903 258,010 308,904 2,525,890 620,329 4,570,461
91,517 86,055 25,124 31,266 28,743 55,261 109,617 26,609 114,916 569,108
-
665,046 181,313 99,501 110,527 63,646 313,271 418,521 2,552,499 735,245 5,139,569
RM Building Office renovation Office equipment Hospital equipment Exhibition equipment Computer equipment Furniture and fittings Mobile trailer Capital work in progress Motor vehicle
Building Office renovation Office equipment Hospital equipment Exhibition equipment Computer equipment Furniture and fittings Mobile trailer Motor vehicle Net book value
RM
9,899,393
MAKNA has 40,468.6 square metres of donated leasehold land in Mukim Bentong, Pahang under a 99 years lease period from 2 February 1999 to 1 February 2098 which has not been capitalised in the financial statements. The land cannot be transferred, leased or mortgaged and can only be used for commercial building purposes.
36
NOTES TO THE FINANCIAL STATEMENTS
FOR THE FINANCIAL YEAR ENDED 31 DECEMBER 2020 (CONTINUED)
7. INVESTMENTS
2020
2019
RM
RM
9,281,312 (696,026)
9,096,014 (1,287,922)
8,585,286
7,808,092
8,585,286
7,808,092
2020
2019
RM
RM
Quoted unit trusts: Cost Provision for impairment Market value: Quoted unit trusts 8. RECEIVABLES Debtors Less: Provision for impairment
319,466 (206,652)
316,868 (206,652)
Prepayments Cash advances Deposits Accrued interest income
112,814 438,862 43,851 77,112 1,899,561
110,216 218,301 15,147 71,877 1,643,870
2,572,200
2,059,411
206,652
206,652
Movement in provision for impairment: At 1 January/31 December
37
NOTES TO THE FINANCIAL STATEMENTS
FOR THE FINANCIAL YEAR ENDED 31 DECEMBER 2020 (CONTINUED)
2020
2019
9. CASH AND CASH EQUIVALENTS
RM
RM
Fixed deposits with licensed banks Cash and bank balances
122,044,576 6,327,093 128,371,669
Less: Investment in fixed deposits with licensed banks with maturity more than 3 months Cash and cash equivalents
(122,044,576) 6,327,093
The weighted average interest rate per annum of fixed deposits with licensed banks effective as at the financial year end is 2.86% (2019: 4.13%) per annum. Fixed deposits have an average maturity period of 12 to 36 months (2019: 12 to 24 months). Bank balances are deposits held at call with banks. 10. TRADE AND OTHER PAYABLES
Trade payables Other payables and accruals
11. FINANCIAL ASSISTANCE COMMITMENT
Financial assistance commitment
2020
2019
RM
RM
2,359,169 694,745
2,834,656 577,674
3,053,914
3,412,330
2020
2019
RM
RM
1,122,450
742,600
As at 31 December 2020, MAKNA is committed to provide financial assistance to patients. The number of months committed is within the range of 6 to 12 months, for an amount of RM150 to RM500 (2019: RM150 to RM500) per month.
38
NOTES TO THE FINANCIAL STATEMENTS
FOR THE FINANCIAL YEAR ENDED 31 DECEMBER 2020 (CONTINUED)
12. CAPITAL COMMITMENT Semi trailer Mammography machine
2020
2019
RM
RM
832,300 -
700,000
832,300
700,000
On 1 March 2016, MAKNA engaged Eemed International Sdn Bhd (the "Contractor") to obtain on its behalf, from GE Healthcare Sdn Bhd of 2 units of GE Senographe CARE Mamography machines. The balance due on this agreement as at 31 December 2020 is NIL (2019: RM700,000). On 27 July 2020, MAKNA also engaged the Contractor for a refurbishment project on its existing Mobile Mammogram Semi Trailer at an agreed price of RM1,189,000. The balance due on this agreement as at 31 December 2020 is RM832,300 (2019: NIL).
39
MAKNA AWARDS & RECOGNITION 2020 was a remarkably difficult year. But amidst the hardships, however, there is much we can be thankful for. MAKNA is honoured to be granted with prestigious recognitions for our community work and social impact towards cancer patients in Malaysia.
GOLD
Fostering a Culture of Excellence 2020
MERDEKA AWARD Education and Community Award For outstanding contributions in providing financial, medical, emotional and social support to cancer patients while advocating and furthering cancer research for over 24 years. The Merdeka Award Trust (MAT) was established by PETRONAS, ExxonMobil and Shell on 27th August 2007 to recognise and reward excellent individuals and organisations whose works and achievements have contributed to the nation's growth and inspired greatness in the people of Malaysia. Merdeka Award is a prestigious award that honours the outstanding work and achievements that have made an impact on the nation and its people in the following categories, namely Education and Community; Environment; Health, Science and Technology; Outstanding Scholastic Achievement; and Outstanding Contribution to the People of Malaysia.
NONPROFIT IMPACT ASSESSMENT
MALAYSIAN RATING CORPORATION BERHAD 199501035601 (364803-V)
MALAYSIAN RATING CORPORATION BERHAD GOLD Rating – Non-profit Impact Assessment The non-profit has a clear and focused mission and strategy for delivering impact that is grounded in a proven theory of change. The non-profit has also met the threshold requirements of “Strong” and “Very Good” for its “GATE” and sustainability performance assessments, respectively. Incorporated in October 1995, MARC is a full-service domestic credit rating institution. MARC's Nonprofit Impact Assessment is designed to help nonprofits increase their impact by engaging potential donors or givers on their participation in or contribution to creating environmental and/or social impact.
GOLD
MAJLIS KANSER NASIONAL NONPROFIT IMPACT ASSESMENT DECEMBER 2020
MAJLIS KANSER NASIONAL HALPRO ENGINEERING SDN BHD
NONPROFIT IMPACT ASSESSMENT GREEN SRI SUKUK EXTERNAL REVIEW REPORT DECEMBER 2020 JUNE 2019
GOLD
NONPROFIT IMPACT ASSESSMENT
MALAYSIAN RATING CORPORATION BERHAD 199501035601 (364803-V)
NONPROFIT ASSESSMENT DECEMBER 2020
SUMMARY MAKNA’s (Majlis Kanser Nasional or National Cancer Council) Nonprofit Assessment is an assessment of its fulfilment of its social compact and mission impact; and evaluation of the nonprofit’s sustainability. A nonprofit’s social compact is its informal agreement with key stakeholders about its role in society, particularly the social and economic benefits it creates and the public good it serves. MARC’s Nonprofit Assessment aims to provide more than a ‘rear-view mirror’ view of a nonprofit’s social performance. Rather, it represents an opinion on a nonprofit’s mission coherence, its performance in mission impact and governance, as well as ability to sustain itself and perpetuate its mission. This assessment is based on information submitted by and gathered from MAKNA during our on-site meeting with the client, as well as information from the public domain. MAKNA was founded in 1994 and officially launched in 1995 by Dato’ Mohd Farid Ariffin whose sense of mission was borne out of his son’s fight and struggles with cancer. The mission he forged for the not-for-profit social enterprise was a vision to mobilise resources in order to provide curative, preventive, research and support services to cancer patients and families, high risk groups and the general public. Ensuring that underprivileged cancer patients regardless of background, ethnicity, race and socioeconomic status can afford their treatment costs through its need-based programmes has been the heart of MAKNA’s mission since its founding. Through its programmes, MAKNA works to build capacity for, and facilitate participation in ecosystem-based approaches to cancer care. MAKNA promotes equitable access to screening, diagnosis, multimodal treatment, and palliative care. Cancer treatment costs at government hospitals are subsidised, however, the low-income segment of the population may still encounter financial hardship following a cancer diagnosis. The prohibitive costs of newer, cutting-edge cancer drugs often result in the financially challenged forgoing potentially lifeprolonging treatment or incurring catastrophic health expenditure which leads to household impoverishment. MAKNA’s needs-based interventions across the cancer continuum augment and build on public health cancer prevention and control efforts. For most part, they target the most affordable and effective components of cancer control and reflect a deep understanding of national, community and individual-level needs. The role MAKNA plays in advancing social protection, reducing cancer incidence and the impact of cancer is particularly impactful from the standpoint of cancer’s social and economic burden. Exhibit 1: MAKNA’s Role in National Cancer Control
BASED ON 2012-2016 DATA
1
NONPROFIT ASSESSMENT DECEMBER 2020 Beyond the direct beneficiaries of its programmes, MAKNA’s social impact extends to building social capital and encouraging giving among its employees, volunteers, and donors who support the nonprofit’s mission to serve the public good. As a significant employer with a workforce of just over 200 individuals above, MAKNA also spurs economic activity by consuming goods and services that create more employment in delivering its mission. Apart from the cost of running MAKNA’s key flagship programmes which came to around RM16 million in 2018, there are also the necessary operating costs such as the cost of operating and maintaining its infrastructure, as well as salaries and administrative expenses. MAKNA’s governance and organisational structures meet the needs for nonprofit transparency, accountability and mission alignment. The nonprofit has established adequate policies and procedures, and a strong ethics culture to promote ethical behaviour and accountability. In recent periods, MAKNA has refined its approach to measuring performance towards a focus on impact rather than outputs. A meaningful outcome of this has been a higher level of importance and attention to certain aspects of organisational capacity building that are identified as critical to becoming an engine of impact. MARC views these developments as positive for its longterm sustainability. The reliable, steady, and supportive public policy environment in which MAKNA pursue its mission continues to be critical to securing its continued financial sustainability, particularly the tax exemptions it enjoys. MAKNA can be said to be mature in its fund development capacity despite not having a diverse array of funding sources. The nonprofit has demonstrated considerable success in forging long-term relationships with funders, particularly individuals to access adequate, stable and sustained funding for its activities. MARC considers this to be vital to the nonprofit’s financial sustainability given the trajectory of increasing cancer control needs. Based on our overall assessment, we have assigned a “Gold” NonProfit Assessment to MAKNA.
BASED ON 2012-2016 DATA
2
NONPROFIT ASSESSMENT DECEMBER 2020
CONTENTS SUMMARY
01
IMPACT ANALYSIS ..............................................................................................
4
02
ASSESSMENT OF GOVERNANCE, ACCOUNTABILITY, TRANSPARENCY AND ETHICS .................................................................................................
11
03
ANALYSIS OF SUSTAINABILITY PERFORMANCE ..........................................
14
04
OTHER INFORMATION ................................................................................
16
05
RATING SCALE .............................................................................................
17
MARC…………………………………………………………………………………………………….
18
BASED ON 2012-2016 DATA
3
NONPROFIT ASSESSMENT DECEMBER 2020
01
IMPACT ANALYSIS
NATIONAL CONTEXT As the second highest cause of death in Malaysia, cancer is a major public health and economic issue. The cancer burden is expected to rise with the ageing and growth of the population. Hereditary predisposition, epigenetic changes, sedentary lifestyles and unhealthy diets are major causes of cancer in the country. Cancer resulted in 16,000 deaths in 2018 and has been on the rise with a cancer incidence rate of 86 out of every 100,000 males and 102 out of every 100,000 females for the five-year period 2012-2016. Beyond the human toll, there is also the economic impact of cancer which disproportionately affects the country’s working-age population. This relates to the economic value of lives lost and cancer-related disability, inability to work, and resultant early retirement. Indirect costs are a significant driver of the economic burden of cancer and may increase in importance over time. National labour force productivity losses constitute a significant “unseen” percentage of cancer cost. This consists of human potential lost through early mortality and health that is compromised by disease and disability. Finally, physical capital accumulation is reduced because public and private resources are diverted to finance treatment costs. The health-insured part of treatment costs, in turn, translates into higher private health insurance premiums. This reduces aggregate savings and hampers economy-wide physical capital accumulation. Competition for healthcare expenditure may also affect national cancer control efforts cancer health services. Evidence shows that for many types of cancer, stage at diagnosis is a critically important determinant of health outcomes and mortality risks. According to the World Health Organization, between 30% to 50% of cancers can currently be prevented by avoiding risk factors and implementing existing evidence-based prevention strategies. In Malaysia, the number of patients diagnosed at the third and fourth stages is also increasing from 58.7% from 2007 to 2011, to 63.7% from 2012 to 2016. The impact of late-stage diagnosis is strongly related to poorer survival; late-stage cancer also requires more expensive treatments, hospital stays, and monitoring. Turning early detection of cancer into a routine reality and improving the continuity of care increases the likelihood of favourable oncologic outcomes Exhibit 2: Gaps in Universal Health Coverage in Public Sector Cancer Control in Malaysia
Reference: The State of Cancer: UHC in the Malaysian Cancer Context, The National Cancer Society of Malaysia
BASED ON 2012-2016 DATA
4
NONPROFIT ASSESSMENT DECEMBER 2020 MAKNA supports the national cancer community through integrated interventions across the cancer continuum ranging from prevention and early detection to treatment and palliative care. MAKNA’s programmes augment and build on public health cancer prevention and control efforts to promote access to comprehensive and cost-effective prevention, treatment and care for the integrated management of cancers. MAKNA’s holistic approach to cancer care also encompasses emotional support for the patients and their families with the active involvement of survivors. MAKNA’S PROGRAMMES
1 Bursary (Patient Assistance Programme) MAKNA’s Bursary Assistance Programme helps financially challenged cancer patients seeking treatment for cancer at government hospitals afford drugs that are not listed in the Ministry of Health’s (MOH) formulary. Non-formulary drugs are typically out of reach given their high price tags, yet some of these newer targeted Medical Social Work cancer therapies are often Department officers based in highly effective and offer the 92 participating government hope of long-term remissions, hospitals throughout Malaysia if not cures. screen applications for assistance based on patients’ MAKNA assists with a monthly ability to afford treatment costs allowance, prosthesis, surgical and their socioeconomic equipment, and ancillary items background. The relevant to enable them to cope with information from the cancer cancer. patients is gathered and once gathered, this will be Absent MAKNA’s intervention, forwarded to MAKNA for the financially challenged assessment. Eligible patients patients who cannot afford will receive financial assistance their non-formulary drug bill would have to forgo potentially from MAKNA. life-prolonging treatment or incur catastrophic health expenditure which leads to household impoverishment. Based on current demand, RM9 million is needed every year to assist patients financially through MAKNA Bursary Assistance programme.
BASED ON 2012-2016 DATA
The MAKNA Home Visit team pays visits to patients receiving bursary assistance all year long to check on their status and well-being. These visits help maintain rapport with patients, comfort them and encourage them to keep scheduled appointments at their hospitals.
Social Impact
>4,000 cases handled yearly
Referrals from 92 government hospitals
5,320 approved cases in 2019 involving 4,994 adult patients and 326 paediatric patients and total assistance of RM11.9 million Home Visit
2019: 3,277 patients visited in 14 states 2018: 2,921 patients visited in 14 states
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NONPROFIT ASSESSMENT DECEMBER 2020 2 PPUKM-MAKNA Established in collaboration with Universiti Kebangsaan Malaysia Medical Centre (UKMMC) in 1999, the MAKNA Cancer Centre (MMC) provides quality cancer treatment to cancer patients of all financial backgrounds. The UKMMCMMC, otherwise known as Wad Onkologi Tengku Ampuan Afzan, comprises an oncology ward and a stem cell transplant ward. MAKNA also wholly funds the nurse staffing of UKMMC-MMC.
Social Impact
150,000 cases have been helped since 1995 2019: 1,066 patient admissions (476 male and 590 female) 2018: 838 patient admissions (385 male and 453 female)
The UKMMC-MMC, a recognized center of excellence for cancer care in the region today, has treated close to 100,000 patients to-date.
150 bone marrow transplants performed to date
thousands provided with radiotherapy services 3 Digital Mobile Mammogram Unit MAKNA’s mammography screening services aims at reducing the proportion of breast cancer patients who are diagnosed at late stage. Earlystage cancer treatment is significantly less expensive than treatment for advanced disease.
Social Impact
32,168 mammogram screenings since from 2011-2019 (2019: 3,704 screenings)
MAKNA’s mammogram and clinical breast examination (CBE) programmes covers 12 of 13 states in Malaysia. Given the importance of stage at diagnosis, identifying cancer at its earliest stages when it is easier to treat is key to saving lives, avoiding costly late stage treatments and achieving better treatment outcomes.
BASED ON 2012-2016 DATA
In 2011, MAKNA launched its a 40- foot trailer equipped with a mammogram machine manned by qualified radiographers and nurses, to provide free mammogram screenings to women in rural areas who have no access to the facility or lack breast cancer awareness.
2019: 2,442 clinical breast examinations and 8 confirmed breast cancer cases via mammogram screening 2018: 3,647 clinical breast examinations 7 out of 11 cases detected early at stage 1 and 2
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NONPROFIT ASSESSMENT DECEMBER 2020 4 Cancer Research MAKNA supports a broad spectrum of research activities, from basic, preclinical and clinical research to epidemiology as well as health policy and outcomes research.
Social Impact
The MAKNA Cancer Research Award was initiated in 2001 to promote research and development by local scientists in advancing knowledge that is geared towards helping cancer patients and discovering potential cures for the disease.
5 Education and Awareness MAKNA organises exhibitions and gives talks at community centres, schools, universities, private companies and hospitals, among others to drive cancer awareness and encourage positive health behaviour changes, aimed at increasing knowledge of cancer symptoms and risk factors, and the importance of healthy lifestyles and screening for early detection.
RM1.46 million cancer research funding awarded to date to a total of 51 researchers since initiation of award MAKNA awards three research awards grants to institutions of higher learning with the value of each award not exceeding RM 30,000 yearly. Social Impact
MAKNA visits schools and universities to educate student on cancer prevention and living a healthy lifestyle.
2019: 125 exhibitions in 13 states 2018: 142 total campaigns of which 92 were in Klang Valley and 50 outside Klang Valley.
MAKNA raises cancer awareness using both print and digital media. 6 Halfway Houses MAKNA Halfway Houses provide short-term accommodation to patients who are unable to afford the travel costs or may not be physically fit to undertake the journey between hospital and their homes and their caregivers for the duration of their hospital treatment. Gaps in the geographical availability of services affect patient follow-through with treatment.
BASED ON 2012-2016 DATA
Social Impact
2019: 392 incoming patients 2018: 102 total incoming patients MAKNA’s halfway houses are in Kubang Kerian (Kelantan), Kepala Batas (Penang), Johor Bahru (Johor), Putrajaya, Likas (Sabah) and Kuching (Sarawak). In the pipeline are two more halfway houses.
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NONPROFIT ASSESSMENT DECEMBER 2020 7 Cancer Support Group and Cancer Helpline MAKNA’s holistic approach to cancer care also encompasses emotional support for the patients and their families through cancer support groups with the active involvement of cancer survivors. MAKNA’s Cancer Support Group is led by trained staff and volunteers to provide counselling to patients, family members, caregivers or anyone in need of emotional support.
Social Impact Cancer Support Group
The MAKNA Cancer Helpline
212 total activities in 2019 58 talks, patient visits, support group meetings, etc.
The MAKNA Cancer Helpline (1800-88-62562) is managed and handled by oncology trained personnel to provide information and support to cancer patients, family members, caregivers and the general public. MAKNA also accepts queries via email.
Cancer Helpline
2019: 383 calls 2018: 374 calls 2019: 230 emails 2018: 319 emails
2019: 130 social media messages 2018: 50 social media messages 8 MAKNA in Vietnam The International Division of MAKNA was established in May 2008 with the objective of increasing its presence in Southeast Asia through collaborations with other NGOs across the region. MAKNA has been working in partnership with Bright Future Foundation in Vietnam since 2011 to raise awareness regarding the prevention and treatment of cancer through knowledge transfer.
BASED ON 2012-2016 DATA
Social Impact
Emotional support event at Hanoi Oncology Hospital
Total attendees for emotional support group
Total women attendees (Hanoi community) for education and awareness events
Patients visited at home or hospitals
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NONPROFIT ASSESSMENT DECEMBER 2020 ECONOMIC AND SOCIAL IMPACT OF MAKNA’S CONTRIBUTION TO CANCER CONTROL MAKNA’s approach to delivering its mission aligns with the integrated total cancer care approach espoused in the National Strategic Plan for Cancer Control Programme (NSPCCP) 2016-2020. Integrated with noncommunicable disease control as set out in Malaysia’s 10-year National Strategic Plan for NonCommunicable Diseases 2016-2025, the NSPCCP calls for better collaboration and coordination across government and private sectors as well as the non-governmental and professional organisations for optimal cancer control and care. Malaysia recorded an absolute poverty rate 5.6% in 2019 following the revision of the national poverty line income (PLI) to RM2,208 per household per month in 2019 from RM980. Another point to note is that while the median income for the B40 (bottom 40%) grew strongly by 19.1% per annum in the 2012-2014 period (M40 at 11.8% per annum; T20 at 8.9% per annum), its growth decelerated sharply to 1.8% per annum over the 2016-2019 period (M40 at 4.2%; T20 at 4.6%.) M40 refers to the middle 40% whilst T20 refers to the top 20%. Through need-based programmes, which provide a continuum of services to the financially challenged, MAKNA promotes equitable access to treatment and integrated management of cancer for individuals and households on which cancer imposes the greatest burden. Through offering volunteer opportunities to support cancer patients and their families through their cancer journey, MAKNA forms and sustains networks that strengthen the bonds of communities across the country. MAKNA contributes to the achievement of national Non-Communicable Diseases (NCD) targets and the corresponding positive economic and social impacts of NCD reduction as shown in the exhibit below. Investing in cancer prevention and control not only improves health and saves lives, but also improves economic productivity. It can improve workforce participation and productivity and limit the financial burden of unexpected health costs on individuals and families. Above and beyond the ways that it contributes to economic and social impact of its direct beneficiaries, MAKNA also spurs economic activity as an employer and by consuming and paying for goods and services in delivering its mission. Exhibit 3: Contribution to Economic and Social Impact
ECONOMIC IMPACT
SOCIAL IMPACT
Adapted from ‘Saving Lives, Spending Less: A Strategic Response to Noncommunicable Disease’, World Health Organization
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NONPROFIT ASSESSMENT DECEMBER 2020 SDG IMPACT ASSESSMENT: RELATED SDGS The United Nation’s Sustainable Development Goals (SDGs) were set in September 2015 and form an agenda for achieving sustainable development by the year 2030. MAKNA advances the following UN SDG goals and targets: SDG 1: End poverty in all its forms everywhere. SDG 3: Ensure healthy lives and promote well-being for all at all ages, to improve the quality of life of cancer patients and target 3.4, reiterating the commitment to reduce, by 2030, premature mortality from cancer and other noncommunicable diseases by one third. SDG 10: Reduce inequality within and among countries. SDG 17: Strengthen the means of implementation and revitalize the global partnership for sustainable development. MAKNA’s flagship bursary programme helps the financially challenged to avoid catastrophic health expenditure which can lead to household impoverishment. MAKNA’s programmes collectively contribute to reducing social and economic inequity. They also reduce morbidity and mortality and improve the quality of life of cancer patients and their families. By championing public education, research and the sharing of information on cancer, MAKNA advances cancer mitigation and prevention. MAKNA ties up with healthcare and charitable organisations in other countries to foster competency building and training as well as sharing of expertise and knowledge. As a full-fledged member of the Union for International Cancer Control (UICC), MAKNA commits to UICC’s mission of taking the lead in initiatives that unite and support the cancer community to reduce the global cancer burden, promote greater equity, and to ensure cancer control continues to be a priority in the world health and development agenda.
Overall Mission Impact Assessment Very Significant
The nonprofit has a clear and focused mission and strategy for delivering impact that is grounded in a proven theory of change. Its programmes address urgent needs and generate high impact.
Significant
The nonprofit has a clear and focused mission and strategy for delivering impact that is grounded in a credible theory of change that articulates the logic of how that strategy will achieve that mission. Its programmes address urgent needs and generate considerable impact or hold promise for high impact at scale.
Fairly Significant
The nonprofit has a clear and focused mission and strategy for delivering impact that is grounded in a credible theory of change that articulates the logic of how that strategy will achieve that mission. Its programmes address urgent needs and generate noteworthy impact or hold promise for considerable impact at scale.
Marginal
The nonprofit does not have a clear and focused mission and strategy for delivering impact that is grounded in a credible theory of change. Its programmes generate relevant but limited impact.
Not Significant
The nonprofit does not have a clear and focused mission and strategy for delivering impact that is grounded in a credible theory of change. Its programmes generate negligible impact.
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ASSESSMENT OF NONPROFIT GOVERNANCE, ACCOUNTABILITY, TRANSPARENCY AND ETHICS
Governance
MAKNA has an active and engaged board of trustees comprising individuals who are selected with the nonprofit’s needs in mind. Both the board of trustees and MAKNA’s executive committee (EXCO) have clearly defined terms of reference, as set out in its constitution. The roles of the board of trustees are clearly differentiated from the EXCO’s. Both the EXCO and board of trustees are appointed by the membership of MAKNA at the nonprofit’s biennial general meeting. MAKNA’s constitution does not limit the number of terms that the EXCO may serve, which provides stability, as well as continuity in policies and culture. The EXCO meets at least quarterly or on an as-needed basis while the board of trustees meets biannually. The nonprofit’s EXCO oversees organizational policy, provides approval for strategic and operational matters including the annual budget and supervises its day-to-day operations. The EXCO is also responsible for ensuring appropriate succession of the board of trustees; it acts as the nominating committee for the board of trustees. MAKNA’s founder Dato Mohd Farid Ariffin and the nonprofit’s general manager Farahida Mohd Farid serve on the EXCO as President and Assistant Honorary Secretary respectively, along with 10 other office bearers. The office bearers bring relevant knowledge and experience to MAKNA, perhaps even diverse perspectives which should augment the nonprofit’s strengths in areas important to its work. The EXCO meets once every quarter to review MAKNA’s accounts and to identify any underspending or overspending. The responsibility of the board of trustees is primarily to act as fiduciaries of MAKNA’s assets. Protecting the nonprofit’s assets is central to serving the interests of donors who support the charitable nonprofit through their philanthropy. As the trustees leave the board of trustees or complete their term of office, the EXCO will nominate individuals of good standing in their community, with no active political affiliation and who bring experience and or professional background to the nonprofit. Their appointment is secured through endorsement at MAKNA’s biennial general meeting. The board of trustees receives reports from the EXCO generally twice a year or annually at minimum. Overall, MARC believes that MAKNA’s governance structure provides for effective oversight of the organisation. Also, information that should be regularly acquired for proper governance is being provided for. The EXCO discusses and endorses the proposed strategic plans as presented by MAKNA’s General Manager and developed with staff and stakeholder input. MAKNA’s strategic plan guides annual operational planning in which MAKNA’s longer-term strategic objectives are translated into short-term tangible goals and actions.
Accountability
BASED ON 2012-2016 DATA
Accountability requires well-informed strategic and operational planning, and specific measures of progress. MAKNA uses the balanced scorecard as a device to plan and monitor performance of the organization, teams and individuals. With key performance indicators (KPIs) grounded in an
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NONPROFIT ASSESSMENT DECEMBER 2020 organisation’s strategic objectives and yearly strategic planning process, the balanced scorecard defines and communicates operating objectives to employees. The nonprofit’s budget is tied to its operational plan. The cost of MAKNA’s programmes are closely monitored by management team. Statements of accounts produced on a monthly basis are reviewed by the management team who also submits a quarterly review of accounts to the EXCO.
Transparency
Transparency
MAKNA supports stakeholder inclusive reporting and communicates its social performance and impact through annual reports, as well as regular targeted informal communication through social media, emails to donors and its newsletter. Its website provides access to information regarding its mission, the underlying theory of change and programmes. In addition, MAKNA also communicates its social impact to donors visually through infographics annually. In doing so, MAKNA ensures that engaged donors, stakeholders, and interested members of the public have access to appropriate and accurate information regarding MAKNA’s finances, operations, and results. MAKNA regularly updates the organisation’s website with current, detailed information on its programmes, including information on where money is going, and the effectiveness of the programmes. Its annual report is posted on its website; its audited annual financial statements are made available for public inspection. Overall, MAKNA exhibits a strong commitment to provide visibility for its activities and utilisation of resources to stakeholders. This includes donors, those whose need its programs, employees, and authorities that grant the nonprofit exemption from taxation. The nonprofit discloses administrative costs in its audited financial statements in a clear and non-misleading way. MAKNA has policies, procedures, conduct codes and compliance structures in place to promote self-governance and commitment to ethical conduct in the areas where nonprofit ethical issues typically arise. These areas are compensation; conflicts of interest; confidentiality and privacy of personal data, donation solicitation; financial integrity; investment policies; and use of donated funds. MAKNA’s governance structure, its compensation structure and performance measurement framework lend further support to the nonprofit’s ethical conduct. MAKNA’s code of conduct fosters candour in solicitation to mitigate the risk of fundraising based on misguided assumptions and any corresponding violation of public expectations in the use of resources.
Ethics
BASED ON 2012-2016 DATA
MAKNA’s code of conduct for employees and volunteers addresses the ethical problems of misrepresentation, unconscionable conduct in relation to charitable solicitation, conflicts of interest and the reporting of unethical organisational behaviour, among others. Its code of conduct for employees and volunteers are found within its employee handbook and its website, respectively. Confidential information from donors or any organisation or individual in MAKNA’s possession is managed, stored and kept securely within its premises. Beyond what is required legally, MAKNA ensures that the dissemination of any information to the general public is consistent with the organisation’s confidentiality policies.
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Overall Assessment Overall Evaluation of Governance, Accountability, Transparency and Ethics Framework Excellent Strong Adequate Weak Equal consideration is given to each of the four areas: Governance, Accountability, Transparency and Ethics in arriving at the overall evaluation which is expressed on the above four-point descriptive scale. Each of the four areas is assessed in terms of oversight mechanisms and the framework of policies and procedures that the nonprofit has established to foster and reinforce good governance or conduct that is accountable, transparent and ethical, as well as demonstrated commitment to build a culture of governance, accountability, transparency and ethics.
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ANALYSIS OF SUSTAINABILITY PERFORMANCE
Sustainability in the nonprofit context encompasses talent development, strategic adaptability, as well as financial sustainability, and capacity building in core areas such as relationship building with funders and programme delivery that contribute to nonprofit effectiveness. In the 25 years following its launch, MAKNA has grown significantly in reach and impact. In recent periods, MAKNA has refined its approach to measuring performance towards a focus on impact rather than outputs. A meaningful outcome of this has been a higher level of importance and attention to certain aspects of organisational capacity building that are identified as critical to becoming an engine of impact. The more holistic approach to performance management has also been accompanied by organisational capacity building in the areas of leadership succession planning, talent development and retention. MARC believes the development of these strategic leadership capabilities in lockstep with programme development will be critical to pursuing impact at scale over the long term. MAKNA’s leadership team is also devoting much attention to shaping the nonprofit’s cultural environment and perpetuating a mission-centric and needs-based innovation culture. MAKNA’s enhanced workflow automation for its bursary programme provides its management the benefit of streamlined and timely access as well as visibility into all pending applications, patient data, proposed treatment strategies and costs, to date disbursements. Apart from allowing MAKNA to develop greater processing efficiencies, the data on the disease burden, economic impact and trends can be used to inform policies in cancer care. MAKNA has also built a diversified workforce with significant female representation that speaks to the diverse backgrounds, experiences and perspectives of the communities it serves. When hiring candidates, culture fit is an important consideration. Founding values are internalised through staff onboarding, workplace policies and practices. MAKNA involves all its employees in its home stay programmes which it runs every year to support them in aligning their shared values behind its mission of helping patients and their families to navigate their cancer journeys. The nonprofit provides professional development opportunities for its employees in technical roles so that they can keep abreast of developments in their field. MAKNA’s ability to reproduce social capital among volunteers and donors, meanwhile, is evidenced by a widening base of support for its cause. MAKNA’s number of active volunteers increased considerably by 130 individuals or 43% in 2019, helped by the development and execution of effective recruitment, screening, training, and retention strategies. MAKNA has a sizeable base of individual donors joined by common concerns about cancer health disparities. MAKNA has managed to sustain its fundraising momentum by building a comprehensive retention programme for donors and adding 9,000 to 12,000 new donors yearly to its donor base. MARC sees the development of highly professional internal fundraising capabilities and funding diversification as important next steps in the evolution of MAKNA’s funding model and securing financial sustainability. This is because the needs that MAKNA is aiming to meet are growing due to demographic changes and the likelihood of greater funding gaps in public cancer care services, going forward. This underscores the importance of growing its donor base to keep the level of funding that it can expect to receive in the coming years in alignment with the cost of subsidising publicly funded care. MAKNA’s budget philosophy is built on the foundation of sustainability and surplus budgeting. The nonprofit aims to maintain enough reserve funds to sustain its operations for at least three years to deliver its programmes in a consistent and uninterrupted manner. MAKNA’s financial management capacity in respect of financial planning, accounting and budgeting is appropriate relative to its size and revenue base to provide a timely and accurate monitoring of its financial situation. MAKNA maintains a highly liquid balance sheet and conservative investment stance with its reserve funds held mostly in the form of fixed deposits with licensed banks.
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Sustainability Performance Assessment Excellent
The nonprofit has built a very strong reputation for providing relevant and vital services to the community. Its core programmes are well established and recognised in the community. It has a strong fundraising capacity due to success in attracting a broad base of funders or donors, providing flexibility during recessionary periods. There is consistent evidence of the nonprofit’s strategic adaptability, ability to build capacity and social capital, as well as sound financial management and prudent resource use.
Very Good
The nonprofit has built a strong reputation for providing relevant and vital services to the community. It has good fundraising capacity, although this is not as well developed as that of a nonprofit with an “excellent” sustainability performance assessment, and accordingly, affords less flexibility during recessionary periods. There is evidence of the nonprofit’s strategic adaptability, ability to build capacity and social capital, as well as sound financial management and prudent resource use. Capabilities essential to achieving sustainable mission impact, such as executive leadership, information technology, strategic planning, and knowledge management are strong but not as robust as that of a nonprofit with an “excellent” sustainability performance assessment.
Good
The nonprofit’s programmes are generally well executed and meets the needs of the community. It has adequate fundraising capacity, although this is not as well developed as that of a nonprofit with higher sustainability performance assessment, and accordingly, affords little flexibility during recessionary periods. The nonprofit has adequate, albeit less extensively developed capabilities essential to achieving sustainable mission impact.
Fair
The nonprofit’s programmes are functioning well but there is evidence of shortcomings affecting its ability to deliver programme outcomes consistently, add new programmes or support projected growth. This may include persistent underfunding of overhead and capacity building and/or loss of credibility with funders or donors, amongst others. The nonprofit should have three to six months of liquid reserves to cushion financial shortfalls.
Poor
The nonprofit is encountering challenges in delivering its programmes that are relevant to the community and effective and/or there are question marks over financial sustainability with the nonprofit showing significant signs of financial stress, such as chronic budget deficits and fewer than three months of liquid reserves to cushion financial shortfalls.
MARC’s assessment of the nonprofit’s sustainability performance is expressed on a five-level descriptive scale that runs from “Excellent” to “Poor”.
BASED ON 2012-2016 DATA
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04
OTHER INFORMATION Operational Highlights Employees (total number) Volunteers (total number of active volunteers) Financials Donations and Fundraising Revenue Investment Income Bursary Expenditure Activities Costs Salaries and Related Costs Total Assets Total Liabilities Accumulated Fund
2018 181 300
2017 179 250
41,870,350 4,186,932 7,584,172 11,039,926 10,818,924 124,891,985 3,690,280 121,201,705
36,803,950 3,477,766 6,170,143 9,842,546 10,560,280 110,038,193 2,506,012 107,532,181
Source: MAKNA’s audited financial statements, impact newsletters
BOARD OF TRUSTEES YAM Tengku Puteri Seri Lela Wangsa Pahang Tengku Tan Sri Hajjah Meriam Binti Sultan Haji Ahmad Shah YBhg Professor Tan Sri Dato’ Prof Dzulkifli Abdul Razak EXECUTIVE COMMITTEE Dato Mohd Farid Ariffin Professor Emeritus Dr Cheong Soon Keng Dr Imran Khalid Encik Rosleem Haji Nordin @ Bohari Douglas Tan Hock Kee Farahida Mohd Farid Professor Aziz Baba Professor Aini Ideris Professor Jafri Malin Dr Teoh Hoon Koon Encik Rohaizad Ismail Encik Zainol Talib
President Vice-President Secretary Treasurer Assistant Treasurer Assistant Honorary Secretary Ordinary Member Ordinary Member Ordinary Member Ordinary Member Ordinary Member Ordinary Member
AUDITORS PriceWaterhouseCoopers PLT HEAD OFFICE MAKNA (Majlis Kanser Nasional) or National Cancer Council BG 03A & 05, Ground Floor, Megan Ambassy No. 225, Jalan Ampang 50450 Kuala Lumpur, Malaysia CONTACT Mohammad Sukreejit, International Division & Communications Head Telephone +603 - 2162 9178 Home Page https://makna.org.my/
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RATING SCALE GRADE
GOLD
SILVER
BRONZE
DESCRIPTION The nonprofit has a clear and focused mission and strategy for delivering impact that is grounded in a proven theory of change. Its programmes address significant needs and generate high impact. The nonprofit has also met the threshold requirements of “Strong” and “Very Good” for its “GATE” and sustainability performance assessments, respectively. The nonprofit has a clear and focused mission and strategy for delivering impact that is grounded in a credible theory of change that articulates the logic of how that strategy will achieve that mission. Its programmes address significant needs and generate considerable impact or hold promise for high impact at scale. In addition, the nonprofit has met the threshold requirements of “Strong” and “Very Good” for its “GATE” and sustainability performance assessments, respectively. The nonprofit has a clear and focused mission and strategy for delivering impact that is grounded in a credible theory of change that articulates the logic of how that strategy will achieve that mission. Its programmes address significant needs and generate noteworthy impact or hold promise for considerable impact at scale. In addition, the nonprofit has met the threshold requirements of “Adequate” and “Good” for its “GATE” and sustainability performance assessments, respectively.
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MARC Incorporated in October 1995, MARC is a full-service domestic credit rating institution. MARC's ratings are recognized and accepted in the Malaysian capital markets. MARC is recognized by Bank Negara Malaysia and Securities Commission, respectively, as an External Credit Assessment Institution (ECAI) under Basel II and as a bond rating agency regulated under the Guidelines on the Registration of Credit Rating Agencies issued by the Securities Commission on 30 March 2011. MARC adopts practices and procedures for Domestic Credit Rating Agencies based on the guidance on the Code of Conduct Fundamentals provided by the International Organisation of Securities Commissions (IOSCO) and the Association of Credit Rating Agencies in Asia (ACRAA). MARC’s Nonprofit Impact Assessment is designed to help nonprofits increase their impact by engaging potential donors or givers on their participation in or contribution to creating environmental and/or social impact. MARC’s analytical framework consists of three components: (1) an assessment of the nonprofit’s effectiveness in delivering its mission and the significance of its positive impact on a particular environmental or social need; (2) an assessment of the nonprofit’s governance structure, accountability, transparency and ethics; and (3) an evaluation of the nonprofit’s ability to sustain itself over the long-term as informed by an assessment of its organisational capacity, financial sustainability and strategic adaptability. Nonprofits which meet or exceed the “Fairly Significant” impact threshold will be rated Gold, Silver or Bronze.
For more information marc@marc.com.my.
BASED ON 2012-2016 DATA
on MARC, visit
https://www.marc.com.my/
or contact
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NONPROFIT ASSESSMENT DECEMBER 2020
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(Majlis Kanser Nasional/National Cancer Council) BG 03A & 05, Ground Floor, Megam Ambassy, No 225, Jalan Ampang, 50450 Kuala Lumpur, Malaysia Telefon: +603-2162 9178 Faksimili: +603-216 29203 Email: makna@makna.org.my