So how will Malaysia manage? There are three key areas for any country to build resilient health systems and these will be especially vital in Malaysia.

A strong civil service

Politicians may come and go but civil servants remain. Outgoing health minister Dr Dzulkefly Ahmad won plaudits for his effective approach and human touch. During the coronavirus outbreak, his performance and demeanour have reassured Malaysians. The country had 22 cases, mostly involving Chinese nationals, and 20 of those have recovered.

His departure is regrettable, although he could still return given the politically fluid situation. Nevertheless, much of the health system capacity, institutional memory and leadership remains within the technocracy of the Ministry of Health (MOH). This apparatus is led by the director general of health, currently a surgeon, and is battle-hardened from previous outbreaks of Sars, H1N1, Nipah and Mers-COV.

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The 270,000 employees of the MOH are also familiar with more common infectious diseases, dealing with dengue and tuberculosis daily. They are also supported by world-class laboratory and research functions.

For example, Malaysia’s Institute of Medical Research developed the primers and probes for real-time polymerase chain reaction (PCR) testing to identify infection the same day Chinese scientists released the DNA sequence of Covid-19 into an open-access repository. This was earlier than World Health Organisation (WHO) laboratory protocols.

For better or worse, Malaysia has had a high turnover of health ministers: 20 since 1955. Yet the health service’s consistent progress is testament to the skill, sacrifice, independence and stability of the MOH and its civil servants.

A tightly knit health fraternity

The most important thread uniting Malaysia’s diverse health fraternity is the shared set of professional and medical ethics underpinning clinical care offered by doctors, nurses, pharmacists, dentists and paramedics.

The country’s professional societies include Islamic medical and scientific organisations, such as the Islamic Medical Association of Malaysia (IMAM) and IKRAM Health. Their clear philosophies and credo allow them to provide an essential and well-regarded service to Malaysia, while also uniting through faith.

All professional societies are equally committed to science and service, and their membership includes both public and private practitioners. This is yet another layer of unity.

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Despite an ongoing brain drain to the private sector, a period of compulsory public service means everyone currently in the private sector still has friends, former colleagues, seniors and juniors in the public service. These social links are crucial in promoting and maintaining cohesion and a shared purpose.

Although there will be the inevitable minority of black sheep, the Malaysian health fraternity is tightly knit. It’s helpful that health is less adversarial than the legal fraternity. Especially during times of national crisis, the health fraternity unites to save lives: as it did during Sars, H1N1 and Nipah, and as it will again now.

Independence from politics

The social determinants of health – such as housing, employment, gender equity and early childhood education – are arguably more important than the services delivered by doctors in hospitals.

This reinforces the role of “Health in All Policies”, a World Health Organisation framework that encourages governments to think beyond the MOH.

Nevertheless, the specifics of health care – such as delivering medicines or performing surgeries and other procedures – are generally left to the MOH rather than other government entities that contribute to public health more generally.

Most politicians keep their distance from health care because of the scary jargon, scientific complexities and its life-and-death decisions. And members of society too often take their health for granted until they need health care. As a result, in Malaysia health care is essentially ring-fenced from politics.

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Health care professionals are trusted, especially public sector practitioners rightly regarded as self-sacrificing, committed and highly competent. The technocracy of the MOH is appreciated by the public for delivering health care with autonomy and relative insulation from petty politics.

Some politics is inevitable, of course, but this ring-fencing allows the MOH to be more operationally independent than other government agencies. They will retain their self-sufficiency and effectiveness in fighting Covid-19 and delivering the routine services.

Although the timing of Malaysia’s political upheaval is not ideal, the skill, stability and resilience of the health system’s professionals will enable it to confront the current challenge posed by the coronavirus, even without a permanent health minister.

Swee Kheng Khor was a frontline doctor in a Malaysian public hospital during the 2009 H1N1 swine flu outbreak. He specialises in health systems, health policies and global health, and is currently based at the University of Oxford.