The Politics of Technocracy in Malaysia (1957-2012)

Malaysia’s technocracy (administrative elite) and the government of the day (political elite) have had and continue to enjoy a harmonious and symbiotic relationship. Such synergy had its origins and background in British colonial rule when promising Malays were groomed for administrative positions. The dawn ofmerdeka (national independence) allowed for the transition from administrativepositions to political leadership. The first three prime ministers, namely TunkuAbdul Rahman, Abdul Razak and Hussein Onn were drawn from these ranks.There was an organic development in the relationship between the ‘old’ technocrats and politicians expressed in shared strategic outlook and direction. As such, national development was characterised not by intermittent periods of political disruption but a sustained period of continuity in the pre-conditions for economic growth which extended and heightened throughout the premiership ofMahathir Mohamad. His successor, Abdullah Badawi, started to install corporatefigures as technocrats to professionalise the governance of the administrativesystem. Under Najib Razak the role of these ‘new’ technocrats was further entrenched and enhanced

The Southern Provinces in bilateral cooperation during the Mahathir and Abdullah years

Malaysia’s relations with Thailand can be described as paradoxical. On the one hand, bilateral ties had been the least ‘problematic.’ On the other, the situation in the Southern Provinces had constrained relations and this could be seen during the administrations of Mahathir and Abdullah which became preoccupied with finding solutions. In ‘aggregating’ these two polar states together (‘superposition’), one could construe or amplify bilateral relations within a broader range of so-called overall ‘benign neglect’ that to a certain extent – characterised the approach of successive administrations of both countries. The objective of this paper as conditioned by archival sources as well as interviews seeks, therefore, to highlight the under-appreciated and overlooked role of the leadership factor in bilateral relations. This is in turn co-related to developments in political contestations and reconfigurations centred in Bangkok (“national politics”) which whilst promising little hope on the resolution for peace and stability in the Southern Provinces – contributes to the (unchanging) broader narrative. In short, directions in bilateral relations have been – to a critical extent – determined, influenced and constrained by the inability to achieve a breakthrough to the situation in the Southern Provinces

Empagliflozin in Patients with Chronic Kidney Disease

Background The effects of empagliflozin in patients with chronic kidney disease who are at risk for disease progression are not well understood. The EMPA-KIDNEY trial was designed to assess the effects of treatment with empagliflozin in a broad range of such patients. Methods We enrolled patients with chronic kidney disease who had an estimated glomerular filtration rate (eGFR) of at least 20 but less than 45 ml per minute per 1.73 m(2) of body-surface area, or who had an eGFR of at least 45 but less than 90 ml per minute per 1.73 m(2) with a urinary albumin-to-creatinine ratio (with albumin measured in milligrams and creatinine measured in grams) of at least 200. Patients were randomly assigned to receive empagliflozin (10 mg once daily) or matching placebo. The primary outcome was a composite of progression of kidney disease (defined as end-stage kidney disease, a sustained decrease in eGFR to < 10 ml per minute per 1.73 m(2), a sustained decrease in eGFR of & GE;40% from baseline, or death from renal causes) or death from cardiovascular causes. Results A total of 6609 patients underwent randomization. During a median of 2.0 years of follow-up, progression of kidney disease or death from cardiovascular causes occurred in 432 of 3304 patients (13.1%) in the empagliflozin group and in 558 of 3305 patients (16.9%) in the placebo group (hazard ratio, 0.72; 95% confidence interval [CI], 0.64 to 0.82; P < 0.001). Results were consistent among patients with or without diabetes and across subgroups defined according to eGFR ranges. The rate of hospitalization from any cause was lower in the empagliflozin group than in the placebo group (hazard ratio, 0.86; 95% CI, 0.78 to 0.95; P=0.003), but there were no significant between-group differences with respect to the composite outcome of hospitalization for heart failure or death from cardiovascular causes (which occurred in 4.0% in the empagliflozin group and 4.6% in the placebo group) or death from any cause (in 4.5% and 5.1%, respectively). The rates of serious adverse events were similar in the two groups. Conclusions Among a wide range of patients with chronic kidney disease who were at risk for disease progression, empagliflozin therapy led to a lower risk of progression of kidney disease or death from cardiovascular causes than placebo