DECEMBER1 — By the time the sun goes down today, nine Malaysians would have been newly infected with HIV. Bad as this may sound, the number of new infections has in fact dropped significantly compared to the time when it was 19 people newly reported contracting the virus each day. I remember that time.

Today, it is estimated that there are more than 85,000 people living with HIV in this country. In 2013, 3,393 individuals were newly infected. More than 16,000 people have died of AIDS related illnesses. 

But this issue is more than just about the numbers. Like all things, there is good and not-so-good news when it comes to reports from the frontlines of the AIDS epidemic in Malaysia.

The good news is that since 2006, the harm reduction programme with people who use drugs, which was introduced with great courage and foresight has helped prevent more than 13,000 new infections and saved RM47 million in direct annual healthcare costs. The number of those contracting HIV through the drug route has reduced drastically. The halving of new infections compared to the epidemic at its peak can be attributed to this intervention.

In fact, Malaysia is a success story frequently showcased by the United Nations as what can happen when resources are invested in a programme supported by proven strategies and evidence backed interventions such as needle exchanges and opioid substitution therapies. 

However, despite these gains, it is sobering to note the fact that the number of people infected with HIV since the Malaysian epidemic began in 1986 passed the 100,000 mark last year. Not a milestone to celebrate about.

The not-so-good part of recent developments has been the fact that from 2010 onwards, Malaysia’s HIV epidemic experienced an identity change. From being an epidemic predominantly dependent on the sharing of needles by people who use drugs, it has now evolved and is now spread through sexual transmission.

73 per cent of new HIV cases are now contracted through sexual intercourse, the majority of which are heterosexual transmission and a smaller percentage through the homosexual route. Today, for every two persons infected through the use of drugs, seven individuals contract the virus sexually.

Seven hundred and twenty-eight of new cases last year were among women and girls. Almost 11,000 cases of HIV have been among women. Most of these infections were via sex. 

Yet despite this stark reality and the now changed nature of the epidemic, the national AIDS response continues to suffer from the lack of funding, commitment and support for programmes which address sexual transmission. Malaysia spends less than 15 per cent of the national AIDS programme on prevention. And the proportion spent on programmes targeting sexual transmission is smaller still.

For example, in 2012, only US$10,000 (RM33,824) in grant funds were allocated to HIV prevention among the men who have sex with men (MSM) community despite 22 per cent of new HIV cases being reported through this route. A drop in the ocean when you consider the millions spent for treatment and harm reduction.

Most funders are turned off by the prospect of contributing to projects which deal with often socially marginalised communities such as sex workers, transgender persons, MSM and various other “undesirables”, preferring instead safer subjects such as education and children. 

As such, HIV prevention programmes are continuously starved for funds, are heavily dependent on government funding and are frequently forced to fight tooth and nail for their survival each year, taking away attention from the actual work at hand with the communities on the ground.

On this World AIDS Day which falls on December 1, I call on the government and various public and private sector funders to renew their commitment to fighting HIV in this country and have the courage to invest in programmes which address prevention of HIV through sex. 

We need more success stories. We cannot afford to rest easy with our success of the harm reduction approach at the cost of neglecting sexual transmission of this disease. Today, this is where the need is greatest and can make the most impact.

* This is the personal opinion of the columnist.