DECEMBER 1 ― It’s the end of 2015. Next year will mark three decades since the first recorded HIV case was detected in Malaysia. We have come so far and achieved so much in that time but it is sobering to also realise that there remains much that has not been done.
That was made clear during the Pertubuhan Pembangunan Kebajikan dan Persekitaran Positif (SEED Foundation)’s event last Sunday held in conjunction with World AIDS Day.
Every 1st of December is World AIDS Day. It is a day for those working in the field of HIV and those whose lives have been touched by AIDS to take stock and reflect.
Globally, around 37 million people are now living with HIV. Two million adults and children were estimated to be newly infected in 2014. 1.2 million people lost their lives to AIDS related illnesses by the end of that year.
Despite that there have been immense gains made. Already 15 million people are now accessing life-saving HIV treatment. New infections have been reduced by 35 per cent since 2000 and AIDS-related deaths have been reduced by 42 per cent since its peak in 2004. We are told that investments made between now and 2020 could reduce new HIV infections by 89 per cent and AIDS-related deaths by 81per cent by 2030.
We can do this. We know what works. We have what it takes to break the back of the AIDS epidemic. So it’s good news.
But if this is so, then why is it that in the Asia and Pacific region there are now more than 220,000 individuals between the ages of 10-19 living with HIV and whose numbers are growing instead of shrinking?
Perhaps the answer lies in looking at the Malaysian response.
By the end of World AIDS Day, nine Malaysians would have been newly infected with HIV. It used to be 19 people daily. Though more than 103,000 people have contracted HIV since the mid-80s and there are now an estimated 90,000 people living with the virus, Malaysia has been a success story.
Since 2006, the harm reduction programme with people who use drugs, 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 fallen drastically. The halving of new reported infections from its peak of almost 7,000 can be attributed to the success of utilising this form of intervention.
Malaysia is frequently showcased internationally as an example of 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.
But from 2010 onwards, Malaysia’s HIV epidemic changed. It is now no longer an epidemic driven by the sharing of needles, but one that is spread through sex. Heterosexual transmission, to be specific and a smaller percentage through homosexual sex. Today, for every two persons infected through the use of drugs, seven individuals contract the virus sexually.
During the launch, Marhalem Mansor and his wife, Jamaliah, both members of the people living with HIV community in Malaysia, expressed their frustration at what they perceived to be government behaving as if the epidemic was all over. A thing of the past.
Lalita Abdullah, executive committee member for the SEED Foundation, cautioned on the need to combat such complacency in the national HIV response. She expressed her disappointment at the Ministry of Health’s continued reliance on NGOs to deal with sexual HIV transmission but refusing to provide adequate funding, support for sufficient coverage or even talk about promoting contraceptive education and condom use.
There continues to be insufficient political will, funding, and support for programmes which address sexual transmission. Less than 15 per cent of the national AIDS programme is spent on prevention. The proportion spent on programmes targeting sex is even smaller.
NGOs just don’t have the enough resources and manpower to do what is needed. This is the role of the government. Wake up and get real on HIV, Lalita stressed.
Listening to Khartini Slamah, long time transgender rights defender, you can hear the frustration in her voice. “After 30 years, we are still talking about the same thing when it comes to sex and HIV. Why? Where is the leadership?”
Simply put, when it comes to preventing HIV through sex from the perspective of HIV activists, it seems that nobody has the guts, courage or the moral fortitude to commit and do what is needed. This is despite knowing what works.
The same courage and political will that succeeded in pushing harm reduction to the forefront of HIV prevention in Malaysia’s response is now needed to address sexual transmission. It needs radical thinking, Lalita stressed.
The SEED Foundation is one of those NGOs working with marginalised communities at the forefront of the HIV epidemic. It runs a shelter for the people in that community, their children, people living with HIV as well as the homeless and destitue. They provide a safe space to rest, eat and shower as well as obtain vocational skills training, job placements, medical aid and identification papers.
This World AIDS Day, let’s do our part in preventing HIV in Malaysia., If you want to help or donate, contact Mitch Yusmar at [email protected] or 012-385 9624.
Let’s not leave anyone behind.
*This is the personal opinion of the columnist.
