KUALA LUMPUR, Feb 17 — A UK-based group has commended Malaysia as a “world leader” in harm reduction for the country’s controversial needle exchange and methadone programme hailed for its relative success in combating the HIV epidemic caused mainly by injecting drug use.
Harm Reduction International (HRI), a non-governmental organisation that promotes the prevention of harm as opposed to the prevention of drug use itself, said in its Global State of Harm Reduction 2014 report that Malaysia, along with Iran and Australia, had made the largest increase in the number of needle and syringe exchange programmes.
“Although few countries in the region receive national government funding support for harm reduction, Malaysia and India are examples of where the government supports an almost fully fledged harm reduction programme,” said HRI in the report.
Malaysia more than doubled the number of needle exchange programmes from 297 sites in 2012 to 728 last year.
The number of methadone programmes, or opioid substitution therapy, in Malaysia also went up from 674 to 811 sites in the same period.
The report noted that although substitution therapy has been expanded in prisons in Malaysia from one prison in 2008 to 18 by 2013, methadone is unavailable in pre-trial police detention.
HRI said in a statement that HIV rates among people who inject drugs are low – and even almost negligible in some cases – when comprehensive harm reduction is implemented.
“It was the primary reason that HIV/AIDS epidemics amongst drug users in cities like London, Glasgow, New York, Sydney, Amsterdam and Berlin were avoided when AIDS first surfaced in the early 1980s,” said HRI today.
“It is also the reason that countries like Malaysia have been largely successful over the past seven years in turning around what was an injecting drug led HIV/AIDS epidemic by introducing government-led harm reduction initiatives throughout the country,” the NGO added.
Malaysian AIDS Council (MAC) president Datuk Dr Raj Karim said challenges still remained in the areas of HIV and drug treatment access, as well as diagnosis and treatment for related infections like tuberculosis and viral hepatitis.
“Practices and policies that stigmatise and criminalise drug users must be removed and replaced with measures to divert arrests to voluntary drug treatment,” Raj told Malay Mail Online.
“Leadership on all levels is key in sustaining the positive outcomes of the harm reduction programme, and there needs to be continued financial commitment by the government on harm reduction,” she added.
The MAC chief said last December that Malaysia’s harm reduction programme has decreased new HIV infections among people who inject drugs by 50 per cent.
“We would not have been able to achieve the results that we are seeing today without the visionary leadership of our Prime Minister, Datuk Seri Najib Razak, who in his capacity as the chair of the Cabinet Committee on Drugs in 2005 took the bold step to green light the harm reduction programme against much public opposition,” said Raj in her World AIDS Day Message on December 1.
A research study by the Centre of Excellence for Research in AIDS (CERiA) in Universiti Malaya, in collaboration with Australia’s Kirby Institute, released last December showed that Malaysia’s needle exchange and methadone programme – which was once criticised for encouraging drug use – has prevented about 39 per cent of new infections and saved RM47 million in healthcare costs during the first eight years of implementation.
The study also said the programme would prevent a whopping 87 per cent of new HIV infections and save about RM210 million in healthcare costs if continued for another 10 years till 2023.
According to HRI, which cited information from Malaysia’s Global AIDS Response Progress Reports in Geneva in 2012 and 2014, there are 170,000 people who inject drugs in Malaysia and the HIV prevalence among injecting drug users is almost one out of five people, or 18.9 per cent.
HRI also said in its report that although Putrajaya announced more funding for drug control last year, the money was likely targeted at abstinence-based programmes and primary prevention, rather than harm reduction.