Materia Medica Malaysiana

HIV/AIDS - it's everyone's fight

A multisectoral approach is needed to fight the disease with the rising numbers of cases, Malaysian AIDS Council president, Marina Mahathir, tells JESWANT KAUR
MALAYSIA would not be on the brink of a HIV/AIDS epidemic if we had paid more attention to the early warning signs. Instead, a reluctance to confront the problem
head-on and a false sense of security have resulted in the recent World Health Organisation warning that the country is at the initial stage of a HIV break out.
This is not the first warning from WHO which had issued a similar caution a few years ago. Its recent fear, however, was prompted by findings that 15,000 children in Malaysia had been orphaned by AIDS. WHO is now closely monitoring the “progress” of the HIV situation in Malaysia. Its findings are contained in its UNAIDS/WHO Report on the Global HIV/AIDS Epidemic.

Sixteen years after HIV was first detected in Malaysia, the situation domestically has seen little improvement. Official figures state that about 65,000 people have been diagnosed with HIV/AIDS. Of this, 9,444 have AIDS and 7,195 have since died.
“Obviously, the rising numbers indicate that the Government has not done enough. There was this reluctance to tackle the issue of HIV/AIDS head-on, with the false security that somehow we are different from other countries affected by AIDS and that we can do things our own way,” laments Malaysian AIDS Council (MAC) president Datin Paduka Marina Mahathir.

She tells Sunday Mail that Malaysia’s failure to articulate an effective way of tackling the problem had only worsened the situation.
“Everything is deemed sensitive and because of that no one does anything. Is it surprising then that we should be in this situation now?”
“MAC has been voicing the same concern for a long time. We were using the word ‘epidemic’ from the beginning. But unfortunately, we sometimes need to get to a certain level of infection before people really begin to understand how serious it is,” she says.

She says the public’s lack of understanding about HIV/AIDS was responsible for the many misconceptions about the disease.
“I do not think the public is in denial as much as I think they are not very well educated about HIV. There are still many misconceptions about how you do or do not get infected by HIV. It is not surprising then that some people react negatively to suggestions made to improve the situation. If they were better informed, then they would probably be more supportive. We certainly need to do more public education with the aim of eradicating the stigma of HIV/AIDS. That would help a lot with prevention.”
Marina, however, fears that the WHO warning, while revealing the gravity of HIV/AIDS situation in Malaysia, might also result in an adverse reaction from the people.

“My greatest fear is that people will panic and demand the wrong sort of programmes, such as isolation of people living with HIV/AIDS (PLWHAs).
“We need people to be calm and approach the situation based on scientific evidence of what works and what doesn’t. Malaysia is not the first country in the world to be in this situation, so we do not need to invent anything. All we need to do is adapt proven prevention programmes to our circumstances,” she explains.
She says the success of many countries in successfully tackling HIV/AIDS revealed that what was most needed was a multisectoral approach to this disease.

“This means that prevention is being done not just by one group but by everyone in a well-coordinated way. And there needs to be many different approaches to reach many different types of people. As long as we insist that there is only one way of doing things and keep waiting for someone to do that work, we have no hope of tackling HIV/AIDS at all.

Marina stresses that leadership at the highest level was needed to tackle the HIV/AIDS problem, adding that it was heartening to note the Malaysian Government’s decision to implement harm-reduction measures to tackle HIV/AIDS.
“Why has Uganda managed to bring down its HIV/AIDS numbers? It is because President Yoweri Museveni himself heads the national AIDS committee. This is the only way to ensure things will move,” she says.
Health Minister Datuk Dr Chua Soi Lek had recently said that 1, 200 drug users will be given condoms and needles in Government hospitals and clinics beginning October on a trial basis. Prime Minister Datuk Seri Abdullah Ahmad Badawi had said that the plan was the best so far in tackling the HIV/AIDS situation.

Drug abuse is responsible for the bulk of HIV/AIDS cases in Malaysia. There are 13,000 intravenous drug users and a big number of them share needles, escalating the risk of infection.
“It is because we have reached a critical stage in our HIV epidemic that we require these measures. It would have been good if we had done this long ago but still it is not too late to do something now,” Marina says.
She points out that during MAC’s nationwide training of Muslim religious leaders, it was found that at the grassroot level, the leaders yearned for more knowledge on HIV/AIDS.
“These leaders are faced with the issue but without proper knowledge, they do not know how to help and feel helpless. They were happy when we conducted the workshops and asked for more.”
Marina, however, worries most for PLWHAs as they not only had to endure physical suffering but also mental and emotional anguish in the form of discrimination and neglect by people around them.
“Being turned away by one’s family and close friends must be the most painful thing to experience. If society gets panicky and hysterical and starts clamouring for isolation, then we will end up causing more suffering for PLWHAs in our country. We should be ashamed of such lack of compassion towards our own people.”
She also stressed on the importance of involving PLWHAs in the planning and implementation of HIV/AIDS programmes.
“They know what caused them to become infected and they alone know what it is like to be infected. We will not dream of designing programmes for the blind without their input so how can we design programmes for HIV/AIDS without the involvement of PLWHAs? We do this because we think that once someone gets infected, they do not have any brains anymore. That is what is known as prejudice and discrimination,” Marina says.
Marina will be among the participants from Malaysia attending the Seventh International Congress on AIDS in Asia and the Pacific (ICAAP) in Kobe, Japan, from Friday to July 5.