IN Sarawak, Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) is not a new issue; it has been present in the Sarawak and Malaysia since the late 1980s.
However, recent data from the Department of Health Sarawak shows a rising trend in cases over the past seven years. In 2022, as many as 2,720 people tested positive for HIV, with Kuching recording the highest number of cases at 800, accounting for 29.4 per cent.
Sharing statistics from the previous year, Premier Datuk Patinggi Tan Sri Abang Johari Tun Openg revealed that the age group of 20 to 29 made up 41.4 per cent (1,125 cases) of HIV infections, followed by those aged 30 to 39 with 855 cases or 31.4 per cent.
Sarawak also documented 1,093 AIDS cases, with Sibu having the highest count at 243 cases or 22.2 per cent. With the goal of making Sarawak the first HIV/AIDS-free state in Malaysia by 2030, it’s important to revisit the history of HIV/AIDS in Malaysia and understand how the country has progressed in its fight against these diseases.
SUMMARY OF HIV/AIDS
HIV/AIDS is a spectrum of conditions caused by infection with HIV, a retrovirus. After initial infection, a person may not notice any symptoms or may experience a brief period of influenza-like illness.
Typically, this is followed by a prolonged incubation period with no symptoms. As the infection progresses, it further interferes with the immune system, increasing the risk of developing common infections such as tuberculosis, as well as other opportunistic infections and rare tumors in individuals with normal immune function.
The late stage of infection is referred to as AIDS, often associated with unintended weight loss.
HIV is primarily spread by unprotected sexual intercourse, contaminated hypodermic needles, blood transfusions, and from mother to child during pregnancy, delivery, or breastfeeding.
HIV/AIDS has been recognised worldwide since the early 1980s, and it has had a significant impact on society, both as an illness and as a source of discrimination.
There are many misconceptions about this disease, including the belief that it can be transmitted through casual non-sexual contact.
Since its identification in the 1980s, it has gained international medical and political attention, as well as substantial funding.
As of 2021, there were 650,000 deaths, and about 38 million people around the world were living with HIV. It is considered a pandemic.
While there is currently no cure or vaccine, antiretroviral treatment can slow the course of the disease and may lead to a near-normal life expectancy. Treatment is recommended as soon as a diagnosis is made.
HIV/AIDS IN MALAYSIA
In 1986, the first HIV/AIDS case made its somewhat “debut” in Malaysia, and since then, it has become the country’s most serious health and development challenge.
In 2017, former Minister of Human Resources, Datuk Seri Richard Riot Jaem, announced that the government had been working closely with the Malaysia AIDS Foundation (MAF) to legislate the HIV and AIDS in Workplace Policy. This vision was pushed forth by MAF. Although there is a Code of Practice on the Prevention and Management of HIV and AIDS developed in 2001, companies only voluntarily adopt the policy.
At that time, Riot wanted to change that, making it compulsory for companies to comply with the code of practice.
“The code of practice needs to be reviewed and updated, and the word ‘stigma’ is very important here. We must not forget that there is no risk of People Living with HIV (PLHIV) transmitting the virus to their colleagues through workplace-appropriate interactions, unlike other airborne diseases,” he said.
According to the website CodeBlue, which promotes healthcare as a human right, a report by the federal Ministry of Health (MOH) Global AIDS Monitoring 2021 progress report revealed that about 87 per cent of an estimated 92,063 PLHIV in Malaysia were aware of their status as of 2020. Additionally, 58 per cent of reported PLHIV received antiretroviral therapy, and 85 per cent of those on antiretroviral treatment became virally suppressed.
Despite making outstanding progress, the country fell short of meeting the global 2020 HIV goals of 90-90-90, with a scorecard of 87-58-85. This is due to the shift in the local HIV epidemiology landscape from needle-sharing to sexual transmission and the stigma and discrimination faced by PLHIV, which impedes efforts to link the newly diagnosed PLHIV with care.
As of 2022, there were 3,177 new HIV cases reported last year, and most of the cases involved men aged between 20 and 39 years old. Deputy Minister of Health Lukanisman Awang Sauni added that every year, 77 per cent of new cases involve youths aged between 20 and 39, and more than 90 per cent of this age range are men.
Lukanisman then explained that Pre-Exposure Prophylaxis (PrEP) medicine is the most effective pharmaceutical preventive measure. It successfully prevented HIV infections through sexual intercourse with a 99 per cent success rate.
“This method was scientifically proven in many studies abroad, and a study by the Centre of Excellence for Research in AIDS (CERIA) showed that the usage of PrEP saved RM47 million in government expenses between 2006 and 2013 in HIV treatments,” he explained.
MALAYSIA AIDS FOUNDATION
In 1993, MAF was founded, and it was fully incorporated in 2003 under the Incorporation Act 1952.
According to MAF’s website, the objective is to prevent the spread of HIV in Malaysia and provide education on HIV/AIDS matters to the families, friends, the public, and authorities across the country.
MAF also provides support to PLHIV, protects the human rights of people in Malaysia who may face discrimination due to their HIV status, and offers financial assistance or other forms of support to organisations, including the Malaysian AIDS Council, to carry out activities and services.
Notable moments in history include the launch of the Paediatric AIDS Fund (PAF) in aid of children living with or affected by HIV.
In 1998, MAF introduced the Medicine Assistance Scheme, later rebranded as the Positive, Audacious Living (PAL) Scheme in 2011. This change reflected the growing optimism and progress in HIV medicine. The newer generation of Antiretroviral (ARV) medicines were able to restore PLHIV to normal health and enable them to lead productive lives.
MAF continues to run the PAL programme today due to the high financial burden faced by PLHIV in need of second-line medication.
Since 2015, Yayasan Sime Darby has been the principal partner for this programme. Currently, PAL supports around 173 underprivileged individuals in Malaysia, ensuring continuous access to medication and a second chance at life.
Another programme by MAF is the MyLady Assistance Scheme, an empowerment initiative for women living with HIV from underprivileged backgrounds. This scheme offers women and single mothers with HIV the knowledge and skills to start small-scale businesses. It also provides zero-interest micro-credit loans of RM5,000, aiming to guide women toward self-reliance and greater financial independence.
This year, MAF remains committed to providing assistance to the affected community, especially during the pandemic. Thanks to the dedication and support of its programmes, treatment, care, and support continue as usual.
In Sarawak, MAF supports a special project called Teratak Kasih Tok Nan in collaboration with the state government. This initiative aligns with the state’s goal to combat HIV/AIDS and become Malaysia’s first HIV/AIDS-free state by 2030, just seven years from now.
The second part of this series will delve into the stigma faced by PLHIV and their ongoing battle.
