Closing the gap in HIV, AIDS prevention

November 27, 2014

A community-based organisation hopes to see more money spent on fighting HIV and AIDS in Malaysia.

COMMENT

by Anthony Thanasayan

This year, World AIDS Day, which is celebrated annually on December 1, will give Malaysians a moment to reflect on the nation’s response to HIV and AIDS.

According to the marketing and communications director of Pink Triangle (PT) Foundation, Raymond Tai: “December 1 will be an opportunity for us to join forces with the world community to unite in the fight against HIV.”

Tai, who started off as a volunteer before joining PT full time, has been with the community-based organisation for the last 20 years.

PT advocates HIV and AIDS prevention, support and care.

“It will also be a chance for us to show our support for People Living with HIV (PLHIV) and to commemorate people who have died from AIDS,” he said, adding that it would be a timely occasion to reflect on the progress and challenges that Malaysia has made in the fight against HIV and AIDS.

Tai noted that since the first case of HIV was discovered in Malaysia more than 25 years ago, the total number of PLHIV in Malaysia is estimated at 85,332.

In December last year, Malaysia had a cumulative figure of 101,672 reported HIV cases, 20,285 AIDS cases and 16,340 cases of AIDS-related deaths.

The epidemic in Malaysia, he pointed out, remains concentrated among key affected populations, namely People Using Drugs (PUD), sex workers, Men who have Sex with Men (MSM) and transgenders.

The annual number of new HIV cases reported by the Ministry of Health (MOH) has been on a decline from a peak of 6,978 in 2002. It has stabilised in recent years. In 2013, only 3,393 new cases were reported, with an average of about nine new cases every day.

The good news is that the official notification rate of HIV has also continued to experience a decrease – from 23.4 in 2005 to 11.4 cases per 100,000 people in 2013.

This is close to meeting the United Nation’s Millenium Development Goals (MDG) target of 11 cases per 100,000 people by 2015.

“What is of concern, however, is that we believe that a good number of HIV cases remain unreported, as HIV testing is still considered sensitive,” said Tai who is also a member of the Council of Representatives in the 2012-2014 Asia Pacific Council of AIDS Service Organisations.

During the early phase of the HIV epidemic in Malaysia, the abuse of drugs via injections was the driving factor.

This trend has changed in recent years, from only one sexual transmission for every nine PUD in 1990 to two sexual transmissions for every eight PUD in 2000.

In 2012, sexual transmissions superseded PUD as the main factor for the HIV epidemic, with a ratio of seven sexual transmissions for every two PUD cases.

According to Tai, PLHIV in Malaysia are predominantly male and constitute 90 per cent of cumulative HIV cases.

However, the female to male ratio changed from 1:99 in 1990 to 1:10 in 2000, with the gap closing in 2013, at 1:4.

In addition to the concentrated epidemic scenario, there is concern about the percentage of cumulative HIV infections reported in young people aged between 13 and 29 years.

“In the past decade, the Ministry of Health has done a commendable task in reversing the rise of HIV among injecting drug users by introducing the distribution of clean needles and syringes to injecting drug users, and methadone maintenance therapy to encourage heroin users to switch to methadone,” Tai said.

Tai believes that while these efforts need to be maintained, what warrants immediate attention is the rising trend of HIV infection through sexual transmission.

According to data obtained from the www.aidsdatahub.org, only 12 per cent of Malaysia’s expenditure on HIV and AIDS in 2012 was spent on prevention.

And from that figure, only 50 per cent of prevention efforts, or USD5 million was targeted at key affected populations, of which 60 per cent constituted people who inject drugs.

That left only USD10 million to spend on female sex workers, and USD 10,000 for the MSM population.

“The lack of funding on sexual transmission prevention has left non-governmental organisations such as PT Foundation on the brink of closure despite being in existence for as long as HIV has existed on the shores of Malaysia since 1987,” lamented Tai.

Tai said he hoped this would change soon as the beneficiaries of AIDS-related deaths include the families, partners of PHIV and the children from these key affected populations.

Anthony Thanasayan is an FMT columnist.

It’s an increasingly aging world

November 10, 2014

There’s a need for universal health care to prevent older people from slipping into poverty and being unable to pay for health services.

COMMENT

By Anthony Thanasayan

One of the frustrations I have faced growing up with a disability all of my life, and later working as a councillor with the Petaling Jaya City Council (MBPJ), is coming across people who think that being handicapped is something that only happens to other people.
They couldn’t be more wrong.
Basically, this false notion is the reason why government at the various levels seems to respond in a sluggish manner to calls from disability groups for infrastructure to include disabled and elderly-friendly facilities.
MBPJ is an exception in this case.
Little by little, the planning, engineering and building departments here have begun taking positive measures to build a barrier-free society for everyone.
We are not only concerned about the growing elderly population with increasing disabilities, but equally worried about the many handicapped citizens “imprisoned” in towns and cities that have never really cared for them or considered their participation in society.
While several councils in Selangor said they needed “more convincing facts” that the lack of facilities was a problem, others are mostly in a state of denial that people with disabilities even existed, and if so in significant numbers.
An increasing aging population
A report last week by American broadcast institution, the Voice of America (VOA), on an increasingly aging population should serve as a timely wake-up call for everyone concerned.
The VOA quoted the World Health Organisation (WHO), as saying that “Governments the world over must now prepare to deal with an increasingly aging world.”
“Otherwise, the growing burden of chronic diseases will seriously affect the quality of life of older people and create economic and other hardships for national health systems.”
The VOA revealed that these findings appeared in a new series on health and aging published in the British journal, The Lancet.
According to them, the latest statistics show that by 2050, an estimated two billion people will be aged 60 and older, more than double the 841 million today.
The WHO noted that 80 per cent of these older people will be living in low and middle-income countries.
A burden to society
The increase in longevity in affluent countries is largely due to the “decline in deaths from cardiovascular disease resulting from simple, cost-effective strategies to reduce tobacco use and high blood pressure.”
A VOA interview with WHO Senior Policy and Strategy Adviser in the Department of Aging and Life Course Islene Araujo revealed that life expectancy in Africa now is 60 years.
She explained that cardiovascular diseases such as stroke and infarction are not only responsible for killing most elderly people but causing stroke survivors to “become disabled, burdening society”.
She also pointed out that cardiovascular diseases can be prevented by controlling hypertension, which can save many lives and avoid disability.
Besides heart disease and stroke, VOA reported that other major illnesses of aging include cancers, chronic lung disease, sensory disorders, vision problems, mental and neurological disorders.
One WHO report author told the VOA that “there are low-cost strategies that can help older people live healthier lives” like reducing one’s salt intake.
A policy change
According to the VOA, the report’s authors also suggested changing policies to encourage older adults to remain part of the workforce beyond their retirement age.
They also agreed with the WHO’s call for universal health care to prevent older people from slipping into poverty and being unable to pay for health services.
The VOA also suggested that people of all ages should not smoke, do more physical activity, and practice moderate alcohol consumption and good nutrition in order to enjoy good health dividends later in life.
Anthony Thanasayan is an FMT columnist

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