THE MALAYSIA NATIONAL CONFERENCE ON HIV/AIDS IN CONJUNCTION WITH WORLD AIDS DAY 2009

SPEECH BY YB DATO’ SRI LIOW TIONG LAI
MINISTER OF HEALTH MALAYSIA

AT THE MALAYSIA NATIONAL CONFERENCE ON HIV/AIDS
IN CONJUNCTION WITH WORLD AIDS DAY 2009

HARD ROCK HOTEL, BATU FERRINGHI, PULAU PINANG
3 DECEMBER 2009

Y.Bhg. Prof Tan Sri Dato’ Dzulkifli Abdul Razak,
Vice Chancelor, Universiti Sains Malaysia.

Y.Bhg Dato’ Dr Hasan Abdul Rahman,
Deputy Director General (Public Health),
Ministry of Health Malaysia.

Y.Berusaha Prof. Madya Ismail Baba,
Convenor, AIDS Action & Research Group, and
Organising Chairman of the National Conference on HIV/AIDS.

Distinguished guests, ladies and gentlemen,
Good morning and Salam 1Malaysia.

1. First of all, I would like to thank the AIDS Action Research Group, School of Social Sciences, Universiti Sains Malaysia, for convening this Malaysia National Conference on HIV/AIDS, in conjunction with World AIDS Day 2009.  I would like to congratulate the Organizing Committee for successfully organizing this conference. 

2. As you are aware, HIV/ AIDS is a global health and socio-economic problem.  As of 2008, over 33 million people worldwide are living with HIV, and an estimated 7,400 newly infected cases are being reported daily.  An estimated 2 million people died from AIDS last year. Clearly, the world has yet to break the trajectory of this devastating pandemic.

3. In Malaysia, the first case of HIV was reported in late 1986. Until December 2008, a total of 84,630 cases had been reported, of which 14,576 (17.2%) had developed AIDS and 12,589 (14.9%) had died.  About 77% of the reported HIV cases occurred among those aged 20 to 39, i.e. the younger and potentially more productive segment of the nation’s population.

4. Fortunately, we appear to have reached peak incidence in 2002, when 6,978 new cases were reported. This was equivalent to a notification rate of 28.5 HIV cases per 100,000 population. Since then, the rate had gradually dropped to 13.3 per 100,000 population by 2008. Our surveillance data for the period January to September 2009 (with 2,252 cases) indicated that the rate might fall further to 11.0 per 100,000 population this year, which is in line with our target for the Millennium Development Goal (MDG) of “halting and reversing the spread of HIV by the year 2015”. I hope that this decline is real and will continue into the future.

5. Up to December 2008, the majority of our HIV infections were among injecting drug users which constituted about 71% of cases. Another 18.5% acquired the infection through the sexual route, 0.9% were babies born to HIV-positive mothers, and the remainder were through other transmission routes. Over the past few years Malaysia has experienced a gradual “feminization” of its HIV epidemic, with an increasing trend of newly reported HIV infections being transmitted by the sexual route. This is evident from the rise in the percentage of reported HIV cases through sexual transmission, from 18.9% in the year 2000 to 29.8% in 2008. Over the same period, the percentage of women among HIV reported cases had increased from 9.4% to 19.1%. 

Ladies and gentlemen,

6. It was the high proportion of HIV infections among injecting drug users (IDUs) that prompted the Ministry of Health to introduce the Harm Reduction Program in 2005 / 2006. Harm reduction is not about legalization of illicit drugs. It is about providing internationally-proven health services to injecting drug users to prevent them from transmitting HIV and other blood infections among themselves and to their partners through unsafe practices.

7.  In October 2005, the Ministry of Health introduced the Methadone Maintenance Therapy (MMT) Program for opiate-dependent addicts to reduce their vulnerability to HIV/AIDS. As of June 2009, 6,538 active drug dependents have been registered under this program. Currently there exist 131 centers dispensing methadone, the majority of them in government hospitals and health clinics, and a few in the private sector. These also include 24 service centers managed by the National Anti Drug Agency and 10 centres managed by the prisons.

8. The average retention rate of clients on the MMT Program was 72.2% in the year 2008; with the National Anti Drug Agency achieving an outstanding retention rate of 92%. The success of the MMT Program can be seen from the fact that only 3% of the clients were positive on repeat opiate urine testing, and 66% of clients are able to maintain full-time employment.

9. The country’s Needle Syringe Exchange Program (NSEP) was initiated in 2006 through a strong partnership with non-governmental organizations. By June this year, at least 15 sites are operational for the program, including 6 government health centers. Initially there were 42 outreach ports but the number has now increased to 106 ports. This program has managed to register 15,537 clients, of whom 66.5% were regulars, with an average 64.2% return rate of needles and syringes. Condoms are also distributed to the clients under this program with the intention of preventing HIV transmission through the sexual route.

10. To strengthen the Harm Reduction Program, the Ministry of Health has published several documents, including Policy and Standard Operating Procedures, Guidelines and Training Modules.

Ladies and gentlemen,

11. The Government is committed to providing anti-retroviral (ARV) therapy to all those who need it, by making it affordable and accessible to all. We have taken courageous steps to make cheaper antiretroviral drugs available in the country. Indeed, since May 2006, Malaysia has been successfully manufacturing its own combination of 3-in-1 ARV drugs. Currently, ARV drugs are given free to those who need such treatment in our government hospitals and health clinics. Up till the end of 2008, a total of 8,197 people living with HIV were being treated with ARV, compared to the target of 8,000. This year, we aim to achieve 9,000 patients on antiretroviral therapy, and from the progress so far we should be able to achieve the target. In our efforts to scale up ARV therapy in the country, we are training more physicians and medical staff on ARV treatment, and upgrading our laboratory support facilities.

Ladies  & Gentlemen,

12. As far back as 2006, we have made clear, at the UN General Assembly, our commitment to ensuring universal access to HIV prevention, treatment, care and support. It is my hope that this conference will help us identify some of the obstacles to achieving this universal access, and provide us with practical solutions to overcoming them.

13. We are approaching the final year of our current National Strategic Plan on HIV/AIDS 2006–2010, and it is about time we begin to engage all the stakeholders in drawing up a new strategic plan for the future. It is therefore also my hope that this conference will help to point the way forward in our fight against the disease.

14. On that note, ladies and gentlemen, let me wish you all the best in your deliberations. I am pleased to declare your National Conference on HIV/AIDS officially open. Thank you.