Article Written by: Akbar Jaya (Program Director for A Journey in Fighting HIV/AIDS)

Historically, HIV epidemic in Malaysia has been driven by people who injecting drug (PWID). The Needle Exchange Program (NEP) and Methadone Maintenance Therapy (MMT) had successfully bringing down HIV among this population. However, last 10 years, the epidemiology has shifted from PWID to increasing by sexual transmission among key population and their intimate sexual partners includes PWID, sex workers, MSM, TG. The key response towards AIDS is primarily concerning early testing and treatment. There is overwhelming evidence that early antiretroviral treatment keeps people who living with HIV (PLHIV) healthy and carry out daily routine normally.

Malaysia has implemented the 90-90-90 target at the National Strategic Plan of Ending AIDS 2016-2030, in which 90% of key population get tested and know the result, 90% of people diagnosed with HIV placed on antiretroviral (ARV) and 90% people on ARV achieving the HIV suppression (undetectable viral load). This can be achieved by scaling up the testing and treatment.

Furthermore, to develop effective messages and methods for HIV prevention in the changing sexual transmission scenarios. The transmission occurs due to unprotected sexual intercourse, which is still largely confined in the key populations and their intimate sexual partners, will need to reverse. Providing the knowledge of newly available PREP and PEP tools for prevention in specific key population and circumstances. It also a needy to encourage more pregnant women in risk to enrolled in Prevention Mother to Child Transmission (PMTCT) and intensify the availability program in government clinic.

Reducing the stigma and discrimination faced by the key population still need to be addressed in multi-sectoral collaboration – NGOs, civil society, law enforcement and policy maker. The convenient public policy and environment in providing the social and legal protection. To look this issue in the lenses of human dignity, gender and sexuality. Ultimately, to create a supportive society. To give support, not judgement.

Decriminalization of drug for small possession also need to be looked again as 60% of current prisoners are those coming from small drug offenses. To rethink and reform the Dangerous Drug Act 1952 is crucial as to see them as criminal is far away from human rights rather than providing treatment and support. The outbreak of covid-19 at prison globally, including in Malaysia, due to overcrowded, lack of physical distancing as the number of prisoners exceeded the facilities of the prison can be a push factor to decriminalizing drug for personal use. It is also concerns regarding the suboptimal health care support for prisoners. Alternatively, to improve rehabilitation centre and make this as the first choice is much effective than putting them in prison.

The roadblock that we face are coming from fear, mind set and ideology. Advocating and educating the policy makers and society is important. To convince them to see the evidence and put behind sentiments. The self-righteous attitude is not welcoming. Everyone plays role to end AIDS by 2030. COVID-19 has taught us a lesson that how important public health is. Even we are not the healthcare practitioner or person who do involve directly in the plan, we have the responsibility as a part of supporting society. Young generation need to acknowledge on current situation and be observed, concern and supported.

Hospitals Beyond Boundaries are honored to be partner for this online forum that are organized by a group undergraduate students from various university . We would like to congratulate the organizing committee, advisors and speakers that involved in making this online forum a great success. Congratulations and well done!