A senior researcher and advocate pushes for change
special section on HIV
in 1997, a year after Adeeba Kamarulzaman returned here with a medical degree from Australia and a specialty in infectious diseases, she spoke with the head of the Malaysian AIDS Council (MAC) Marina Mahathir, who was the daughter of the Prime Minister of the country at the time. "I asked him," Do you have needle and syringe programs here? "Remembers Kamarulzaman. It was a pertinent question given that Malaysia was an emerging epidemic among people who inject drugs and the Australia had all but derailed HIV with harm reduction efforts (see p. 156). "She said," Are you kidding? We can hardly say the word "AIDS".
Kamarulzaman undertook to modify the response to HIV / AIDS in Malaysia, a multiethnic country with a Muslim majority that ultraconservative views on many social issues. "It was clear to me that it was crazy," said Kamarulzaman. "Patient after the patient has been infected with drug use and we did nothing about it."
This is not true, thanks in part to his efforts, but Kamarulzaman, dean of the medical faculty by the University of Malaya, still has serious doubts about the approach of his country to the HIV / AIDS. "We have done everything right in terms of obtaining harm reduction programs on the ground, but still, I think the coverage is still far from where we should be, "she said. "And the real problems now with prevention for MSM [men who have sex with men], and transgender sex workers. There is almost no kind of national program for any dent in the epidemic among these populations."
Kamarulzaman, who also attended high school in Australia and speaks English with a slight Australian accent, is linked to the Malaysian royalty and can speak his mind with little fear of serious consequences. It continues to do so. "She made many enemies, especially in government offices," says Hisham Hussein, who serves with her on the MAC executive committee. "I do not see anyone in the country who can speak as she can without fear or favor . Nobody. no . "
Adeeba Kamarulzaman ( left ) speaks speech and walks the walk
PHOTO :. MALCOLM LINTON
Kamarulzaman has published more than 100 studies on HIV / AIDS in Malaysia examining all efforts to reduce harm to the molecular epidemiology of viral spread to the effectiveness of new treatments. She also won enthusiastic supporters in the affected communities. "She is my idol," said Elisha Kor, a transgender woman infected with HIV who runs a program for sex workers at the PT Foundation, a nongovernmental organization (NGO) here which also helps MSM. "She brings a lot of opportunities in Malaysia, and open the eyes of my Government with HIV / AIDS."
Stopping the spread of HIV among drug users was the first country Kamarulzaman. In 03 she received a grant from the US National Institutes of Health is set to influence the drug policy, which was then heavily focused on punishment, collecting comprehensive data on HIV and users who injected and represented 76% of infections. It also created a reduction in working group misdeeds with the assistance of Australian experts. But their data did little to influence the national Agency for fight against drugs and the police. "He became clearly we did not want to go anywhere until we got the attention of politicians, "said Kamarulzaman.
In January 05, she obtained a meeting with the Cabinet Committee on Drugs, which approved later pilot project to convert injecting drug users on methadone. This June, the government, to the astonishment of Kamarulzaman, announced it would also allow the small scale needle and syringe exchange. These efforts have increased, the government slowly moved from a strictly punitive attitude towards drug users in a more compassionate view they had health problems. Prisons have started offering maintenance programs with methadone. And in 2010, voluntary centers "cure and care" began to replace the compulsory detoxification centers.
Harm reduction in Malaysia is still facing many challenges, including too harsh drug laws. (Hanging remains a sentencing option, even for marijuana.) The country mainly relies on NGOs to provide needles and syringes. But as Kamarulzaman wrote in a commentary in the 2013 June 15 issue of The Lancet entitled "The fight against the HIV epidemic in the Islamic world," the harm reduction advocacy in Malaysia Indonesia has succeeded in part because it focused on "Islamic values about the preservation of life."
These same arguments, however, did not convince the government to deal with sexual transmission. "It's a little more difficult to argue for sex work and MSM along these veins," she said. Indeed, Sharia law in some states can imprison Malay Muslims simply transvestism.
Pang Khee Teik for, one of the few openly gay activists HIV / AIDS in the country, government inaction against lesbians, gays, bisexual and transgender (LGBT) has strong political connotations. in two infamous trials called Sodomy 1 and Sodomy 2, the government in 1998 sued a former deputy prime minister who hoped to run the country, Anwar Ibrahim, to have had sex with men. "They see LGBT as a political force and it to do with targeting Anwar Ibrahim, "said Teik
the Ministry of Health recognizes the problem. the recent report of the United Nations noted that relatively small surveys of MSM, prevalence HIV was a "huge increase from 3.9% to 12.6%" between 09 and 2012. "the new HIV infections through sexual transmission outnumber injecting drug use in the past 3 years," said Hussein MAC. "And until now, the government has not done anything new, and they are fully aware of what is happening."
Kamarulzaman said the government has "urgent" need to fill gaps, but it takes the long view, saying: "Given where we were, I think we have made a good start . "
Kajang Prison provides methadone and care specialized HIV
PHOTO :. MALCOLM LINTON
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