KUALA LUMPUR, 8 March 2012 – The Malaysian AIDS Council (MAC) acknowledges the efforts taken by the government led by the Ministry of Health (MOH) to raise public awareness of the HIV epidemic and taking steps to prevent the spread of HIV to key affected populations (KAPs) through close partnership with the NGO community.
The MOH had demonstrated a tremendous foresight in its response to the HIV and AIDS epidemic by committing RM 40 million in 2003 for HIV and AIDS prevention efforts for a period of 10 years. This figure was further increased to RM 65 million to implement the Needle Syringe Exchange Programme (NSEP), which requires significant investment for procurement of commodities, training of outreach workers and site maintenance. Indeed, through this generous and sustainable funding scheme, we have seen a slowing down in the spread of the epidemic.
Recently, MOH approved a total of RM 5.3 million to fund 27 HIV prevention programmes. From this amount, RM 2.9 million will be spent on prevention programmes for injecting drug users (IDUs), RM 2.2 million for the procurement of commodities such as needles and condoms, and RM 365,000 for hospital peer support programmes. Only RM 100,000, or 2 % of the fund will go towards HIV prevention programmes for sex workers (SWs) and transgender (TGs), considering sexual (hetero and homo/bisexual) transmission now seems to be the primary mover of the epidemic. No budget was allocated for men who have sex with men (MSM) HIV prevention programmes. The allocation breakdown was determined based on recommendation made by the MOH-appointed Technical Review Panel (TRP) who convened earlier this year to assess each application based on merit, value for money and compliance to reporting.
We found that the TRP placed implicit importance on reporting compliance as it was considered the most important deciding factors when awarding the fund. This led to a very significant funding reduction for the SW and TG programme compared to the RM 835,000 that the community received in 2011. As a result of this budget cut, these programmes will no longer be operational. The budget cut will also cause two NSEP sites in Johor and one site in Kuala Lumpur to cease their operations.
While there have been shortcomings in the reporting, be that as it may, it would be prudent for the TRP to allow MAC to clarify its position. To do otherwise would cause great loss in term of human and technical resource that we have invested in setting up the prevention programmes.
Given that data from a study undertaken jointly by MOH and MAC in 2009 which showed that 1 in 10 of sex workers and transgender in the Klang Valley and 1 in 5 injecting drug user is infected with HIV, these cuts could seriously jeopardise efforts to reverse the HIV epidemic amongst these population. What is needed is a scale up of these programmes with adequate funding and not the reverse. This funding cut is also not in keeping with the National Strategic Plan for HIV for 2011 – 2015 that was jointly formulated and agreed upon by key government agencies, NGOs and other stakeholders that calls for greater response to address the increasing trend of HIV via sexual transmission across all populations.
At the grassroots level, the funding cut will have an adverse impact on the livelihoods of programme implementers, many of whom are community members that have made great inroad in leaving behind their former lifestyle that put them at greater risk of HIV infection. Without immediate funding, an estimated 80 community outreach workers will soon lose their job increasing the risk of them returning to the street and engaging in behaviours that previously put them at risk of HIV making our efforts to promote their social reintegration futile.
At this critical juncture, we sincerely hope the MOH will reaffirm its commitment to fight HIV by investing more in prevention programmes for KAPs, the main drivers of the epidemic in Malaysia. Stronger collaboration framework, including the formation of a task force for scaling up HIV prevention programmes for KAPs, in which MAC and its Partner Organisations could play vital roles, should be considered in the immediate term.