Rising up to Challenges of ‘Getting to Zero’

KUALA LUMPUR, 1 DECEMBER 2012 – Every year on the first day of December, the world comes together in the face of a growing public health concern that has affected more than 34 million lives worldwide.

In a statement to commemorate this year’s World AIDS Day, President of the Malaysian AIDS Council (MAC) Datuk Dr Raj Karim remarked,

“The World AIDS Day is a celebration that provides an opportunity for all of us – individuals, communities and political leaders – to take action to ensure that human rights are protected and that our shared goals of creating a world free from negative impact of HIV/AIDS are met. It is also the time for us to recognise the progress we have made in our collective response to the HIV and AIDS epidemic, while at same time, reminds us of the many profound challenges that lie before us in achieving the ‘Getting to Zero’ goals.”



Then first case of HIV in Malaysia was reported in 1986. As of 2011, Malaysia has seen a cumulative total of 94,841 HIV cases, of which 17,686 progressed to AIDS. At least 14,986 AIDS related deaths have been reported, making the number of people living with HIV in Malaysia, 79,855 persons.

The annual number of reported new HIV cases has been on a steady decline over the past decade. From a peak of 6,978 cases in 2002, the 3,479 new cases reported in 2011 were approximately half of what was reported ten years ago, with an average of 9 new cases reported each day. The notification rate of HIV also continues to experience a decline from 28.4 cases per 100,000 persons in 2002 to 12.2 cases per 100,000 persons in 2011.

Malaysia is classified as having a ‘concentrated’ HIV epidemic, in that HIV prevalence is less than 1% in the general population but consistently more than 5% in most at-risk populations, particularly people who inject drugs, female sex workers and mak nyah (transgender women). Unsafe drug injecting practices constituted more than 70% percent of the overall HIV infections reported since 1986. However, beginning in 2010, new cases of sexually transmitted HIV have been consistently outnumbering those via the drug-injecting route. In 2011, 55% of new HIV cases were transmitted sexually (hetero and homo/bisexual transmission collectively), compared to 38% that were reported in drug users. This trend is potentially indicative of the future HIV epidemiological landscape of the country – one that will be ‘driven’ by sexual transmission.



Contrary to popular belief, the vast majority of sexually transmitted cases of HIV reported in this country are attributed to heterosexual risk behaviour, which constituted close to 19% of all HIV cases. Homo/bisexual contact, on the other hand, represented only 2.5% of cases.

The ten-fold increase over the past decade in the number of women living with HIV, most of whom acquired the infection through heterosexual contact, underscores the dynamics of sexual transmission of HIV. Wives and partners of drug users are particularly at greater risk in this regard, which presents a formidable challenge to address as the prevailing gender inequality impedes safer sex negotiation and other risk reduction measures.

Young people between the ages of 20 and 39 are another group of particular concern to the growing sexual HIV epidemic. Approximately 76% of all HIV cases were reported in this age group, which calls for an integrated approach to sexual and reproductive health education and services. Evidence-based discourse around sex, gender and sexuality must also be encouraged in order to demystify commonly held misconceptions that have been known to negatively affect access to accurate HIV information.



Beginning in 2011, World AIDS Day celebrations across the globe will carry the theme “Getting to Zero: Zero New HIV Infections, Zero Discrimination, Zero AIDS Related Deaths”. The campaign is aligned with the UNAIDS and United Nations Millennium Development Goal targets of reversing the trend of the HIV epidemic, i.e. 50% reduction in new cases, by the year 2015.

Zero New Infections reaffirms our commitment to formulate our response to the current realities of the HIV epidemic. MAC is committed to address the rise in new HIV infections through sexual transmission, and central to this effort is the Red Ribbon Youth Club, our active engagement with people in the country with the aim of promoting responsible health behaviour. MAC will also continue to support and implement harm reduction programming and other public health measures that have been proven effective in addressing HIV in key populations. We look to scale up the Needle Syringe Exchange Programme for drug users, while measures to mitigate the risk of sexual transmission of HIV in sex worker, mak nyah and men who have sex with men populations will continue to be strengthened. We are confident of the Ministry of Health’s effort to eliminate mother-to-child transmission of HIV through its wide coverage of antenatal HIV screening programme.

Working towards Zero Discrimination, MAC is committed to extol the virtue of compassion and empathy for all. We strive to eliminate all forms of discrimination and persecution based on gender and health status that impede access to HIV prevention, treatment, care and support services. Working closely with various stakeholders to achieve this goal, MAC has also identified priority areas in its advocacy response with the hope of establishing and maintaining an enabling environment that aims to reduce HIV stigma and discrimination; respects human dignity, gender and sexuality; and is supportive of HIV interventions.

Zero AIDS Related Deaths signifies our push towards greater access to treatment for people living with HIV. We strive to address internal and external barriers that hinder Government’s effort to provide near universal coverage of anti-retroviral treatment for Malaysians living with HIV. This goal also drives MAC to create greater awareness, especially among communities most affected by HIV, on the importance of seeking early diagnosis and treatment to prevent the HIV disease progression to AIDS.

As MAC re-establishes its commitments to ‘Getting to Zero’, each and every one of us is also urged to take the opportunity that the World AIDS Day offers to renew our resolve to fight the epidemic in our own personal capacity. Take part in as many meaningful World AIDS Day related events in the country and learn how you too can play your part in ‘Getting to Zero’.