'Right to health' progress in Malaysia's HIV/AIDS threatened by lack of respect

Thanks to the expansion of harm reduction – a risk reduction strategy built on the respect for the rights of people who use drugs – new HIV infections via the drug injecting route have declined by over 60 since the programme was introduced in 2006. — AFP

“To uproot the AIDS epidemic, it will be necessary to deal with its root societal causes – namely a lack of respect for human rights.”

Those cautionary words of Dr Jonathan Mann – pioneer of the global AIDS movement at the height of the epidemic in the 1980s – could not ring any truer today as we observe this year’s World AIDS Day aptly themed 'Right To Health'.

Regarding the spread of HIV as a social injustice, Dr Mann established the intersection of health and human rights. The way the world viewed the AIDS epidemic was forever changed, or at the very least, challenged.

The many successes of the AIDS response that we take for granted today was the result – direct or otherwise – of Dr Mann’s groundbreaking work.

Without Dr Mann’s authoritative voice and fierce advocacy, especially during his time as Director of the World Health Organisation’s Global Programme on AIDS which he founded, we could not possibly dream of a world where the global scale-up of antiretroviral therapy has contributed to a 48% decline in deaths from AIDS-related causes, and enabled the more than 20 million people with HIV around the world to lead full lives.

At home, we share some of the progress made in the global AIDS response. New HIV infections and AIDS-related deaths continues to stabilise. Cases of mother-to-child transmission have fallen to a 20-year low.

And thanks to the expansion of harm reduction – a risk reduction strategy built on the respect for the rights of people who use drugs – new HIV infections via the drug injecting route have declined by over 60% since the programme was introduced in 2006.

However, there were instances this past year where, in the words of Dr Mann, “(the) lack of respect for human rights” threatened to undo the advances in the national AIDS response and the growing visibility and understanding of sexual minorities impacted by HIV/AIDS, namely men who have sex with men and transgender women.

With the rise of sexually transmitted HIV, which accounted for 84% of new infections last year, certain quarters were quick to point the finger of blame to these sexual minorities and the LGBT community.

In response, we warned about the harms of hate and fear mongering and spoke against allowing homophobia and transphobia from pervading the HIV/AIDS discourse.

Transgender women – a key population whose HIV prevalence is 14 times higher than the general population – continue to suffer systemic harassment, abuse and persecution for expressing their gender identity.

Not only are these acts contrarian to human rights, they unjustly deny their access and right to health. The ominous “lack of respect for human rights” has no place in the AIDS response, particularly now that we, together with the Ministry Of Health Malaysia, have embarked on a mission to end AIDS by 2030.

To this end, we have introduced new community-based health innovations to tackle the escalating sexual health crisis.

The case management approach for men who have sex with men, the pilot project of which has proven successful, is now being expanded for scale and reach to cover other key populations such as people who use drugs and sex workers with life-saving HIV prevention, treatment and support.

Community-based testing, an approach to complement the Government-provided anonymous HIV testing and counseling at health clinics, empowers key populations to undergo HIV testing with the help of their peers without fear, stigma or prejudice.

Our commitment to the protection of rights of people living with HIV at the workplace pushed our advocacy and that of our sister organisation, the Malaysian AIDS Foundation, for the legislation of an anti-discrimination act. Our efforts paid off when the Minister of Human Resources himself announced his Ministry’s support for this proposition.

The right to health also underpinned our work in advancing discussions with the Ministry Of Education via its Deputy Minister on the integration of HIV/AIDS education into secondary school syllabus.

In our bid to further improve the understanding of HIV/AIDS issues through the religious lens, we worked with the Department Of Islamic Development Malaysia on the Resolution of the Islam & HIV Roundtable Meeting, built on the principles of public health and values of compassion, acceptance and respect for the right to health.

We have more than enough evidence to show that a rights-based approach to the AIDS response is a right one, and we will continue to work within a human rights framework in meeting the targets and addressing the challenges of the ending AIDS phase.

Dr Mann passed away almost 20 years ago. Today, let’s honour his legacy by making the protection of the individual’s fundamental right to health our shared responsibility.

Bakhtiar Talhah is President of the Malaysian AIDS Council.

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