Listen to experts on new AIDS initiative

MALAYSIANS are rightly baffled at the sudden move from an all-out war against drug abuse by promoting prevention, treatment of drug users and the prosecution of drug traffickers, to an initiative that is perceived to be accepting, or even encouraging and promoting, drug abuse. There is an urgent need to answer the question: "How does harm reduction, especially in the context of providing free needles, fall into place with Malaysia's more than 30 years of aggressive fight against drug abuse?" Advocates of harm reduction must take the time to answer this question.

After decades of government ads, messages and images, living through campaigns with themes such as "dadah musuh negara", "dadah cegah sebelum parah" and "dadah membawa padah", it is unacceptable to assume that Malaysians should and can switch their perception to a tolerance of drug use practically overnight.

How do you reconcile the act of distributing needles for the purpose of HIV-prevention with the act of preventing drug abuse, which accounts for more than 150,000 people in the country? Though it is clear to those working in the field of HIV/AIDS prevention that preventing the spread of this disease and the prevention of the actual act of drug abuse are two separate areas of public health intervention, it is less clear to the public at large. This issue must be addressed in order for it to be understood.

Former drug user associations engaged in treatment such as Persatuan Pengasih Malaysia have clearly stated their opposition to such harm-reduction initiatives which tolerate continued drug abuse. Instead, they advocate a therapeutic approach to rehabilitation with the objective of total abstinence. This is in clear contradiction to the approach of harm reduction. Not addressing this dilemma of mixed and contradictory messages dooms any public support for harm-reduction aimed at preventing new HIV cases. The distribution of needles and condoms, as part of harm-reduction, has been successful in many countries around the world, including Iran and Pakistan. But it is not enough to say that other countries have done it and succeeded.

We have learnt from our HIV/AIDS medical experts and their experience in dealing with the disease among drug users that harm-reduction can work.

However, the programme must first be given a fair trial.

Therefore, I was dismayed that its fate could rest on the Government's decision to rely on the edicts of the National Fatwa Council. The treatment and, most importantly, the prevention of HIV/AIDS is, and has always been, first and foremost a public health issue that has required the participation of all sectors to ensure its success.

But this should not obscure or supplant the valuable lessons that have been learnt by our medical experts at considerable expense and loss of lives after dealing with this phenomenon for 19 years. We know what works and what doesn't. We need to trust our HIV/AIDS medical experts and their evidence, to guide our policies in addressing this epidemic. We know from other countries, particularly our neighbours Indonesia and Thailand, that it takes courage and long-term commitment to the make bold and often unpopular decisions that are necessary to effectively address and prevent the spread of AIDS.

I pray that our Government will remain steadfast in in its determination to begin the harm-reduction programme, for it is long overdue.