The Galen Centre for Health and Social Policy is concerned with advisory from the Selangor Mufti Department on the issue of pre-exposure prophylaxis (PrEP) as stated on its website.
The advisory is misinformed and likely to mislead the public on this issue.
It is essential to ensure that health interventions to address public health priorities such as HIV/AIDS and most recently, Covid-19, are evidence informed, rights based and grounded in the realities of the communities we work with.
We have learned from bitter and tragic experiences of the past, that imposing beliefs, judgements, attitudes, and dogma into such programmes, often brings about more harm than good.
It makes us feel better but has either no relevance or impact on those communities or worse, brings about harm, and deprives them of much needed assistance and treatment.
In this case, it would deprive them of a way to prevent HIV infection. Why should we deny people at risk access to life-saving treatment?
Denying or providing selective access to pre-exposure prophylaxis (PrEP) is bad medicine, poor practice, and has no basis in public health. This is proven treatment which has about a 99 per cent rate of effectively preventing HIV infection. We know it works.
The evidence and data which demonstrates this is not only derived from experiences and studies in countries around the world, it is based on research conducted here in Malaysia.
PrEP has been available in this country since late 2017. However, it has been limited to a small number of public and private clinics in various locations across the country.
In fact, the role and use of PrEP has been integrated into the Malaysian government’s key policy document on HIV/AIDS, the National Strategic Plan for Ending AIDS 2016–2030. It is time to make PrEP more widely available.
Providing access to PrEP to those who need it, without discrimination, is key to ensuring that the treatment does what it is supposed to do, reduce the number of people newly infected with HIV.
For almost 20 years, the Ministry of Health has taken a pragmatic, compassionate and far-reaching approach to HIV prevention by adopting the harm reduction programme, which involved exchanging needles and syringes, and providing opioid substitution therapy.
Malaysia’s HIV epidemic has changed dramatically. New infections have dropped significantly, and the epidemic is no longer driven by injecting drug use. Malaysia has been highlighted as a best-practice country.
We know what works and has impact, and what does not. We need to be guided by the science, patient-centred care, and the experiences of the people and communities who need such services.
We recommend that the Selangor Mufti Department review its published position on this issue and consult with Malaysia’s infectious diseases and public health experts to improve its understanding of this issue.
Azrul Mohd Khalib is the chief executive officer of the Galen Centre for Health and Social Policy.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
