MMA: Decision on anti-HIV drug must be science-based for best outcome

The Malaysian Medical Association has stressed that any decision on the government providing a drug meant to prevent HIV infection must be based on scientific evidence.

This was amid a controversial discourse over the public distribution of Pre-Exposure Prophylaxis (PrEP) to high-risk groups, with conservatives - including doctors - fighting against giving the LGBT free access to the drug.

"With due respect to religious viewpoints expressed on the use of PrEP, the sole purpose of allowing people at highest risk of HIV access to PrEP is to prevent the spread of HIV in the population and save lives," MMA president Dr Muruga Raj Rajathurai said in a statement today.

"The intended use of PrEP is to prevent HIV infections and the decision to allow high-risk groups access to it has to be a decision based on scientific evidence in order to achieve the best possible outcomes for the community," he added.

The PrEP has a 99 percent efficacy rate of preventing HIV transmission through sex and a 74 percent efficacy of preventing transmission through injection.

It reduces the viral load in an infected person’s body so they cannot transmit it through sex or injection.

The Health Ministry is dispensing PrEP for free to target groups at selected Public Clinics, as part of a two-year pilot study funded by The Global Fund, an international body working against HIV, tuberculosis, and malaria.

It is expected to reach 10,000 people at selected public clinics in Selangor, the Klang Valley, Johor, Penang, and Sabah.

MMA president Dr Muruga Raj Rajathurai

Sexual transmission is now the main driver of HIV transmission in Malaysia.

Men who have sex with men are expected to be the main key population affected by HIV in Malaysia in 2030, according to projections published by the Health Ministry.

Access to PrEP

Last week, the Selangor Mufti Department said providing PrEP to those engaging in “homosexual lifestyles” is colluding in sin, and that it is only permissible to be dispensed to married heterosexual couples where one of them is infected with HIV.

Earlier, a group of Muslim healthcare professionals said the Health Ministry’s move to dispense PrEP for free to target groups, including men who have sex with men, is against their faith.

The group also said PrEP should be coupled with risk-reduction counselling, where the recipients are counselled against high-risk behaviours.

Muruga, however, argued that it was imperative that the groups at the highest risk of HIV infection be given access to PrEP to effectively prevent and control the spread of the disease.

"This would be in line with Malaysia's commitment to Universal Health Coverage (UHC) where all have equal access to healthcare (including preventive care) and that no one should be left behind," he added.

However, he said PrEP alone could is not the solution to HIV prevention and must be coupled with increased education and awareness programmes.

At the end of 2020, a total of 92,063 people in the country were living with HIV, with 13 percent unaware until notified through the national surveillance system.

In 2020, a total of 3,146 new cases were reported, with this figure projected to be on the rise and reaching levels from three decades ago by 2030. - Mkini