KUALA LUMPUR – Saving lives with HIV-prevention drugs and curbing the spread of AIDS is more important than whether those who are given such help are morally upright or not, Health Minister Datuk Seri Dr Dzulkefly Ahmad told the Dewan Rakyat today.
He said the ministry ensured it obtained the views of Islamic authorities such as the Islamic Development Department (Jakim) and state fatwa councils on the pre-exposure prophylaxis (PrEP) medicine which is taken to prevent HIV infection.
Even the Perlis Fatwa Committee had agreed with the government and medical practitioners that PrEP should be provided to prevent the spread of HIV, the minister said during today’s parliamentary question time.
“The Perlis Fatwa Committee in its conference on July 23 and 24, last year, was of the view that the harm caused by the contagion of HIV is far worse than the harm caused by any abuse of PrEP medication by those with same-sex activities,” he said.
Dzulkefly was answering Datuk D. Ahmad Yunus Hairi (Kuala Langat-PN) who asked about the status of the government’s PrEP programme for individuals who have a HIV-positive partner, without any fatwa or religious decree on the matter so far.
Dzulkefly said the government’s pilot project for PrEP which began in 18 health clinics in January last year, had been increased to 21 clinics by the middle of 2023.
The programme will be expanded to 31 clinics this year, he added.
Dzulkefly said early findings from the pilot phase showed that the PrEP programme was effective among the 3,451 individuals who have received it as of January 11 this year.
The programme has cut the spread of Syphilis from 11% to 6.5% after six months, and to 1.3% after 12 months of PrEP.
The percentage of clients who practise constant use of condoms had also increased from 30% to 38.6% in the first six months, and to 44% after 12 months of PrEP.
The percentage of clients with one sexual partner (monogamous) had also increased from 7.2% to 19.4% in the first six months, and to 29.6% after 12 months of PrEP.
Additionally, a total of 51 clients have stopped using PrEP as they no longer conduct high-risk sexual activities, Dzulkefly said.
Dzulkefly also said that the target group of the programme is those aged 21 to 49, where 92.4% of this group is sexually active.
“(Overall) the early findings of this study showed that clients who took PrEP obey and practice precautions to prevent HIV, through consistent use of condoms and better behavioural change, even though they are still using PrEP.
“Even though it is clear that we don’t support LGBT activities or same-sex activities, the ministry’s priority is to save lives, and this is a need.
“So we are taking the stance of the (Perlis) Fatwa to adopt a more beneficial approach.”
In response to a supplementary question on the programme’s cost Dzulkefly said the purchase of PrEP medicines has cost about RM510,000; or about RM100 to RM120 per patient.
However, he said the cost is fully funded by the Malaysian AIDS Council through a global fund.
“What is important is not only the cost but the implementation of a programme that is effective. We can clearly see that the programme is effective, and we take the approach that is less harmful and more beneficial,” he said.
Dzulkefly also added that the government would consider expanding the coverage area of the PrEP programme per the capability of the ministry. – March 20, 2024