Fighting HIV globally: Dr Adeeba to become first Asian to head International AIDS Society

PETALING JAYA, July 29 — As if her huge plate of work was not enough, Prof Datuk Dr Adeeba Kamarulzaman is now taking on another important task.

As the president-elect of the International AIDS Society (IAS).

Her appointment also means that she is the first Asian to helm the world's largest association of HIV professionals (make that more than 12,000 members from 120 countries).

Although she will officially become president in July next year during the society's conference in San Francisco, United States, Dr Adeeba has already started work.

“It is a tremendous honour to have been elected as the president-elect for this society especially as the first Asian President and only the fourth from the global south,” she told Malay Mail.

The infectious diseases expert added that she was initially anxious as it was a huge responsibility.

“I am also excited because we are at a juncture in the HIV epidemic where we have so much knowledge and so many tools to mount an effective response,” she said.

Dr Adeeba is well-known nationally and globally as an advocate and medical professional in the fight to end AIDS.

She was formerly Malaysian AIDS Council president and remains Malaysian AIDS Foundation chairman.

And if that wasn't enough, the Malay Mail Care Fund trustee is also a member of the newly-formed National Health Advisory Council besides being University of Malaya medical faculty dean (she remains the only woman to helm the position).

She graduated from Monash University in 1987 and was trained in internal medicine and infectious diseases at the Monash Medical Centre and Fairfield Infectious Diseases Hospital, Melbourne, Australia.

Dr Adeeba set up the infectious diseases unit at the University Malaya Medical Centre upon returning to Malaysia in 1997.

When it comes to HIV research, she is still involved in UM's Centre of Excellence for Research in AIDS which she established.

Among the responsibilities that she has when it comes to IAS was planning the programme for the just-concluded HIV Science Conference in Mexico City and doing the same for the upcoming International AIDS Conference in San Francisco.

She will from now together with Professor Hendrik Streek director of the Institute for HIV Research at the University of Duisburg-Essen, Germany be starting to plan for the Berlin Conference in 2021 which she will co-chair with Professor Streek.

“Aside from that I have been involving myself in a few of the other programmes that IAS is involved in such as on HIV associated tuberculosis and stigma,” she added.

“Additionally, IAS is undertaking a major governance review of the organisation and a review of the conferences itself. Needless to say it keeps me very busy with frequent teleconferences."

Plans for IAS

Dr Adeeba also said that she would like to shine the spotlight on the HIV epidemic in South East Asia and Asia during her tenure as president.

“As a region we appear to be lacking behind the African countries in achieving the 90-90-90 targets, with the exception of Thailand, Cambodia and Vietnam.”

The 90-90-90 targets were set by UNAIDS and envisions that by 2020, 90 per cent of people living with HIV will know their status.

In addition to this, its goal is also for 90 per cent of those diagnosed with HIV will have “sustained antiretroviral therapy” and 90 per cent of people on antiretroviral therapy will have the virus suppressed.

She wants to focus more on key populations because in our region including in Malaysia individuals who are most at risk are those from these populations. This includes focusing more on stigma we is one of the most important barriers towards achieving epidemic control. This besides also continuing her work on drug policy reform.

“This is crucial if we want to control HIV among people who inject drugs,” she said.

Dr Adeeba has already scored a major win together with her colleagues in Malaysia when it comes to decriminalising drug use following the recent announcement of the government about the move.

She admitted that there remains much to be done in terms of implementation.

“What needs to be done includes an expansion of the treatment programmes, training of relevant staff involved including healthcare and law enforcement professionals and a review of the relevant laws,” she added.

“Nonetheless, we are very pleased to see the government's shift towards acknowledging that drug use and addiction are first and foremost a health, public health and social issue.”

Fighting to end AIDS

As a medical professional and advocate, Dr Adeeba is among the individuals who is in a unique position when it comes to fighting the epidemic.

While she said it should be much easier now since there is a lot more knowledge about the virus and the epidemic including better medication and treatment, the challenges remain when dealing with key populations.

These include people who inject drugs, sex workers, men who have sex with men and transgenders.

“Criminalisation of many of the behaviours that put people at risk is one of the obstacles we face,” she said.

“Secondly, we are now seeing a retreat in the global response to HIV/AIDS financially amidst concern for the rise in non-communicable diseases and antimicrobial resistance. So, there is and there will continue to be less money for the HIV response.”

Asked whether the goal of ending AIDS by 2030 can be achieved, Dr Adeeba said that it was a “little optimistic.”

“This is especially when I look around what's happening in KL alone — with the number of new patients that we see each day.

“However, it can be done. Many cities in the global north and several in the global south including in neighboring countries like Cambodia, Thailand and Vietnam are close to achieving the 90-90-90 targets.”

In recent years, there has been a marked change in how the virus is transmitted in Malaysia.

While previously it was because of injecting drugs, the statistics now show that about 90 per cent of new infections is caused by sexual transmission.

She emphasised once again that to realise this goal requires not only significant investment, both domestic or international but also a truly multisectoral effort.

“And we need to finally overcome the deep stigma and discrimination against those most at risk.”

She lamented the fact that Malaysia is just not “there yet” as various stakeholders have yet to reach out to key populations while increasing testing, treatment and using pre-exposure prophylaxis (PrEP) remained a small project.

PrEP is a pill that can be taken daily by those who are not infected but are at high risk.

By taking the pill they can prevent HIV infection.

What needs to be done in Malaysia

She added that more investment needed to be pumped into the fight against HIV/AIDS besides building the capacity of community groups who can play a big role in providing prevention and treatment programmes.

“We need to get as many people tested as possible — the so called first 90 and if they are positive to be started on medications immediately."

“Ending AIDS requires as many people who are living with HIV to be on treatment and to have undetectable viral levels.”

To have such viral levels, she said meant patients could not only lead a healthy life with normal to near normal life span but they also would not transmit the virus to their sexual partners and in the case of women to their children.

“We need to scale up PrEP, particularly to those at risk men-when-have-sex-with-men, transgenders and partners of those living with HIV.

“We need to relook at the laws and policies that criminalise sexual behaviour and drug use — the main source of stigma and discrimination that drive those affected away from seeking help and medical attention when they need it.”