These strategic targets or objectives aim for :

• 95 per cent of the critical population to have their HIV status diagnosed and to be notified of the results ;

• 95 per cent of those who have HIV to be started on antiretroviral therapy ( ART ) treatment ; and

• 95 per cent of these ( i . e ., in reference to the 95 per cent in the second bullet point – who have started the ART treatment ) to adhere to treatment with a suppressed / reduced viral load . However , more has to be done to realise these envisioned goals .

It ’ s vital , therefore , for the government to ensure that the National Strategic Plan for Ending AIDS ( 2016-2030 ) and , by inclusion , the 95-95-95 strategic targets or objectives and , in turn , the “ Three Zeros ” are implemented holistically and in a comprehensive manner – entailing and necessitating a “ whole of government , all society ( private sector , civil society , communities and families )” approach .

To appreciate the overall situation , it ’ s important to re-highlight the nature of AIDS ( Acquired Immunodeficiency Syndrome ) which is a condition resulting from a HIV ( Human Immunodeficiency Virus ) that originated directly from sexual activities , principally via the exchange of bodily fluids , and transmitted secondarily

EMIR-SING

BY JASON LOH AND

JACHINTHA JOYCE

via the sharing of needles and exposure to infected blood . It could also be through passing on an infection from mother to child when pregnant ( MTCT ), which occurs during pregnancy , labour , delivery and breastfeeding .

The HIV virus attacks and destroys the immune system ’ s infection-fighting CD4 cells ( CD4 T lymphocytes ) – that coordinate the immune response . In other words , the CD4 are white blood cells that play a significant role as a defence mechanism to fight against infections , viruses , etc .

The CD4 count for an average healthy person should range from 500 to 1500 cells per cubic millimetre of blood ( mm3 ). However , the number can decrease to 200 cells / mm3 and below in the case of a person with HIV whose condition has progressed or advanced to AIDS – which can vary ( dependent variable ) among individuals – e . g ., as early as within six months or as late as 20 years in the absence of antiretroviral treatment ( ART ).

The purpose of ART is to suppress the replication / multiplication of the HIV ( based on the formula of “ undetectable equal untransmittable ” – U = U – vis-à-vis the viral load ).

Globally , there were about 38.4 million people living with HIV in 2021 and 650,000 died in the same year alone ( see “ HIV ”,

WHO , Sept 9 , 2022 ).

As maintained by the Ministry of Health ( MoH ), it ’ s projected that 81,942 people were living with HIV ( PLHIV ) at the end of 2021 and 67,822 ( 83 per cent ) of these individuals were aware of their condition and were informed by the national surveillance system . Only 44,916 were receiving ART which is only 55 per cent of the total .

Normally , PLHIV are carriers – including those with AIDS – who continue living because of ART ( i . e ., longer than if they haven ’ t received ART ).

However , ART for PLHIV increased to 66 per cent last year compared to 28 per cent in 2015 ( see , “ Health Ministry : New HIV infections in Malaysia drop 70 per cent in 20 years ”, Malay Mail , Dec 1 , 2022 ).

However , according to Deputy Director-General of Health ( Public Health ) Datuk Dr Norhayati Rusli , “ the decline in HIV cases and the increase in treatment coverage is still insufficient for the country to eliminate AIDS by 2030 . Inequalities are the obstacle to this effort . Therefore , the availability , quality and suitability of services for HIV treatment , testing and prevention must be improved ”.

There ’ s a critical need for an all-inclusive and comprehensive HIV treatment .

The HIV virus attacks and destroys the immune system ’ s infection-fighting CD4 cells ( CD4 T lymphocytes ) – that coordinate the immune response . In other words , the CD4 are white blood cells that play a significant role as a defence mechanism to fight against infections , viruses , etc .”