I would like to address the issue of the distribution of free needles and condoms to drug users in preventing the continued spread of HIV/Aids.

Malaysians are rightly baffled at the sudden move from what was an all-out war against drug abuse to an initiative that is perceived to be tolerating, accepting or even encouraging and promoting drug abuse.

Therefore, there is an urgent need to at least answer the question: 'How does harm reduction, especially in the context of providing free needles, fall into place or co-exist with Malaysia's more than 30 years of aggressively fighting drug abuse?' Advocates of harm reduction must take the time and opportunity to answer this question.

After decades of seeing and hearing the government anti-dadah messages and the battle cries, 'Dadah musuh negara', 'Dadah: Cegah sebelum parah' and 'Dadah membawa padah', it is unacceptable to assume that Malaysians would change their perception overnight and start tolerating drug addicts being given free needles and condoms for their habit.

How do we reconcile the act of distributing free needles for the purpose of HIV prevention with the message of preventing drug abuse? Though it is clear to those working in the field of HIV/Aids prevention that preventing the spread HIV/Aids and the prevention of drug abuse are perhaps two separate issues of public health intervention (both of which are necessary), it is less clear to the public at large.

Some former drug user associations engaged in rehabilitative treatment have clearly stated their opposition to such harm reduction initiatives which tolerate continued drug abuse. They instead advocate a therapeutic approach to rehabilitation with an objective of total abstinence.

This is in clear contradiction to the approach of harm reduction. Not addressing this contradiction will certainly affect public support for harm reduction aimed at preventing new HIV cases.

For its part, the distribution of needles and condoms as part of harm reduction have without a doubt been successful in many countries around the world including Iran and Pakistan. These countries have active and former drug users who have been able to advocate and most importantly, practice harm reduction through needle exchange programmes.

However, it is not enough to say that other countries have done it and succeeded. We have learnt from Malaysian medical experts working among drug users, that harm reduction to prevent HIV infection in this country can work. However, the programme must first be allowed to exist.

However, I am dismayed at the recent news that the possible fate of this harm reduction programme could ultimately rest on the government's decision to rely on an edict from the National Fatwa Council .

The treatment and, most importantly, the prevention of HIV/Aids is, and has always been, first and foremost, a public health issue which has requires the participation of all sectors to ensure its success.

However, this participation should never forget nor supplant the valuable lessons obtained through the substantial sacrifice of both lives and resources by our medical experts who have dealt with this epidemic in Malaysia for 19 years. We know what works and what doesn't.

We need to trust our HIV/Aids medical experts and, more importantly, their evidence, to guide our policies in addressing this epidemic in our country. We know from other countries, particularly our neighbours Indonesia and Thailand, that it takes courage and long-term commitment to make the necessary bold - and often unpopular - decisions necessary to effectively address and prevent the spread of Aids.

I pray that the people in our government will be courageous and steadfast enough in their determination and conviction to begin the harm reduction programme. It is long overdue.