Malaysia's lack of commitment to prevention and harm reduction strategies will lead inevitably to a spread of HIV/Aids of epidemic proportions, said Malaysian Aids Council (MAC) president Marina Mahathir.

She said the government should invest in prevention strategies in an "honest and meaningful" way in order to avert the spread of Aids to the general population.

"In an era where treatment is available, we must not forget prevention. We can't just be promoting awareness via billboards and hope that it will work," she told malaysiakini .

Marina, who is attending the 15th International Aids Conference in Bangkok, was a panelist at a symposium yesterday on mobilising women leaders in the fight against HIV/Aids.

She is one of 30 Malaysian delegates to the six-day conference , which has attracted 20,000 participants from all over the world.

Marina acknowledged that the government has contributed by subsidising anti-retroviral drugs for the treatment of Aids and ensuring access to generic anti-Aids drugs under its compulsory licensing programme.

But she also pointed out that, without prevention strategies being put in place, the infection rate will continue to rise.

"The government's aim of treating 6,000 patients a year cannot keep up with the rate of new infections, now at 7,000 a year. Even with generic drugs, our resources would be strained," she said, adding that prevention is the only way to contain the Aids pandemic.

Iranian model

She said that, where Malaysia is still wary of talking about sex education, the Islamic Republic of Iran has instituted condom distribution in prisons and is sponsoring programmes that face up to the sexual transmission of HIV.

Iran also has a five-year strategic programme that includes needle exchange and availability of methadone therapy for heroin abusers. Methadone is recognised internationally as an effective way to

"Malaysia still lacks a national strategy... a long-term plan to fight Aids, rather than short-term projects. We don't even have a national commission on HIV/Aids," she said.

A commission would be able to track and monitor those most vulnerable to infection, she said.

Malaysia's HIV/Aids epidemiology reflects the Asian model, where Aids starts with intravenous drug users (IDU) and, if not controlled, spreads to other segments of the population.

Ministry of Health's statistics reveal that IDUs account for about 70 percent of HIV infections (or 6,756 new infections last year). However, this trend has been declining over the years, with the rate of heterosexual transmission having gradually increased.

ONG JU LYNN is reporting on the conference from Bangkok for malaysiakini .