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Islam & Harm Reduction

Islam & Harm Reduction. Adeeba Kamarulzaman Faculty of Medicine, University of Malaya Member, IAS Governing Council. Interventions to prevent HIV and Hepatitis C in people who inject drugs: A review of reviews to assess evidence of effectiveness. McArthur G et al. IJDP Jan 2014.

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Islam & Harm Reduction

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  1. Islam & Harm Reduction Adeeba Kamarulzaman Faculty of Medicine, University of Malaya Member, IAS Governing Council

  2. Interventions to prevent HIV and Hepatitis C in people who inject drugs: A review of reviews to assess evidence of effectiveness McArthur G et al. IJDP Jan 2014

  3. “Mega-Epidemics” Wolfe D. Lancet August 2010

  4. The higher purposes of Islamic law Maqqasid Syariah Preservation of • Faith • Life • Intellect • Progeny • Wealth

  5. Legal maxims in Islam • “A lesser harm may be tolerated in order to eliminate a greater harm” • “A particular harm may be tolerated in order to prevent a general one” • “Public interest (Maslahah ammah) must be given priority over private concerns” • “Harm must be treated and benefits must be brought forth”

  6. Jan 2004 Formation of Harm Reduction Working Group June 2005 MOH approves harm reduction programs June 2005 Formation of National Harm Reduction Task Force Oct 2005 Pilot MMT program implemented Feb 2006 Pilot NSP program implemented April 2006 Cabinet Endorsement for Harm Reduction Program

  7. National Task Force on Harm Reduction • Ministry of Health • Ministry of Internal Security • Police • National Antidrugs Agency • Prisons Department • Malaysian AIDS Council • JAKIM • Academia

  8. MALAYSIAN HARM REDUCTION PROGRAM2005-2015 NSP 2006 – 2010 Reduce HIV vulnerability among IDU NSP 2011 – 2015 prevent / reduce infection, improve QoL of PLHIV, and reduce the social and economic impact Up scaling of harm reduction program 2001 - 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Jan 29,05 : PM statement on MDG HIV Jan 15 – endorsement of MMT by MTMDK June 3, 05 : MoHannoucement on NSEP June 23,05 : NTFHR Oct, 05 : MMT piloted • 2nd Review of SOP • Review of SOP • Piloted Klinik Kesihatan Angkat Project • 3rd Review of SOP • NSPEA consultation • MMT in prison and NADA • NSEP at health clinic • Endorsement of up scaling of harm reduction in NSP 2011-2015 • Endorsement of up scaling MMT by JRP meeting • Harm Reduction program by Global Fund • Support activities of harm reduction by HIV/AIDS Alliance funding NSPEA preparatory work Feb 2006 : NSEP piloted April 2006 – Malaysia cabinet Endorsement on HR 2001 - The Declaration of Commitment on HIV/AIDS adopted by United Nation General Assembly Special Session on HIV/AIDS (UNGASS) in 2001, for which Malaysia was a signatory 2002- 2005 : Proposal of harm reduction

  9. NUMBER OF REGISTERED PATIENTS ON OST AND OST CENTERS2006 – 2014

  10. NSP PROGRAM 2006 – 2014

  11. MalaysiaAnnual Reported HIV Cases2000-2014 AIDS/STI Section, Ministry of Health Malaysia. 2015

  12. Transformation of Compulsory Drug Detention Centers into Voluntary Treatment & Care Centers

  13. Major Developments since 2010 Sangeeth Kaur IAS 2013

  14. C&C – Outcome Study 28663had received services at C&C or CCSC between 2010 and April 2013 Of 313 interviewed • 56.3% - Helped maintain employment • 54.3% - Continued education • 77.6% - Improved family relations • 72.1% - Obtained permanent homes • 75.9% - Prevented arrest into prisons

  15. New HIV Infections

  16. Cost Savings in Direct Health Care By preventing HIV transmissions among PWIDs, the harm reduction programmes allowed the government to accrue savings from direct health care costs • Direct health care cost savings from avoided infection are expected to increase over time due to • disease progression for those who are not on treatment • require higher intensity health care and higher health care cost for government

  17. People Who Inject Drugs & the Heroin Trade • There are 625,000 PWID in MENA Mumtaz G, et al. HIV among people who inject drugs in the Middle East and North Africa: Systematic review and data synthesis. PLoS Medicine, in press.

  18. Emerging HIV Epidemics among People Who Inject Drugs • At least one-third of MENA countries are affected by emerging HIV epidemics among PWID Mumtaz G, et al. HIV among people who inject drugs in the Middle East and North Africa: Systematic review and data synthesis. PLoS Medicine, in press.

  19. Cairo Declaration of Human Rights "All men are equal in terms of basic human dignity and basic obligations and responsibilities, without any discrimination on the basis of race, colour, language, belief, sex, religion, political affiliation, social status or other considerations. True religion is the guarantee for enhancing such dignity along the path to human integrity."

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