Sunday, September 30, 2007

Matter on AIDS

AIDS in Malaysia

Malaysia is home to the fifth fastest growing AIDS epidemic in the East Asia and Pacific region with its current rate of HIV infections doubling every three years.

Between the first detected case in 1986 and 2006, 76,389* people have been infected with HIV while 9,155* have died of AIDS. These statistics suggest that an average of 17 people test positive for the virus each day.

Malaysia's epidemic is largely dominated by injecting drug users who make up about 73% of total cases. There is concern however that heterosexual transmission is on the rise. The proportion of women reported with HIV has increased dramatically in the last decade from 4% of new cases in 1995 to 15% of new cases in 2006. Surveys show that in 2006, more housewives tested HIV-positive than sex workers. At the same time, the percentage of babies born with

HIV has also increased from 0.2% in 1991 to 1.4% in 2006.
As in most parts of the world, young people in Malaysia account for an increasing number of HIV infections every year. December 2006 statistics from the Ministry of Health reveal that 36% of infections are amongst people aged between 13 to 29 years old. It is likely that people infected with HIV before the age of 30 were infected in their twenties and sometimes even during their teens.

Gender inequity, stigma, discrimination, silence, denial and ignorance fuel the epidemic in Malaysia.

* Source: Ministry of Health, Malaysia
another related article, but in larger scope:

How widespread is the HIV/AIDS epidemic?

The HIV/AIDS epidemic is an unprecedented challenge to humanity. HIV/AIDS was once concentrated primarily in sub-Saharan Africa, but the epidemic knows no borders. It has spread to every region in the world and affects people regardless of age, gender, wealth, geography or sexual orientation. HIV/AIDS is now the fourth-biggest cause of death worldwide.

Concentrated Epidemics
In many countries, HIV is still considered 'low' or 'concentrated, ' confined mainly within groups at especially high risk, such as men who have sex with men, people who inject drugs and sex workers. An epidemic is considered 'concentrated' when less than one per cent of the general population but more than five per cent of any 'high risk' group are HIV-positive.

Generalized Epidemics
In sub-Saharan Africa, parts of Asia, Central America and the Caribbean, HIV has become a 'generalized' epidemic that is not contained within any section of the population. An epidemic is considered 'generalized' when more than one per cent of the general population carries the virus.

Sub-Saharan Africa
Nine out of ten children with HIV or AIDS are African. Sub-Saharan Africa is the worst affected region in the world. With just 11 per cent of the global population, the region is home to three-quarters of all people living with HIV and AIDS. Some 30 million people are carry the virus, and is AIDS the leading cause of death on the continent. One in ten people between the ages of 15 and 49 are HIV-positive in 12 countries. The majority of new infections occur among young people aged 15 to 24, especially among girls.

In Botswana, South Africa and Zimbabwe, it is estimated that more than 60 per cent of boys currently aged 15 can expect to become HIV-positive. In parts of southern Africa, more than 30 per cent of pregnant women are HIV-positive. Nine out of 10 children with HIV or AIDS are African.

Asia
In Asia, an estimated 7.2 million people are believed to be HIV-positive. Concentrated epidemics among injecting drug users and sex workers have crossed over into the general population in Cambodia, Myanmar and Thailand, resulting in generalized epidemics. In Indonesia, Nepal and Viet Nam, infection rates are exploding among those two high-risk groups, of whom the majority are under the age of 25. In China, home to a fifth of the world's population, concentrated epidemics have emerged in several provinces and HIV is moving so rapidly that many fear the country is on the verge of a generalized epidemic. India is home to the world's second-largest HIV-positive population.

Central and Eastern Europe and Central Asia
Central and Eastern Europe and Central Asia have the fastest-growing epidemic in the world. Around 1 million people aged 15 to 49 were living with HIV/AIDS in 2001, and the number is growing by 250,000 people a year. The epidemic is concentrated among addicted injecting drug users, but it is now spreading to a wider population of occasional injecting drug users and their sexual partners, most of whom are young. In the Russian Federation, there were 3,008 reported new HIV infections among injecting drug users aged 10 to 19 in 1999. By 2000, that number had more than tripled to 9,612.

The Caribbean and Latin America
About 1.9 million adults and children now live with HIV and AIDS, and the epidemic is in danger of spreading rapidly and widely. The Caribbean, with a 2.3 per cent prevalence rate among 15¡V49 year olds, is the most affected region after sub-Saharan Africa. Unsafe sex among men who have sex with men appears to be rife across the entire region; a large proportion of these men also have sex with women. Prevalence levels are highest in The Bahamas, Guyana and Haiti. Most new infections are being reported among young women aged 15-24.

Middle East and North Africa
In the Middle East and North Africa, more than half a million people are living with HIV/AIDS. Available data point to increasing HIV prevalence rates, with about 83,000 new infections in 2002. Significant outbreaks among injecting drug users have occurred in about half the countries in the region, notably in North Africa and in the Islamic Republic of Iran.

High-income countries
Approximately 76,000 people became HIV-positive in high-income countries in 2002, and 23,000 died of AIDS. About 1.6 million people now live positively with the virus, in large part thanks to anti-retroviral drugs that have made remarkable headway in holding back the development of AIDS symptoms. Unfortunately, the advancement in treatment comes with an underestimation of the risk and gravity of HIV/AIDS. Infections are on the rise again apparently because many people view HIV/AIDS as a treatable disease and are therefore not taking precautions to prevent contracting it.

HIV status to tie the knot

Note: this is an exemplary effort from reno, :) I hope I could maintain this site with contributions from all of you.

28th Sept 2007 (Fri)
BP training for NHSD
In front of KTSN PBSM, 20000

THW make it compulsory for future spouses to disclose their AIDS status
OG: Matthew, Reno
OO: Izzati, Nina
CG: J, Hafizah
CO: Prisca, Pravita
Adjudicators:
Chair- Bernard
Panel- Wen Nee, Stella

PM
:
The problem is basically about the rise of AIDS cases in Malaysia due to unawareness of HIV status. Unawareness of spouse’s HIV status, if the spouse is HIV positive, it is more likely that he/she may be infected, including their offspring. It’s unfairness in marriage.

Mechanism
:
  • Premarriage counseling is conducted on future couples and HIV test is advised and make compulsory
  • Medical result regarding HIV test must be presented during marriage legalization in marriage registrar
  • If one/both of the couple is HIV positive, an agreement doc should be signed to make sure another half is well informed of this
  • Check and balance: regular HIV test for an interval of approximately 5 years
*Medical confidentiality and practitioners of the test should be mentioned

1st point from the PM: Duty of state (on the societal health)
It is duty of state to make sure that the HIV status of their spouse is being well informed to each other. We want to create a healthy society and increase AIDS awareness in this country, especially in this particular case of marriage.

Leader of Opp:
Rebuttals:
  • On Duty of State - Right of choice whether to disclose the HIV status or not, because the positive or negative HIV is going to cause a big impact on their relationship.
  • On Registrar - Feasibility is being question on free HIV test and bribery in marriage registrar (human nature is being brought up)
  • On trust - It is up to the HIV positive partner to choose appropriate time to disclose his/her HIV status, because we believe in love is built on trust
1st point from OO: Negative implication of the proposal (Freedom of Choice)
Discussed on the levels of human’s right of making choice and impact of tourism? of M’sia (*not much elaborated because running out of time)

* Adjudicator note: right to privacy is going to be a better point brought upon by Leader of Opp
=> I would love to listen to the argument on HIV status and tourism

DPM:
Rebuttals:
  • On Freedom of Choice - Right to choice are less likely to be prioritized since it’s jeopardizing another human’s right of information/ fairness/ and even life of another half (even whole family, if including offspring) of the marriage.
  • On trust and integrity - Bribery cases are insignificant enough to be ignored. Persons elected for the marriage registrar is elite and bound to rules, religion (since this case setup is in M’sia), and regulation.
  • On feasibility - More people will attend to HIV test after this proposal is implemented, thus create AIDS awareness among Malaysians, which is out objective
  • Tourism - Impact of tourism is not likely because the HIV status is only known by 3 parties: the patient, their spouse, and marriage registrar
2nd point from OG: Fairness of the marriage
  • Discussed in two levels: marriage partner and their children
Deputy Leader of Opp:

Rebuttals:
  • Why the govt want to target only on disclosure of HIV status in marriage, why don’t target on other things that make more contribution to the HIV population in M’sia? e.g. IVDU (intravenous drug usage)
* 0.3% of M’sian are HIV positive
*60% are caused by IVUD
(it is outdated data; more recent data should be sought)
** please note that the National Health and Morbidity Survey 2006 (once in 10 years) has been released by the MOH lately.I've been trying to get it but to no avail, can anyone with access (doctors and medical line people alike) help? (ww) - would be helpful for debate on health - and politics in healthcare

CG:
Extension: Trickle down effects of the proposal
  • Stigma removal from society which will further create societal acceptance on this case
*stigma is a good point but not well explained
- stigma always include fear, evasiveness and partial knowledge about an issue.
- revealing HIV status sends out a message that -
1. HIV is a disease, like cancer, like the common flu
2. The fact that it has no cure shouldn't create fear, because unlike SARS/EBOLA/even cancer, HIV is not genetic or highly communicable- (doctors would tell you that even healthy lifestyle may not prevent you from a strong inheritance of cancer), and conscious effort (condoms, abstinence) can prevent it.
*A bit of technical knowledge here - HIV is a Biosafety Level 3 virus, a step below Biosafety Level 4 bacteria, Tuberculosis (TB). If migrant workers are required to undergo check for TB, why not HIV in spouses?
3. HIV exposure will tell people that yes, it is deadly, but there are thousands of ways people can contract HIV - not necessarily promiscuity. And if the spouse can't take it, maybe they shouldn't be in the same bed together anyway. => better than getting a divorce later with HIV eh?

CO:
  • *Inconsistency because the member of Opp gave me the feeling that HIV is really a serious thing in M’sia, but the whip came out and even said AIDS is just a small matter in this country
  • Rebuttals are mainly discussing about love, trust, and how disclosure of the HIV status will destroy a marriage. *Better elaboration about it is up to the HIV patient to choose time to tell their partner. It can be countered by saying procrastinating and lazy nature of human. However, it was not brought up by the CG whip
Extension: Impact on the marriage
** I think so…’cause I hardly catch the points being discussed…I knew only trust and love is being discussed throughout in the closing half of the debate. The CO also mentioned about the positive impact if the patient is given the choice to choose their appropriate time to disclose their HIV status.

p/s:
* indicates comment from adjudicators
** is my personal think about the debate
** the whole debate was not carried out well because of the environmental situations. (We actually had people screaming around us during the debate…they got their crazy own activities lah…) Few new people from KTSN is also being exposed what the hell is BP style. Everyone has presented well.

A selection for NHSD in KTSN will be conducted next week…be ready for the battle!

By
Reno
29 September 2007
It’s late in night…just finished watching Ultraviolet with other guys…sleepy… :)

Tuesday, September 25, 2007

Welcome!

Welcome to the first UKM debaters blog. Anyone and everyone in the team can post anything related to debate here. I'm currently working on the links first, and the articles can come later... there is an email I created where everyone can forward their matter mails to, and I will post it here.

Will update more in ukmdebaters@yahoogroups.com, stay tuned! =)