Established in 1992, the Malaysian AIDS Council (MAC) is an umbrella organisation coordinating Malaysia’s community-based HIV response. Working with partner NGOs, government, private sector and international bodies, MAC strengthens prevention, treatment, care, support and advocacy, with a focus on vulnerable and marginalised communities and people living with HIV in Malaysia.

Fundado en 1992, el Malaysian AIDS Council (MAC) es una organización paraguas que coordina la respuesta comunitaria al VIH en Malasia. En colaboración con ONG socias, el gobierno, el sector privado y organizaciones internacionales, MAC fortalece la prevención, el tratamiento, la atención, el apoyo y la incidencia política, con especial atención a las comunidades vulnerables y marginadas y a las personas que viven con el VIH en Malasia.

Fondé en 1992, le Malaysian AIDS Council (MAC) est une organisation faîtière qui coordonne la riposte communautaire au VIH en Malaisie. En collaboration avec des ONG partenaires, le gouvernement, le secteur privé et des organisations internationales, MAC renforce la prévention, le traitement, les soins, le soutien et le plaidoyer, en mettant l’accent sur les communautés vulnérables et marginalisées ainsi que les personnes vivant avec le VIH en Malaisie.

Malaysian AIDS Council (MAC)

Palani Narayanan, Malaysian AIDS Foundation: 

This push for drug policy reform—this push for decriminalisation—needs to take into consideration that we are shaking, rocking a lot of boats. Many people have been very comfortable with the status quo, with the income they’ve received from the investments made in law enforcement and incarceration. We need to redirect those investments away from law enforcement and towards health.

Decriminalising drugs would also reduce stigma, making it easier to access services. People could be more open about their consumption, for example with their doctor, without fear of being criminalized. Sellers could face fewer barriers to accessing testing services, meaning they could have their substances analyzed. I think this would help ensure access to safer substances, or a wider variety of substances that meet different needs—giving people access to their substance of choice. Avoiding the cycle of going in and out of prison also helps people make progress in their lives, without losing what they’ve achieved, without losing housing, and without being further stigmatized.

Daniel Rojas Estupiñan, Acción Técnica Social: 

In Colombia, decriminalisation has been a fundamental step in recognising rights and, especially, in reducing violence against people who use psychoactive substances—particularly violence from state organisations — such as the police. I believe it was also one of the great steps towards understanding substance use more from a public health perspective.

Ann Fordham, International Drug Policy Consortium (IDPC): 

It's really important for policy makers to understand that decriminalisation does not exist in a vacuum. Of course, we need to remove criminal sanctions for people who use drugs and reduce their contact with the criminal justice system, but decriminalisation must also include meeting the broader needs of people who use drugs: ensuring access to housing, education, employment, healthcare, and full-spectrum harm reduction. Given that in many parts of the world drug markets are unregulated, this also includes providing a safe supply.

Alí Bantú Ashanti, Colectivo Justicia Racial: 

In Colombia, we have learned from the experiences of civil society organisations working on the decriminalisation of use, trafficking, and especially the situation of those who cultivate coca. We are talking about small farmers. It is absolutely necessary to decriminalise the entire chain. Here in Colombia, the human costs are enormous: people are being killed, disappeared, imprisoned. It is urgent, and from Colombia we make a call to rely on scientific evidence in order to decriminalise all drug use.

Louis Letellier de Saint-Just, l'Association des intervenants en dépendance du Québec (AIDQ):

 Decriminalisation is desirable. We must move toward the decriminalisation of simple possession of drugs. But in each country, if the decision is made to adopt a model of decriminalisation, it is crucial to define how. There are dozens of ways to design decriminalisation, and it is important to choose the right one.

Does decriminalizing drugs reduce harm?

It is with great pleasure and excitement that the Vienna NGO Committee on Drugs (VNGOC) and New York NGO Committee on Drugs (NYNGOC) introduce the relaunched Civil Society Task Force (CSTF). The CSTF — a joint initiative of the NYNGOC and VNGOC— will serve to promote inclusivity of civil society at all proceedings leading up to and at the Ministerial Segment of the 62nd Session of the Commission on Narcotic Drugs in 2019.


The CSTF is co-chaired by the chairs of the VNGOC and NYNGOC and consists of 5 additional Steering Group members, 18 representatives of global regions
and 10 representatives from affected populations and global voices.


The VNGOC and NYNGOC were established in 1983 and 1984, respectively, and serve as representative platforms for discussion and debate on drug policy issues, as well as being interfaces between civil society organisations, the United Nations system and its member states. Emerging in 2015, the CSTF was originally created by the NYNGOC and VNGOC to ensure comprehensive, structured and balanced participation by civil society at the 2016 UNGASS on the world drug problem. In the process leading up to the 2016 UNGASS, the CSTF was an effective vehicle for increasing the inclusion of civil society voices at all
stages of preparation prior to the proceeding. The CSTF successfully delivered a range of actions and consultations. This included the selection of high quality civil society speakers at the 2016 UNGASS itself from around the world. In order to maximize the engagement of civil society in the 2019 Ministerial Segment and its lead-up, the VNGOC and NYNGOC bilaterally signed the Memorandum of Understanding during the 61st CND in March 2018. Following an open call and selection process, the Task Force now comprises 35 individuals from around the world.


In order to support civil society participation in the Ministerial Segment, in accordance with CND Resolutions 60/1 and 61/3, the Civil Society Task Force has been replenished and relaunched in 2018. The CSTF’s goal is to secure the comprehensive and meaningful participation of civil society actors in the implementation of the recommendations made in the 2016 UNGASS outcome document. The CSTF will also work towards fostering an environment where evidencebased
approaches to drug issues (including methodologies and ideologies) are comprehensive and where regional and gender diversity is represented through various inputs. In preparation of the 2019 Ministerial Segment, the CSTF will promote the contributions of civil society with expertise in various drug-related areas.

The CSTF is excited to begin working immediately to ensure that civil society is active and present at all preparatory stages of the 62nd CND. In the short time available, the Task Force’s plans include: a post-UNGASS global consultation process, to inform a comprehensive output document to support the debate; civil society hearings in Vienna and New York to bring together civil society speakers and member state representatives; the selection of speakers for all opportunities at the United Nations in Vienna and New York; and the delivery of any further activities that will require CSTF attention.

In particular, the CSTF will identify and facilitate speaker inclusion for all relevant preparatory events and UN meetings, host regional and thematic online consultations, organize civil society hearings on the margins of the third committee negotiations and during the 62nd CND, co-host an Interactive Civil Society Hearing for all stakeholders with the Chair of the CND culminating in a recognized document preserving all conclusions from the event as a part of the preparatory process and ensure drug-related and wider civil society, policy makers and member delegations remain aware of relevant updates regarding CSTF projects and events leading up to the 2019 Ministerial Segment. In the pursuit of encouraging the acknowledgment of civil society contributions, the CSTF looks forward to the participation of many diverse civil society stakeholders and organisations toward the 62nd CND preparatory process.
For all questions and inquiries, the CSTF may be reached by e-mail at info@cstfondrugs.org.

Please visit: https://www.cstfondrugs.org/membership/

Civil Society Task Force on Drugs re-launched

Most recently, Malaysia was lauded as one of the countries having the fastest growing needle and syringe programmes (NSEP) in the world. Methadone maintenance therapy (MMT) is widely available in Ministry of Health community clinics, and given positive results, will likely be scaled up in Ministry of Health facilities. Importantly also, this year a commendable process began at the Ministry of Home Affairs to reform national drug policy. These programs were introduced despite challenging legal environments following the earlier adoption of the War on Drugs in Malaysia.
However, today drug policy in Malaysia continues to include imprisonment of people who use drugs (PWUD), judicial corporal punishment, and compulsory detention, representing clear challenges to effective harm reduction service delivery. Some of these measures have been in place since the inception of the Dangerous Drugs Act 1952, i.e. 63 years ago.

Internationally, it has been proven that punitive measures have little impact on the reduction of drug harms, and in fact exacerbates negative health outcomes and displace drug markets to new and wider areas. In 2008, the then Executive Director of the United Nations Office on Drugs and Crime (UNODC), Antonio Maria Costa, released a report which stated: ‘Drug use is often called a disease of development, related to the increasing need for psychoactive substances to reduce stress, increase performance or simply escape from a harsh reality’ . He continued to detail the ‘unintended consequences’ of the law enforcement-based drug control system: i.e. the creation of a criminal black market, the policy displacement of public health taking a backseat to law enforcement measures, geographical displacement of drugs (drug markets shifting to new areas after tighter controls in one area), substance displacement (when one drug was controlled, users move on to different drugs), and the way we deal with people who use drugs, i.e. with marginalisation and stigmatisation. ASEAN as a region continues to see these trends.

Keep up-to-date with drug policy developments by subscribing to the IDPC Monthly Alert.

SDP technical brief on drug harms in Malaysia

The increasingly widespread use of ketum (

 or kratom) in Malaysia earlier this year prompted the Ministry of Home Affairs to lead a push to schedule it in the Dangerous Drugs Act 1952, an Act that contains incarceration, judicial corporal punishment, and capital punishment for drug offences. Ahmad and Aziz (2012) found that out of 562 ketum users surveyed in Northern Malaysia, 88% used it on a daily basis.

Research in Malaysia on ketum indicates that it may have medicinal value. A 2009 study by Vicknasingam et al. of 136 active users in Northern Malaysia indicated that most respondents used ketum to manage opiate withdrawal symptoms and reduce opiate use. The authors note: ‘The claims of so many subjects on the benefits of ketum merits serious scientific investigation. If prolonged use is safe, the potential for widening the scope and reach of substitution therapy and lowering its cost are tremendous, particularly in developing countries.’

The push to schedule ketum as a dangerous drug was something that the Malaysian AIDS Council viewed as undesirable, and harmful to society as a whole. We began engaging Members of Parliament from both the ruling party (Barisan Nasional) and the opposition parties (Pakatan Rakyat) on an informal basis with technical information and evidence on harms of criminalization. MPs understood quite quickly that the creation of a whole new population of people with criminal records for drug use would mean that a larger population would be rendered unproductive as they would not be able to secure jobs, and would have to commit petty crime to survive. We emphasized strongly that criminalization for 60 years has resulted in more disease, more drug use, and more drug harms, and that countries with decriminalization policies had successfully reduced drug harms.

On 1 April 2015, the amendment to the Dangerous Drugs Act 1952 (DDA) was tabled, and was met by opposition from both parties, including MPs from the geographically diverse constituencies of Setiu, Kuala Kedah, Puchong and Bagan Serai. We worked closely with ruling party MPs up to point of debate and throughout the day received positive updates about numerous MPs citing medicinal value and harms of criminalization as the key reasons for opposition of the amendment. Engagement with ruling party MP Dr Noor Azmi Ghazali, a GP by profession, was crucial. A key bit of information that was useful in debate was the vote to schedule ketamine proposed by China at the UN Commission on Narcotic Drugs in Vienna in March 2015. This vote was of course shelved due to opposition from many Member States on the basis of medicinal value.

In the afternoon of 1 April, the amendment to the DDA was shelved. On the same day, opposition MP Wong Chen wrote a Facebook post detailing reasons for opposition to the amendment, including: usage as traditional medication, lack of socioeconomic considerations, and the need for evidence-based rehabilitation. He also emphasized that the country should be moving towards decriminalization of drugs.

Kratom (Ketum) criminalisation successfully shelved in Malaysia

The Quality of Outreach Workers and the Services they provide for the NSEP programme in Malaysia, 

conducted by Malaysian AIDS Council and their research partners, was to examine factors that can influence the quality of services provided by the outreach workers to the PWID through the NSEP programme.

The quality of outreach workers and the services they provide for the NSEP programme in Malaysia

The Malaysian AIDS Council (MAC) is an umbrella organisation of 47 Partner Organisations across Malaysia working to improve the quality of life of people living with HIV (PLHIV), advocating for access to medicines, and undertaking advocacy activities to reduce the harms of injection drug use. Under the project of Asia Action, funded by the European Union, one of the objectives is to incorporate the gender-specific needs of women who use drugs into drug treatment, HIV prevention, and welfare services. As there is a dearth of research on women who use drugs in Malaysia, MAC is undertaking qualitative research with this population to document demographics and understand the needs and barriers facing women who use drugs.

Interviews are ongoing with 45 women who use drugs at urban settings in Kuala Lumpur, Penang, Kelantan and Johor using a semi-structured interview guide. Preliminary results indicate that s majority of respondents were poly-drug users with the mean age of initiation into heroin use in their early 20s. Only one had not had any contact with police as a consequence of drug use. Those who had been held in police custody had been in police custody more times than prison. Poverty was a key theme. The respondents also felt that they did not have adequate access to reproductive health and welfare services. Health literacy was low and early marriage was prevalent.

This report also provides insights into the unique vulnerabilities of young people who use drugs, and provides recommendations to better serve their needs.

Keep up-to-date with drug policy developments by subscribing to the IDPC Monthly Alert.

Understanding women who use drugs in Malaysia

In the month of December 2013, the Policy Team under the European Union-funded Asia Action project organized two events aimed towards improving the human rights environment surrounding people living with HIV and people who use drugs. The first was a Drug Law Reform Parliamentary Roundtable held in the Parliament House in Kuala Lumpur, and the second a workshop/training session with the Royal Malaysia Police aimed towards increasing Police Leadership in Public Health. Details are as follows:

Drug Law Reform Parliamentary Roundtable, 3 Dec 2013

The Parliamentary Roundtable was organized with the intention of discussing four proposed amendments to the Dangerous Drugs Act 1952, and the Drug Dependents (Treatment and Rehabilitation) Act 1983, including reducing the remand period of 14 days, replacing jail and corporal punishment sentences for drug use and drug possession in small amounts with diversion to health, and a revision of the definition of dependence in the Act.

There were five presentations focused on separate themes: Asia Action Policy Manager Fifa Rahman commenced with a presentation debunking misconceptions of diversion and de facto decriminalization, and showing benefits gained by police. Two of her slides are inserted below.

The event continued with a presentation on evidence arising in Malaysia by University of Malaya Dean of Medicine Prof Dr Adeeba Kamarulzaman. Key statistics arising from this were the fact that a majority of prison officers in Malaysia have latent tuberculosis, and that as a result of voluntary outpatient services at Cure & Care clinics, over 76.8% of patients enrolled reported stable housing. Throughout the presentation, participants were enlightened as to several other statistics that proved that health and harm reduction measures were yielding positive results.

The third presentation was given by Prof Alex Wodak, one of the pioneers of harm reduction in Australia. He spoke mainly about international drug policy. Former Bar Council President Ragunath Kesavan spoke about the rationale for reducing 14 day remand, including emphasis on the fact that drug users do not have access to ARVs or methadone during that time, and that this excessive remand period was contrary to the rule of law.

By far, the highlight of the day was a presentation by former drug user Manje, who said that she was imprisoned for drug use, and that she was never given a chance to get treatment because she was always being arrested. Importantly, she said: “There was not one day that went by that I did not want to quit.”

Discussion thereon was very interesting. Director of Narcotics of the Royal Malaysia Police, Dato’ Noor Rashid Ibrahim said that the police don’t really focus too much on arresting drug users, but more on drug traffickers. This comment may suggest that the police are moving slowly towards an ideology shift. Oddly, the Anti-Drug NGO called Pemadam maintained that no one in Malaysia is arrested for drug use. This point was promptly rebutted by Fifa Rahman, Prof Adeeba Kamarulzaman, and also by way of Manje’s testimony. Member of Parliament Mr Liew Chin Tong suggested the formation of a Parliamentary Select Committee on Drugs Matters.

In closing, Minister Nancy Shukri said that she agreed that a proposal be made to carry out a Parliamentary Select Committee on Drugs Matters. The Asia Action team at MAC will proceed in January 2014 to draft this proposal.

Police Leadership in Public Health workshop, 12-13 December 2013

The workshop was centred around benefits of harm reduction to police, including reduction of crime, reduction of workload, and increased work satisfaction. Participants were given the official NSEP Police Standard Operating Procedure document, which all of them said that they had NEVER seen. They were also given the Malaysian AIDS Council report on the Australia Study Tour, which was explained to them. Key points explained included the benefits to police of providing methadone & ARVs in police custody centres or lockups. Group activities were centred around the issue of corruption and extortion from drug users. Interesting quotes that arose from this session included, “When we are corrupt, my heart is not calm”. Police participants also said that police salaries should increase to prevent corruption.

Based on discussions and feedback from participants and organisers, we have concluded that future action points include a roadshow to meet Officers in Charge of Police Stations (OCPDs), and a half day meeting with Senior Police Officers to discuss the Pilot Project on Access to Medicines in Lockup Centres.

Improving human rights for people living with HIV and people who use drugs in Malaysia  

On 10th September 2013, the International Narcotics Control Board (INCB) attended a meeting at the National Anti-Drugs Agency (known by its Malay acronym, AADK) in Kajang, Malaysia with NGOs including the Malaysian AIDS Council (MAC). Other NGOs in attendance were PEMADAM and Pengasih.

The meeting began with a briefing by AADK on Cure & Care voluntary clinics and remaining compulsory treatment centres. Among information that was conveyed was that the compulsory treatment centres still have 10 roll calls a day to verify the presence of all detainees. They also said that there are 4 models of Cure & Care centres, categorised according to source of funding and body managing it. Curiously, AADK said the centres differentiate between addicts, drug abusers, and drug users, terms which are often used interchangeably, and do not seem to follow any international standard.The two representatives from the INCB enquired as to the absence of an evaluation process for these centres.

The meeting then proceeded to discussions with NGOs. The INCB showed no interest in MAC's policy work with police and media. They instead showed interest in PEMADAM's programs, praising them and stating that abstinence approaches are 'equally important' to harm reduction measures. Pengasih is an organisation that uses the therapeutic community approach and only has residential programs encompassing providing the individual with basic life skills such as hygiene and cooking food. Participants in the Pengasih program are given companions who are former drug users to assist them. The INCB had several enquiries as to Pengasih's program, such as how biopsychosocial factors are addressed.

INCB visit to Malaysia – notes from the Malaysian AIDS Council

Partner organisations of Malaysian AIDS Council (MAC) provide services to family members of people who use drugs – their partners, children and parents. Outreach workers visit the clients and propose the whole range of harm reduction services such as distribution of clean injecting equipment and condoms, counselling, psychosocial support, voluntary counselling and testing not only to people who use drugs, but for their family members as well.

Malaysian AIDS Council (MAC)

Region

Translations

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