KUALA LUMPUR, 20 August 2014 – Salina (not her real name), a 42-year-old single mother of one from Kota Tinggi, Johor contracted HIV from her late husband in 2003. Forced to raise her child on her own, she works as a factory worker earning a monthly salary of RM1,000. She received the first line antiretroviral medicines from the nearest government hospital free of charge but responded very poorly to the treatment. 

After years of battling one debilitating side effect after another which compromised her ability to work and care for her child, her doctor proposed a second line regime with minimal side effects. Unfortunately, the second line antiretroviral treatment is not subsidised by the government, and needless to say, beyond her pocket’s reach. But Salina’s life significantly changed in 2009 when she was introduced to the Malaysian AIDS Foundation (MAF)’s PAL Scheme. She responded to the second line treatment provided by the PAL Scheme so well that her viral load now is undetectable. She is healthier than ever and her quality of life has markedly improved. 

“Looking back on the darkness that surrounded my life after losing my husband and struggling with the side effects of the first line treatment, not a day goes by without me counting my blessings – Alhamdulillah (praise be to the Almighty)! I could not possibly imagine my life without the PAL Scheme. It has given me not only better health but also the confidence to be a better mother to my child, a more responsible employee at work and a more caring member of society,” said Salina. The PAL scheme is a medical assistance initiative of MAF that provides second line antiretroviral medicines to underprivileged Malaysians living with HIV. 

The scheme was launched in 1998 and since its inception has been running solely on MAF’s core funding. However, the continuation of the scheme was threatened since early this year due to lack of funding and the fate of 58 people living with HIV who are currently depending on second line antiretroviral treatment under the scheme became uncertain. Recognising their financial constraint, MAF reached out to Yayasan Sime Darby (YSD) to revive the crucial lifesaving support for people living with HIV. 

“YSD’s contribution of RM1.5 million for the PAL Scheme for the next three years will not only save the lives of the current 58 people living with HIV under the Scheme, but also the lives of another 28 needy patients on the waiting list by the end of this year and up to a total of 100 people living with HIV in its second and third year of implementation,” said YSD’s Governing Council Member YBhg. Datin Paduka Zaitoon Dato’ Othman when announcing the foundation’s support at a mock cheque presentation ceremony. With this new YSD grant, MAF is looking at expanding the PAL scheme in particular underprivileged people living with HIV in the east coast and northern parts of the country. 

“MAF’s expansion plan for the PAL Scheme will enable YSD to reach out to those who face increasing barriers to access treatment and care services due to socio-economic disparities, geographical factors, as well as stigma, discrimination, especially in Kelantan and Terengganu where both states record high HIV incidences yearly. Thanks to MAF, we are now another step closer to the people living with HIV,” Datin Paduka Zaitoon further explained. PAL, short for Positive Audacious Living, offers second line antiretroviral medicines every other month to its beneficiaries with a combined household monthly income of less than RM3,000. 

Synonymous with the PAL brand, the antiretroviral treatment – which is to be taken for life – is highly effective in suppressing HIV and halting the progression of the disease, thus allowing people living with HIV to lead healthy, productive and meaningful lives. At the onset of the treatment, the combination of antiretroviral drugs that a person is given is called first line therapy. If after a while HIV becomes resistant to this combination, or if the side effects are particularly intolerable, then a change to second line therapy is usually recommended. 

At present, the Malaysian Government provides full subsidies of antiretrovirals only for the first line regime. A second line antiretroviral drug in Malaysia costs anywhere between RM558 and RM1,720 per monthly prescription. “While a cure and a vaccine remain elusive, antiretroviral drugs are our best bet in not only treating people with HIV but also preventing the virus from being transmitted to people who are uninfected,” commented MAF Chairman Prof. Dr. Adeeba Kamarulzaman. 

“And while science continues to bring forth new treatment approaches, there is no denying that they come at a very high cost, the brunt of which is something that the majority of people living with HIV in our country are not able to bear financially. We are grateful to YSD for their generous support which has given a new lease on life to our PAL Scheme, which we have been struggling to keep alive,” she added. Prof Dr Adeeba also shared that the Ministry of Health’s projections showed that by 2015, more than 14,764 AIDS related deaths will be averted with the aggressive rollout of antiretroviral treatment by the government since 2002. 

However, treatment coverage currently stands at 45%, which is far below the national target of 80% of all people living with HIV who are eligible for antiretroviral treatment by 2015. “Through the reinvigorated PAL scheme, we hope to complement our government’s efforts and close this gap by putting as many people living with HIV as possible on this medical assistance initiative,” she further commented. MAF and its sister organisation the Malaysian AIDS Council (MAC) are long-term community and health partners of YSD. 

In June 2013, MAC was awarded with a grant worth RM870,000 to support its three-year HIV advocacy and leadership programme focusing on access to treatment, stigma reduction, work place policy development and youth awareness issues. Besides MAF, under its Community & Health pillar YSD also champions initiatives such as the Cancer Research Initiatives Foundation (CARIF), Tabung YSD for the Underprivileged Coronary Patients at UMMC, Hospis Malaysia’s Patient Care Programme, YSD-YOKUK Sayang Home Care Programme – a palliative care initiative in Kelantan, YSD Epilepsy Surgery Fund Programme, “Empowered”: The Cancer Advocacy Society of Malaysia, Women's Aid Organisation, Yayasan Chow Kit, IDEAS Autism Centre, and the Malaysian Federation for the Deaf among others.