The battle against HIV is only half won, however. Injecting drug users “operate under a cloud of fear”, she says, since they worry that accessing clean needles or methadone could land them in prison. Malaysia’s restrictive drug laws are impeding access to HIV treatment, says Kamarulzaman: “You could get hanged for carrying marijuana. We need more rational drug policies.” In prison, HIV and tuberculosis go untreated, and needle exchanges are banned. These are not issues for which there are easy solutions, and the country’s drug laws will be a core subject of discussion at IAS 2013. “In the next few years, I really want to see Malaysia’s drug policy revised; until that’s done, we’re just tinkering”, she asserts.
The HIV epidemic in Malaysia continues to grow in some populations. In 2011, women accounted for about 21% of new infections, up from 5% a decade previously. In men who have sex with men (MSM), meanwhile, the latest figures, Kamarulzaman says, show that between 1990 and 2000 the number of new HIV infections in MSM ranged from 20 to 60 per year, in 2011 this had risen to 358, and by 2012 had almost doubled to 654. She explains that “it is critical that we focus our prevention efforts amongst this key population. Central to it is to encourage them to come forward for HIV testing”, which is vital in the absence of education about safe sex in MSM. This education is unlikely to happen anytime soon, she fears. “As a country we have become more conservative—people can’t seem to separate public health issues from social mores.” Treating injecting drug users “was a walk in the park in comparison to this”, she says. Policy makers are afraid of a public backlash if they are seen to support programmes that help these groups.
While she works on tackling this problem, Kamarulzaman is also helping to advance the university Vice-Chancellor’s “single-minded” vision to steer the institution into the top 100 in the world. Malaysia has far outperformed neighbours like Indonesia in scientific prowess, but Kamarulzaman believes that “competition should give way to Islamic collaboration”. Richer countries could help fund poorer ones, and nations with more established scientific know-how like Malaysia could share their expertise with countries like Indonesia. The history of science in Islamic countries intrigues her and she confesses to harbouring the desire to take a sabbatical to study the “glory days of science and Islam”. The more immediate concerns of fighting the HIV/AIDS epidemic, and her track record of achievements, however, mean this sabbatical is likely to be a long time coming.