ILMC on HIV/AIDS
by Dr. Musa Mohd. Nordin
( IMLC ) held in Kuala Lumpur from 19-23 May 2003. I thank you in anticipation for your kind permission to share some of my personal perspectives of this universal predicament which permeates her obnoxious presence in virtually every aspect of our human endeavours
An outbreak of a rare form of opportunistic pneumonia, pneumocystis carinii, which hitherto only afflicted the severely immuno-compromised, among a cohort of healthy, young, gay men in Los Angeles, heralded the unwelcomed arrival of clinical AIDS in 1981.. Some 22 years into the syndrome complex, the WHO global summary document of the HIV/AIDS epidemic estimates 42 million people living with HIV/AIDS (PLWHA). People newly infected with HIV in 2002 was 5 million and the AIDS mortalities in the same year exceeded 3.1 million. Kofi Annan’s special envoy for HIV/AIDS in the Asia Pacific, Dr. Nafis Sadik in her evening address to the International Muslim Leaders Consultation on HIV/AIDS said that (in stark contrast) the prevalence of HIV/AIDS remains low in the Muslim world with rates below 1% in countries with a Muslim majority and similarly in Muslim minorities in other countries. Amina Wadud, a novice in the HIV/ AIDS frontline by her own admission “In 2002, I had my first encounter with constructive organizational level efforts to respond to the AIDS epidemic at a meeting in Nairobi, Kenya”, would therefore be well advised to be prudent and careful in examinig her basic facts and vocabulary of HIV/AIDS before advancing her unscientific and non-evidence based thesis.
The injunctions of the syariah was stipulated to preserve and protect the very essence of our humanity, namely religion, life, mind, progeny and property. Unless this is jealously guarded the HIV/AIDS scourge with all her ramifications will annihilate mercilessly all these five fundamentals of our human existence. Millions have died and millions more are doomed to this fatal outcome. As the virus create havoc with their immune systems, their bodies are rendered vulnerable to a whole hosts of potentially lethal microbes. Many of those affected are at the height of their prowessnes and the prime of their careers but are now reduced to a wasted and weakened anatomy. As their productivity drops, their incomes dwindle, assets shrink, they are further plunged into destitution and the horrid nightmare further unfolds with the choking and devastation of home and national economies. The family fabric is tragically dismantled as children are orphaned and young teens assume responsibility as household heads. Kids opt out of school to help with immediate food needs. The vicious circle linking poverty, food insecurity, illiteracy and HIV/AIDS can only perpetuate further social upheavals leading to chronic disruption of barely coping health, welfare and education systems. And left unchecked, they constitute the ideal ensemble for a desperate humanitarian crisis.
Addressing the HIV/AIDS pandemic under no uncertain terms demands a comprehensive and integrated response which prioritise preventative strategies, provide therapeutics, care and support to the afflicted and their families and puts in place long term macro-economic and social interventions to redress the socio-economic impact of AIDS. As the figures suggests, the infusion and practice of universal values derived from the Quran and prophetic teachings in individual, family and societal life must have endowed considerable prophylaxis against this deadly disease. The preventative strategies advocated by Islam and shared by most if not all religious denominations emphasise the A for abstinence from sex, the B for being faithful in marriage , the C for condom use and the D for drug abuse avoidance. The Islamic approach dissects in no uncertain terms at the very aetiology of disease complexes and the complicating socio-economic pathologies and HIV/AIDS is no exception. Paraphrasing Dr. Sadik, HIV/AIDS thrive within the high risk groupings whose behaviour and lifestyle predispose them to infection. And this most commonly afflict the community of commercial sex workers, people of either sex with multipe sex partners, homosexuals and intravenous drug users
( IVDU ). The most recent editorial in the British Medical Journal, 21st June 2003, entitled preventing HIV : time to get serious about changing behaviour writes ” But if behaviour cannot be changed then no amount of money is going to make a big difference in prevention because every successful form of prevention requires change in behaviour”. Arthur J Ammann, president of Global Strategies for HIV Prevention further writes “Data from developed and developing countries show that programs that incorporate abstinence, mutual monogamy, delayed sexual intercourse and condom work together to reduce the number of new HIV infections”. The exclusive condom and safe sex paradigm has clouded the better judgement of many stake holders in HIV/AIDS work, many of whom subscribe slavishly to the modernist and liberal world views. This self fulfilling prophecy has blossomed the latex and rubber industry which runs into billions of dollars per annum and unleashed a pornographic culture of promiscuity and permissiveness.. It must be reasserted from the outset that a condom should not condone promiscuity nor clean needles or syringes be a justification for continued drug use.
An emotive issue as HIV/AIDS is bound to provoke a myriad of responses and ideological frameworks. As early as 1987, Peter Duesdberg, a professor of molecular biology at the University of California, Berkeley, championed the view that HIV does not cause AIDS, but is a product of personal behaviour, notably drug abuse or the drugs used to treat AIDS. Together with Kary Mullis, a chemistry nobel laureate, they spearheaded the HIV denialist movement and repeated endlessly like a mantra, the claim that no single scientific paper offers proof that HIV causes AIDS. The architect of the polymersae chain reaction ( PCR ) which represents one of the major breakthroughs in biotechnology, Kary Mullis was reported by the Sunday Times of London in 1993 as saying “If there is evidence that HIV causes AIDS, there should be scientific documents which either singly or collectively demonstrate that fact, at least with a high probability. There is no such document”. Of late there has been a noisy resurgence of this viewpoint and the president of South Africa himself convened a Presidential AIDS Advisory Panel collecting some 52 scientists to discuss and exchange views on HIV/AIDS in 2000. A nation devoured by the AIDS epidemic, with every fifth adult South African carrying the virus, their ANC president was not convinced. Someone as powerful as President Thabo Mbeki, was sucked into the denialist mode and simply could not swallow the logic of blaming everything on a single virus. The HIV denialist movement claimed victory and in a response to the Presidential AIDS Advisory Panel Report from South Africa released on 5th April 2001, proclaimed arrogantly ” Why is it that we ask these very basic questions after almost 20 years of AIDS hysteria ? And what did we do during this time when we fought against HIV/AIDS ? ”
Their gross distortions of science have been debated and refuted repeatedly by mainstream peer reviewed scientific journals and the National Academy of Science assembled a special panel to debunk their claims. Mullis’s contention that his PCR technique was never designed to quantify viral load was empirically disproven when long term follow up of one of the largest and longest AIDS studies, the Multicentre AIDS Cohort Studies (MACS ) showed a profound and predictable relationship between viral loads, CD4+ cell counts and the progression of disease or AIDS death. On the political front it begged the likes of past-president, Nelson Mandela to come upfront to rectify and realign his successor’s faulty, misinformed and dangerous political mindset vis a vis HIV/AIDS.
And without exception, the IMLC was similarly faced with the daunting task of harmonising the multiple divergent views promulgated by various individuals or groupings. Many Muslim HIV/AIDS workers have been psychologically seduced and subdued by the libertarian values of the occident. They indiscriminately ape the modus operandi to combat HIV/AIDS as prescribed by their secular gurus or institutions of liberalism and transplant them piecemeal into their national programs. As perceived from writings in the national dailies, the few in Sisters in Islam ( SIS ) see this as another vehicle to ride on their rhetorics of gender, sexuality and feminism. The papers of Amina Wadud and Riffat Hassan regurgitates ad nauseam their feminist theology to the many unsuspecting IMLC crowd. Quite obviously, the Malaysian AIDS Council
( again with a considerable sprinkling of SIS heavyweights ) went to great lengths to secure the likes of Wadud, Riffat, Esack and Moosa from their adopted homeland, the USA , to the IMLC. Marina Mahathir, the IMLC chairperson has been oft quoted in the lay press that she would like to create space for the diversity of opinions in HIV/AIDS work approaches.Well assisted by the partial antics of her program chairperson and vice chairperson, they created a generous volume of space for these “revisionists” to advance their theology but was unequivocally adamant at not permitting time and space for the “traditionalist” physicians et al to rebut their contentious and perverted ideas. This abhorrent double standards of conference proceedings is unbecoming of any respectable international meet, let alone a Muslim Leaders Consultation, hence the walkout was inevitable. Anticipating a virtual collapse of what began as a cordial and brotherly consultation and intellectual discourse and hopefully too a realisation of the enormity of the profanities and abuses hurled at the Quran and Islam, the organisers hurriedly convened a one hour early morning session to debate the Wadud paper. The debate did not cease but instead spilled into the corridors and the media captured the unhappiness and unfairness that was pervasive in the conference ambience, much the opposite of the gaiety and fairplay of the organisation of the First IMLC in Kampala, Uganda in November 2001. A few others who participated have no direct involvement with HIV/AIDS patients, do not operate institutions which provide care and support to people living with HIV/AIDS (PLWHA ) and do not face the real risk of needle stick injuries in their daily round of duties, yet have the audacity to caricature others notably physicians from the various Islamic Medical Associations as obscurantic, archaic, bigots and uncharitable.
As Muslims, the Tauhidic paradigm envelops our response to the HIV/AIDS pandemic. It is simply put a “back to basics” wholesome blueprint of action which espouses and celebrates universal values of self discipline, chastity, morality, decency and family centricity. Yet again, another whole host of shared human values and code of conduct and ethics guarded enviously by all the major religions of the world. The Quranic and prophetic concepts of Islah ( transformation ) must be cherished in spirit and substance if this ummah is to mount a credible and sustenable response to the awesome challenge of HIV/AIDS. The Muslim
ummah’s response and this extrapolates well to most if not all followers of the great religions of the world, must embrace the theology of mercy, care and compassion, forgiveness, healing, benevolence, brotherhood of mankind and belief in the hereafter.
Dr. Musa Mohd. Nordin
Past President, Islamic Medical Association of Malaysia
Board Member, Muslim Professionals Forum
Consultant Paediatrician & Neonatologist
Damansara Specialist Hospital
Tel/Fax : 603-77293173
musa@mpf.org.my