Dr Roy Chan
In this issue of the ACT, we bring you reviews of the sessions
and papers presented at the 3rd Singapore AIDS Conference.
There is also coverage of the debate in the Straits Times
Forum pages over several weeks in November and December regarding
the promotion of safe sex behaviour and condom use as a means
of preventing HIV infection and STI. This topic periodically
receives attention in the local scene; conservative members
of the public are usually the ones who start the controversy
by opposing anything other than the promotion of abstinence
till marriage and monogamy after marriage in HIV/STI prevention.
Our position has always been that we need to provide much
broader and inclusive messages and information than this;
by all means promote the "No Sex" message - but
not at the expense of removing all information on the usefulness
of condoms. The letters to the ST Forum have been reproduced
in this issue of the ACT, we have also included information
released by the UNAIDS, WHO and CDC on this issue.
Honourable Minister of State for Health and Environment Dr
Balaji Sadasivan, Senator Mechai Viravaidya, distinguished
guests and colleagues, ladies and gentlemen -
Since we last met at the 2nd Singapore AIDS Conference in
December 2000, another 2 million people have become infected
with HIV in Asia alone. There are now over 6.5 million infected
people in the region, it is clear that the epidemic has well
and truly taken off. The most severely affected countries
in the region are Thailand, Myanmar, Cambodia and India; more
recently however the epidemic has been increasing rapidly
in parts of China, Vietnam and Indonesia.
In Singapore in the last 2 years, 450 or so Singaporeans
and Permanent Residents were diagnosed with HIV infection
and AIDS. This brings the total number of HIV infections to
almost 1800, and over 600 have died from AIDS.
The overwhelming majority of infections (>95%) were transmitted
through sexual intercourse. The majority of infections were
seen in heterosexual males, with a significant minority among
homosexual and bisexual males. 9 cases out of 10 are in males;
the proportion in females has not changed much over the years.
While the absolute numbers in Singapore may not be very high,
the per capita infection rate tells a different story. When
we compare per capita figures, we find that HIV infection
in Singapore is more prevalent than many other developed countries
in Europe and Asia. For example HIV prevalence in adults at
the end of 2002 was 0.146% in Singapore, compared with 0.121
in Australia, 0.119 in the UK, 0.02 in Japan. (USA - 0.61%,
Thailand - 1.8%, France - 0.345%).
But numbers do not tell the full story; more important than
numbers is the fact that AIDS has now touched the lives of
thousands of Singaporeans. We have lost and continue to lose
friends and family members, fellow workers and fellow citizens
to AIDS. While many have the support of family and friends,
others have passed away alone and abandoned, and their memories
have been banished by families and friends because of shame
Modern medicine has now rendered AIDS and HIV infection a
treatable disease; it is no more the uniformly fatal infection
as it was when it was in the 1980s and early 1990s. Anti-HIV
medications can give infected individuals a very good chance
to live long, healthy and fulfilling lives.
This conference will have greater active participation by
persons living with HIV and AIDS (or PWAs) in the programme.
PWAs and other affected individuals will share their perspectives
and experiences in plenary number 2, as well as in other sessions.
We are very happy that this time there are individuals brave
and committed enough to speak up and air their fears and hopes.
I would like to recall these words of Nelson Mandela at the
Barcelona AIDS Conference last July, who in calling for greater
visibility of positive people said "You must not be ashamed
of speaking out ... because when you keep quiet ... you are
signing your own death warrant."
At the conclusion of the last conference, delegates affirmed
the need -
- for multisectorial response and approach to AIDS prevention,
care, support and treatment,
- for greater participation of and collaboration between
government institutions, businesses, community based organisations
and non-governmental organisations,
- to overcome AIDS-related discrimination and stigma
- to provide more accessible and affordable treatment and
- for greater PWA participation in prevention, education
programmes, policy discussions and decision-making processes.
We will at this meeting have the chance to assess how far
we have progressed or not progressed in these areas over the
last 2 years.
The theme of the conference this year is "Change - Attitudes,
Behaviours ... The Future". This was chosen because we
believe that it underlines the need to periodically examine
and evaluate our knowledge, attitudes and practices with respect
to all aspects of AIDS - whether it be prevention programmes,
nature and content of educational materials and messages,
medical and nursing care, counseling services, research projects,
defeating stigma and ignorance, implementing sound workplace
policies on AIDS, and so on. If necessary changes must be
recommended and made, if we are to move forward and stay ahead
of the epidemic.
Tonight we are very honoured to have Minister of State of
Health and Environment, Dr Balaji Sadasivan, as our Guest-of-Honour.
His presence here is I believe evidence of the government's
commitment to address the problems associated with AIDS, and
a reflection of his personal commitment to openness and collaboration.
We are also very honoured to have Senator Mechai Viravaidya
from Thailand to deliver the keynote address later on this
evening. I wish to thank -
- my co-chairs Lee Cheng Chuan, Brenton Wong and Grace Chang,
and the organising committee of the conference
- speakers, facilitators and presenters
- our collaborating organizations the Body Shop and Levi
Strauss & Co for the Business Forum, and the Red Cross
Society for the Youth Symposium
I would also like to acknowledge the generous support of
our sponsors without whom we would not have been able to organise
this meeting -.
Our gold sponsors - GlaxoSmithKline, Merck Sharp & Dohme,
Pfizer, and the Health Promotion Board; our silver sponsors
- Abbott Laboratories, Astra Zeneca, Bristol-Myers Squibb,
Wyeth Pharmaceuticals, and our other sponsors - Bayer, Boehringer
Ingelheim, Genelabs Diagnostics, Janssen-Cilag, Kyowa-Hakko
And last but certainly not least the hardworking Conference
Secretariat led by Nina Sharma.