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Malaysia AIDS Decade Plan
Published on 04.07
Malaysia Ministry of Health Strategic Planning Series (II): National AIDS Strategic Action Plan (2016-2030) and Latest Report 2025
The National Strategic Plan for Ending AIDS 2016-2030 (NSPEA) of Malaysia is led by the HIV/STI Section of the Ministry of Health Malaysia. Its vision is to achieve "Zero New Infections, Zero Discrimination, Zero AIDS-Related Deaths." The goal is to end the AIDS epidemic by 2030, progressing through a rapid acceleration phase from 2016-2020 and a consolidation phase from 2021-2030. It adheres to the "90-90-90" (by 2020) and "95-95-95" (by 2030) treatment targets, along with corresponding prevention coverage goals.
I. Strategic Overview of Malaysia's National AIDS Strategic Action Plan (2016-2030)
Malaysia's National Strategic Plan for Ending AIDS 2016-2030 (NSPEA) aims to eliminate AIDS as a public health threat by 2030. This will be achieved by maintaining rapid progress, ensuring 95% of key populations have access to HIV testing and know their results, 95% of people living with HIV receive antiretroviral therapy, 95% of those on treatment adhere to it and achieve viral suppression, and 90% of key populations have access to effective prevention programs.
The Malaysian NSPEA strategy centers on "Ending AIDS" with the vision of achieving "Zero New Infections, Zero Discrimination, Zero AIDS-Related Deaths." It aligns with the UN Sustainable Development Goals (SDG) and adopts the UNAIDS "Fast-Track" guidelines. The implementation will be divided into two phases:
1. Phase I: 2016-2020 Rapid Acceleration Phase (Mid-term Goals)
The first acceleration phase, from 2016-2020, focuses on achieving the "90-90-90" prevention and treatment targets:
(1) 90% of key populations have access to HIV testing and know their results
(2) 90% of people living with HIV receive antiretroviral therapy
(3) 90% of those on treatment adhere to it and achieve viral suppression
(4) 80% of key populations have access to effective prevention measures.
2. Phase Two: 2021-2030 (End Goal)
Building on the strategic implementation of the first phase, with the ultimate vision of "Ending AIDS by 2030," the focus is on advancing the "95-95-95" targets to further enhance prevention and control quality:
(1) 95% of key populations are tested for HIV and know their results
(2) 95% of people living with HIV have access to antiretroviral therapy
(3) 95% of people on treatment adhere to treatment and have a suppressed viral load
(4) 90% of key populations have access to effective prevention measures.
3. Malaysia's Vision of Achieving Zero Through Rapid Progress and Ending AIDS
II. Global AIDS Monitoring 2025: Malaysia National Progress Report
1. Malaysia's HIV/AIDS Epidemic Situation
Despite significant progress in HIV/AIDS over the past few decades, it remains a major public health issue in Malaysia. Malaysia reported its first HIV case in the late 1980s, and the number of people infected with the virus has steadily increased since then. Core research findings indicate a significant shift in the HIV transmission pattern in Malaysia, moving from injecting drug use to sexual transmission. This transition is particularly evident in key populations, including men who have sex with men (MSM), transgender women (TGW), and women at risk (WAR).
By the end of 2024 (Figure 1, Figure 2), an estimated 83,937 people living with HIV (PLHIV) were in Malaysia, of whom 53,996 (64%) knew their infection status and were reported in the national surveillance system. As of December 2024, among those who knew their HIV status, 94% were receiving antiretroviral therapy (ART).
The number of new HIV infections decreased from 6,978 cases in 2002 to 3,185 cases in 2024, a reduction of 54.4%. Furthermore, the estimated incidence of HIV per 1,000 uninfected individuals has steadily declined from 0.43 in 1991 to 0.08 in 2024 (Figure 3).
More than half of new HIV infections originate from densely populated states such as Selangor, the Federal Territory of Kuala Lumpur, and Sabah. Since the beginning of the HIV epidemic, reports of HIV infections have consistently shown a strong male dominance, with a male-to-female ratio of 9.4 in 2024 (Figure 4).
The highest proportion of people living with HIV in Malaysia are young people aged 20-29, accounting for 45% of total cases. This is followed by the 30-39 age group, which accounts for 30%. These figures indicate that the majority of infections occur in younger adults, particularly those in their 20s and 30s (Figure 5).
2. HIV Testing and Treatment
(1) Progress towards the 2030 "95-95-95" goal
Regarding Malaysia's progress towards the "95-95-95" treatment cascade goal (Figure 6), as of the end of 2024, 64% of people living with HIV have been diagnosed and know their test results. Among those diagnosed with HIV, the treatment coverage rate is 94%, indicating a gap in treatment and care. Among those receiving treatment, 93% have achieved viral suppression.
(2) HIV testing volume and positivity rate
Over the years, Malaysia's HIV testing programs have steadily developed, covering both facility-based and community-based testing to reach key populations that are difficult to access. Consequently, the proportion of people living with HIV who know their status has gradually increased (Figure 7), moving closer to the 95% target.
(3) Late diagnosis of HIV
According to the World Health Organization (WHO) definition, late diagnosis of HIV refers to patients with extremely low CD4 cell counts at the time of diagnosis. This means that compared to those diagnosed early, patients diagnosed late have significantly lower CD4 cell counts.
In 2024, the proportion of late-diagnosed HIV patients in Malaysia reached 66% (Figure 8), a slight decrease from the 2023 data. There is still a need to further enhance public awareness of AIDS prevention, especially to conduct publicity targeting high-risk groups and promote their annual HIV testing.
(4) Individuals infected with the human immunodeficiency virus receiving antiretroviral therapy
From 2015 to 2018, the number of patients receiving antiretroviral therapy (ART) steadily increased, highlighting substantial progress in treatment coverage. In 2019, the number of treated individuals reached its peak, signifying significant achievements in patient treatment initiation and retention management. However, from 2019 to 2021, this figure stabilized, and the growth trend stagnated. This stagnation can be attributed to multiple challenges, such as the impact and disruption of the COVID-19 pandemic on the healthcare system. Starting from 2022, the number of treated individuals has shown an upward trend, achieving significant growth by 2024 (Figure 9), reflecting the implementation of healthcare recovery measures and the effective advancement of strategies to improve the accessibility of antiretroviral therapy.
(5) Individuals infected with the human immunodeficiency virus receiving antiretroviral therapy with suppressed viral load
According to the World Health Organization (WHO) definition, HIV viral load suppression means that viral replication is inhibited, but the virus can still be detected; the Joint United Nations Programme on HIV/AIDS (UNAIDS) and Aidsmap clarify that the criterion for determination is a viral load of ≤1000 copies/mL. This means that viral replication is effectively suppressed but not completely cleared, and can still be detected. The viral load suppression rate among people living with HIV in Malaysia has shown a steady upward trend, exceeding 90% as of 2024 (Figure 10).
Currently, as shown in Figure 11, 64% of people know their HIV status, meaning approximately 25,744 more people need to be tested to reach the 95% target. Among those receiving treatment, 94% have received antiretroviral therapy. Among those receiving treatment, 93% have achieved viral control, and 1,429 more people need to achieve viral suppression to reach the 95% target. Overall, these figures are close to the targets, but more people need to be covered at each stage.
(6) AIDS mortality rate in Malaysia
Expanding the availability and accessibility of antiretroviral therapy to all people living with HIV has led to a steady decline in AIDS mortality from 11.9 per 100,000 population in 2014 to 6.2 per 100,000 population in 2024 (Figure 12).
III. Progress in AIDS Prevention and Control in Malaysia
1. Differentiated HIV Prevention Services for Key Populations (DHSKP)
The Differentiated HIV Prevention Services for Key Populations (DHSKP) program aims to provide services to key populations, tailoring HIV prevention, care, and treatment services specifically for those most affected by HIV. These populations include men who have sex with men (MSM), transgender people, sex workers, and people who inject drugs (PWID). This initiative is a result of collaboration between the Ministry of Health, MAF, MAC, and the Global Fund.
The DHSKP program aims to increase HIV testing coverage, strengthen case finding among key populations, and ensure their timely access to treatment, care, and support services. The program emphasizes community-based service delivery, integrating HIV testing, prevention, and treatment services, and adopting a client-centered approach to meet the specific needs of these populations.
In 2023, the Differentiated HIV Services for Key Populations (DHSKP) project underwent significant transformations to enhance its sustainability, efficiency, and service coverage. Firstly, the allocation of funds from the Ministry of Health (MOH) Malaysia was transferred from the Malaysian AIDS Council (MAC) to the Malaysian AIDS Foundation (MAF) in May 2023. This shift aimed to increase funding through MAF's resource mobilization efforts, thereby expanding the reach of DHSKP services. Secondly, DHSKP sites funded by the Global Fund (GF) began a phased integration into the MOH's financing framework over three years. This ensured the project's sustainability while expanding service coverage and optimizing human resource management by establishing a unified core team to oversee both MOH and GF projects. Thirdly, the data management system was migrated from Syrex to MySEJAHTERA, leveraging a government platform at no cost. This improved data security, streamlined data collection, management, and analysis processes, and enhanced project efficiency. These transformations have strengthened the DHSKP program, broadened its service coverage, ensured efficient resource utilization, and improved data management, all of which have significantly contributed to achieving its objectives.
2. PrEPGOV Malaysia: Pre-Exposure Prophylaxis Demonstration Project
The Malaysian Pre-Exposure Prophylaxis Demonstration Project (also known as PrEP Gov) is a project under the Malaysian HIV/STI Prevention and Care Programme (DHSKP), aiming to provide Pre-Exposure Prophylaxis (PrEP) to key populations at high risk of HIV infection. PrEP is a medication taken by individuals to reduce the risk of HIV infection before exposure to the virus.
The PrEP demonstration project aims to assess the feasibility, acceptability, and effectiveness of delivering PrEP to key populations through selected government clinics nationwide, and to identify barriers and facilitators to PrEP uptake, adherence, and retention among key populations. Furthermore, it aims to generate relevant evidence to inform the scale-up of PrEP within the DHSKP program.
3. TestNow HIV Self-Testing
In 2023, the Malaysian AIDS Council's (MAC) HIV self-testing initiative was relaunched under the name "TestNow". The TestNow program is a collaborative effort between the Ministry of Health Malaysia, the Malaysian AIDS Council (MAC), the Malaysian AIDS Foundation (MAF), and the Global Fund. Its purpose is to increase the accessibility of HIV self-test kits, enabling individuals to test their HIV status privately. These kits are available for purchase at designated pharmacies and can also be ordered through the TestNow website.
This initiative is part of Malaysia's broader strategy to end AIDS by 2030, focusing on early detection and treatment to reduce transmission rates. By providing accessible self-testing kits, TestNow empowers individuals to take control of their health, especially those who may be hesitant to visit healthcare facilities due to stigma or privacy concerns. The initiative also offers resources and support for individuals who test positive, ensuring they receive appropriate care and counseling.
4. Southeast Asia Regional Platform (SASEA Platform)
The Southeast Asia (SASEA) Platform is one of ten international networks under "Coalition PLUS," an internationally recognized NGO focused on serving key populations in 4 countries in South and Southeast Asia, and providing care for people living with HIV and viral hepatitis. The platform comprises 6 member associations.
In November 2023, the Malaysian AIDS Council (MAC) was appointed as the lead agency for the Southeast Asia AIDS Strategic Information Platform (SASEA Platform), which was officially launched during the International Testing Week celebration hosted by the Malaysian AIDS Council.
As the leader of the SASEA Platform, MAC collaborates with other platform member countries to strengthen their organizations in three key thematic areas: capacity building in HIV and Hepatitis C virus, community research, and support for advocacy efforts.
IV. Malaysia's HIV Screening Methods and Market Information for Screening Products
1. Malaysia's HIV Screening Methods
2. Market Situation of HIV Screening in Malaysia
(1) Local core enterprises and products
(2) International brands (mainstream agents/distributors in Malaysia)
V. Current Status of HIV Prevention and Treatment Drug Use in Malaysia
1. Approved HIV Pre-Exposure Prophylaxis (PrEP) Drugs in Malaysia
(1) Tenofovir Disoproxil Fumerate / Emtricitabine (TDF/FTC): Suitable for all adults or adolescents weighing over 35 kg, including people who inject drugs (PWID).
(2) Injectable, long-acting Cabotegravir: Once every 2 months; suitable for all adults and adolescents weighing over 35 kg.
(3) Tenofovir Alafenamide / Emtraticibine (TAF/FTC): Suitable for cisgender men who have sex with men and transgender women.
2. Antiretroviral HIV Treatment in Malaysia
Drug HIV treatment consists of taking three or more antiretroviral drugs (ARVs) concurrently. There are many types of ARVs, which can be combined in different ways.
The World Health Organization (WHO) recommends that people starting HIV treatment use a combination of antiretroviral drugs: TDF (tenofovir disoproxil fumarate), 3TC (lamivudine) or FTC (emtricitabine), and EFV (efavirenz).
VI. Core Recommendations for Chinese Pharmaceutical and Medical Device Companies to Enter the Malaysian HIV Testing Product Market
1. Prioritize the breakthrough of HIV self-testing kits (HIVST): Seize the market pain point of young people's privacy needs.
Young people aged 20-29 account for 45% of infections, and high-risk groups are reluctant to go to medical institutions for testing due to "fear of stigma." In recent years, the Malaysian Ministry of Health, in collaboration with NGOs (such as the Malaysian AIDS Council, MAC), has gradually expanded the accessibility of HIVST kits. However, the current market is dominated by foreign brands like Beright, with a scarcity of local products.
2. Supplement professional testing reagents: Align with the government's "95% testing rate" goal.
(1) The Malaysian Ministry of Health aims for a 95% testing rate among key populations by 2030 (64% in 2024), but there is a significant current gap in professional testing reagents (e.g., HIV-1 RNA PCR reagents are imported and expensive).
(2) Launch a "Antigen/Antibody Combination Test (Screening) + HIV-1 RNA PCR (Confirmatory)" combo kit to meet the needs of medical institutions for "one-stop testing."
(3) For infant and young child testing (<18 months old), develop "EDTA Anticoagulant PCR Reagent" (compliant with Malaysian sample transportation standards: 2-8°C storage ≤ 3 days), to support the mother-to-child transmission prevention program (systematic testing for newborns of HIV-positive mothers or those at risk of HIV infection).
3. Layout PrEP supporting tests: Seize the new track of prevention
(1) Sexually transmitted infections account for 95% of new infections. The number of people covered by the PrEP (Pre-Exposure Prophylaxis) program increased from 3368 in 2023 to 10,000 in 2025. Supporting reagents for "PrEP pre-medication screening (e.g., HIV antigen/antibody, liver and kidney function) + on-medication monitoring (viral load)" are required;
(2) Develop a "PrEP specific test kit" including combined HIV antigen/antibody testing and HCV antibody testing (PrEP users need to be screened for Hepatitis C infection), and the reagent needs to be compatible with POCT equipment in Malaysian public clinics (e.g., Abbott i-STAT).
VII. References
1. National Strategic Plan ending Aids 2016-2030, Ministry of Health Malaysia
2. Malaysia Global Aids Monitoring report 2025, MOH Malaysia
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