Malaysia has a concentrated HIV epidemic affecting key populations, with infection rates remaining above 5%. Since 2010, sexual transmission has emerged as the main risk of transmission of HIV in Malaysia. Men who have sex with men and
transgender women are now at the highest risk of acquiring HIV and Sexually Transmitted Infections (STIs), with HIV incidence estimated to be rising among these key populations. The most recent Integrated Bio-Behavioral Survey (IBBS)
2022 has shown a steady decreasing trend of HIV prevalence among the people who inject drugs (7.5%) but remained consistently high across other sexual transmission-related key populations - MSM (12.9%), TGW (5.9%), and Female Sex
Workers (FSW). Syphilis/STI is showing a high detection rate among the sexual transmission groups, while Hepatitis C
screening has persistently picked up reactive cases among the people who inject drugs (PWID) group.
To address the evolving HIV epidemic, Malaysia has mainstreamed and integrated HIV services for the key populations into the primary healthcare system since 2019. Engaging in strategic partnerships with local NGOs, Malaysia has rolled out Differentiated HIV Services for Key Populations Program (DHSKP) in all 13 states as of 2023, with expectations to fully transition to domestic funding by June 2025. The DHSKP program is complemented by the launch of Pre-Exposure Prophylaxis (PrEP) services in 31 public primary care clinics supported by community navigators as well as national HIVST services. Under Grant Cycle 7, Malaysia is planning to scale up PrEP across the country, improve demand and uptake, and address relevant underlying barriers experienced by key population communities.
Malaysia is poised to fully transition off the Global Fund by 2028. The country is committed to addressing sustainability challenges through strategic partnerships, financial planning, and integrating successful projects into the national healthcare system. Under Grant Cycle 6, Malaysia has already begun co-financing community-led responses through a partnership between government and NGOs and joint implementation of the PrEP demonstration project.
Under Grant Cycle 7, efforts are under way to increase private sector investment in healthcare infrastructure, services and programs as well as contributions through funding, technology, and management expertise. The MOH is also exploring strategies to enhance its fiscal space and budget allocation for healthcare while leveraging the fundraising capabilities of Malaysian AIDS Foundations to mobilize additional resources for HIV. Notably, the national PrEP program is expected to be integrated into primary healthcare and positioned to transition to domestic funding by July 2025.
The overall objective of this assignment is to document the Government of Malaysia’s successful response to HIV and its transition away from external donor funding, most notably Global Fund funding. There is a range of products proposed, and these will showcase the successes, challenges and lessons learned. The products are intended for multiple audiences with distribution both within Malaysia and globally.
Specifically, the consultant will develop two products: (i) a 4-to-5-page case study that highlights the Government of Malaysia and other partners successful approach towards sustainability and transitioning of their national response to HIV; and (ii) a short article based on the case study or publication and promotion by the Global Fund.
Both the case study and the short article will be a valuable resource for use within Malaysia showcasing what you have achieved. The Global Fund intends to include the case study in the package of information for the Grant Cycle 8 global
replacement conference to be held in November this year. Malaysia is a strong example of bold leadership and has demonstrated a genuine commitment to transitioning, underpinned by strategic partnerships with a focus on sustainability. This leadership is especially evident in Malaysia’s innovative collaboration between the government, NGOs, the private sector, and public donors. This inclusive partnership model reflects a meaningful and effective transition, demonstrating
a clear return on investment, one that we hope will encourage continued donor support for the Global Fund. The two products will include sub-sections on community responses, social contracting, and integration of HIV services into primary health care centres.
The Sustainability of HIV Services for Key Populations in Asia (SKPA)-2 program is implemented by principal recipient, Health Equity Matters and is funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) to improve the
sustainability of evidence-informed, prioritized HIV services for key populations in Bhutan, Mongolia, Sri Lanka and Malaysia. There are four program objectives:
· Accelerate financial sustainability.
· Improve strategic information availability and use.
· Promote programmatic sustainability.
· Remove human rights and gender-related barriers to services.
Health Equity Matters, as principal recipient, is implementing the program in partnership with the following organizations: Save the Children in Bhutan, Youth for Health in Mongolia, the Family Planning Association of Sri Lanka, the Malaysian AIDS Foundation (MAF) in Malaysia, and regional partners APCOM (formerly the Asia Pacific Coalition on Male Sexual Health) and the Community of Women Living with HIV Asia Pacific (ICWAP). The World Health Organization (WHO) and the Joint United Nations Programme on HIV and AIDS (UNAIDS) provide the program with technical support. The period of performance for the grant is from 1 July 2022 to 31 December 2025.
