State to cover all expenses of HIV infected woman’s children: Health Minister

Minister of Health and Family Dr Mariyam Shakeela has said the state will cover all expenses of all children of the woman infected with HIV due to the negligence of state hospital IGMH up until the completion of their studies.

However, details of how many children the woman has or to what standard the government will sponsor their studies and livelihood were not provided.

Shakeela further stated that the unborn child of the pregnant woman is of “good health” and that the baby is “showing a good response” to medication.

“God willing the baby’s progress is good, and is under continued supervision,” she told media after a press conference held together with the World Health Organization (WHO) on Wednesday.

Shakeela confirmed that the baby is receiving the “best treatment for HIV that is given by the WHO”, adding that the organisation’s head office in Geneva and the Health Ministry is continuing to hold daily teleconferences on the status of the mother and her unborn baby.

WHO Regional Director for South East Asia Dr Poonam Khetrapal Singh reiterated that the organisation is extending assistance, and applauded the Maldives government for having taken “productive action” following the incident.

“As a result of the investigation launched by the government, other such issues in the Health Sector will come to light and incidents like this can be avoided in future. Together with this, the capacity of the laboratory can be increased,” Singh said, mentioning that she had visited the IGMH laboratory on Tuesday.

WHO pledges assistance to the health sector

Today’s press conference was officially held to mark the end of Dr Singh’s two day visit to the Maldives. Dr Singh commended the government for its “commitment and vision for universal health coverage for all its citizens”.

Last week, President Abdulla Yameen’s administration announced the introduction of universal healthcare, maintaining that the enhanced coverage – previously capped at MVR100,000 – was financially sustainable.

“The most major challenges faced by the Maldives, like many other countries in the region, is the issue of having sufficient human resources, and the procurement of medicine,” Singh noted.

She said that the WHO was currently working with the government to explore ways in which to ease the procurement of medicines, adding that some initiatives include purchasing generic medicine instead of patented ones, and promoting bulk purchase of medicines – both of which would bring down costs considerably.

Health Minister Shakeela further stated that the government is paying special attention to training more locals to work as nurses and doctors, stating that this would bring down the number of foreign nationals working in the health sector.

Singh further noted that the Maldives has achieved much on the front of strengthening its disease surveillance, response,and case management capacity for dengue control.

“Despite challenges such as high turnover of doctors in the islands, and difficulty in retaining experience and expertise, Maldives has maintained a low case-fatality rate for dengue.”

“This is a country whose collective efforts and strong determination have successfully eliminated malaria and has sustained this remarkable achievement. Maldives is the only country in WHO’s South- East Asia Region to achieve this goal,” she continued.

“We would like Maldives to reflect on the malaria experience and use their expertise to prevent dengue which poses a major public health risk to its citizens.”

Dr Singh also met with Vice President Dr Mohamed Jameel Ahmed on Tuesday and congratulated him on Maldives’ achievements made towards the Millenium Development Goals and what she termed as “gains in public health more broadly over the past decade”.


“Worst fears over HIV coming true”: Health Minister

Minister of Health Dr Ahmed Jamsheed Mohamed has expressed concern about the risks of HIV spreading rapidly in the Maldives, stating that “our worst fears seem to be coming true.”

Jamsheed said that although the Maldives had remained on the HIV less-prevalent category since the first HIV positive case was found in 1991, “all the habits that may lead to the spread of HIV is excessively in practice here,” stating that it was only through “incredible luck” that the disease had not already spread widely throughout the country.

At the press conference on Sunday, Jamsheed said: “What has always worried me most is that there is a large drug community, and that the virus might find its way into this group, especially the IV drug users. Once it does, it will spread like wild fire.”

“I don’t think this is too far off now. We have already identified one IV drug user who has been infected with HIV. What’s left is to see how much this has spread,” Jamsheed revealed.

Jamsheed further cautioned against assuming that the HIV virus would stay within the injecting drug user circle, pointing out that some drug users do so in secret, and that many are married to non-drug users who could just as easily be infected with the virus.

Minister of State for Health Lubna Zahir Hussain, who heads the National Drug Agency (NDA) and Centre for Community Health and Disease Control (CCHDC) Director Maimoona Abu Bakr said that both their departments were taking preventive measures against the spread of HIV.

Jamsheed, too, said the NDA’s efforts to help drug users out of their addiction is a preventive measure against HIV as drug users are most at risk.

Meanwhile, the CCHDC is working with civil society groups like Journey, Society for Women Against Drugs (SWAD) and regional NGOs to spread awareness about STIs and HIV, and to encourage the public to change their habits to ways that present less risk of contraction.

Practical action or the moral highground?

Jamsheed said that he believed there were issues which needed to be opened to a “national debate” in order to move forward and take stronger preventive measures.

“We can simply stay inactive and keep talking for any amount of time by assuming the moral highground,’ Jamsheed said at Sunday’s press conference.

“That is to claim that we are Muslims, and by living in a Muslim state in Muslim ways we are doubtless protected from this disease. But that is never the reality anywhere in the world,” he said.

Jamsheed said it was unrealistic to assume all Muslims to live as “perfect Muslims”, and that even if they were, there was still a chance of infection. He stated that HIV is not transferred through sexual activity or visits to prostitutes alone.

“This is an argument I do not accept,” he said. “I presume that those among us who are already infected are also Muslims, being Maldivians. Of course, there are certain protections that being in a Muslim community affords us. For example, all of us men have been circumcised, which is proven to provide protection against STIs. To put it short, we need to work on more practical forms to prevent the spread of HIV.”

Sexual promiscuity elevating risks

The minister further spoke of the risks of promiscuity in the society, referring to the 2010 case where police arrested an HIV positive prostitute. He stated that the same prostitute had been identified in the Maldives as being HIV positive in the year 2009 as well, emphasising the risks to the spreading of HIV that such events presented.

Prior to his appointment as Minister of Health, Jamsheed had written about his concerns regarding the spreading of HIV in his personal blog, speaking about the “sexually active” lifestyle of the Maldivian people, which created a higher risk of infection.

“Maldivians have always been a sexually very active and promiscuous community. We have a very high divorce and remarriage rate, which increases the number of sexual partners any individual has over their lifetime. It is also a known fact that despite being a Muslim community, a lot of Maldivians have multiple extramarital relationships,” he had written then.

CCHDC’s Maimoona Abu Bakr also highlighted that “undesired sexual acts”, prostitution, injecting drug users and homosexuality proved to be some of the greatest challenges to preventing the spread of HIV.

In 2011, a total of 18 HIV positive cases were reported, out of which one was of a local. Between 1991 and 2011, 15 HIV cases were reported among Maldivians, while 168 cases of expatriate workers were also filed. Two out of the 15 cases were female, and all patients cited heterosexual transmission as the cause of infection.