I was deeply honoured to be selected as a scholarship recipient to attend the 13th International Conference on Health and Hepatitis in Substance Users (INHSU 2025). This opportunity allowed me to travel to the vibrant city of Cape Town, South Africa, from October 14-17, to present my own research as a Doctor of Public Health (DrPH) candidate from Universiti Malaya and to learn from the world’s leading experts in hepatitis care and substance use.
A personal highlight was the privilege of presenting my work, titled “A Qualitative Study Exploring Barriers and Facilitators to Implementing a Rapid-Start Direct-Acting Antivirals (DAA) Model for Hepatitis C Treatment Among People Who Use Drugs in Malaysia.”
Presenting this during the Poster Tour was a nerve-racking, albeit engaging experience. Attendees were on wireless headsets, which allowed them to listen to my presentation clearly from anywhere in the hall. This format allowed for direct, in-depth discussions about the specific challenges and opportunities we face in Malaysia. The conference was a perfect setting for this, as my work on rapid-start models fit directly into the conference’s key themes of exploring innovative, practical service delivery to improve care for people who use drugs.
The conference schedule was packed not just with plenaries but also with numerous workshops. A key highlight for me was attending the “Early to Mid-Career Researcher Workshop.” This session was incredibly valuable, providing key insights into grant writing, strategies for fostering international collaboration, and practical advice on navigating a sustainable and impactful research career, as well as exposing us to publishing opportunities with multiple high-impact journals.
Presenting my DrPH research findings during the Poster Tour at INHSU 2025
Key Themes and Insights from the Conference
The sessions were incredibly insightful, covering a wide spectrum from high-level policy to on-the-ground clinical practice. My key takeaways were:
- Innovations in HCV Test-and-Treat: My poster was in good company. I was particularly struck by presentations on the “DBS Test-and-Treat (DBS-TaT)” model and the use of the Decompensated Cirrhosis in Hepatitis C Evaluation Questionnaire (DCHEQ). This simple questionnaire can help streamline treatment initiation without immediate, complex lab-based fibrosis assessment, a model that showed a 19% increase in treatment uptake. This, along with NHS-led “opt-out” testing in Emergency Departments, reinforces one of my key takeaways: as clinicians, we must “simplify as much as possible.” This entire theme was a central focus of the conference, showcasing a clear global push toward innovative, simplified models of care.
- The Future of Stimulant Treatment: There was a strong focus on pharmacotherapies for stimulant use disorder, which is currently reliant on psychosocial interventions. I attended sessions on promising trials for Naltrexone-bupropion and agonist therapies like Lisdexamfetamine. This was highly relevant, as agonist therapy is currently off-label in Malaysia. The “pipeline” research, including psychedelic-assisted psychotherapy (PAT) and even vaccines for methamphetamine, was truly eye-opening. The clinical science tracks confirmed that this is a top-priority research frontier.
- Human Rights and Lived Experience: The conference was anchored by the principle that “Drug Users Deserve Dignity”. The “Narcofeminism” track was especially powerful, advocating for humane drug policies by highlighting how harms disproportionately impact women. Speakers noted that women who use drugs often face gender-based violence and are denied child custody or health services. Finally, the focus on incarcerated populations, captured by a quote from South Africa’s very own Nobel Peace Laureate, Nelson Mandela: “It is said that no one truly knows a nation until one has been inside its jails,” was a profound reminder that health equity is impossible without addressing these key populations. This was a core theme reflecting the community’s voice and call for advocacy.
Expanding Harm Reduction: From Theory to Practice
Beyond high-level policy, my key focus was on practical, on-the-ground interventions. Two areas stood out as particularly relevant for my work in Malaysia:
- Wound Care as a Gateway to Care: I was particularly drawn to the practical discussions on wound care during outreach. Sessions highlighted the high prevalence of skin and soft tissue infections (SSTIs) among people who inject drugs and the urgent need to integrate wound management into harm reduction services. This is often a critical gap in our local community services, and it’s a visible, pressing health need that can be a major barrier to engaging in other treatments. The discussions at INHSU provided a fantastic evidence-based framework for a module I plan to develop for our community health workers in Malaysia, empowering them to identify, manage, and escalate these preventable conditions.
- Stimulant Pipes as a Next Step: Similarly, the sessions on stimulant pipes as a harm reduction tool were eye-opening. While Malaysia has a strong needle-syringe programme (NSEP), we lack harm reduction tools for people who smoke or inhale stimulants. Providing safer inhalation pipes can prevent the transition to injecting, reduce the sharing of equipment, and decrease oral, dental, and pulmonary harm. This represents a tangible next step forward for Malaysia. It allows us to use these tools as a crucial “engagement tool” to connect with a population that may not be accessing traditional NSEP services and, from there, begin a conversation about their other needs, such as housing and mental health.
Networking and Future Collaboration
The conference was an unparalleled networking opportunity. It was wonderful to see a strong Malaysian presence. I was fortunate to attend alongside my supervisor, Dr Nur Afiqah Mohd Salleh, and Dr Azri Suan, a PhD candidate from the Department of Social and Preventive Medicine, Universiti Malaya. We also had Dr Chan Huan Keat from the National Institute of Health Malaysia, who presented a plenary slot on his abstract detailing the success of Malaysia’s 8-week DAA trial compared to the standard 12-week trial. His presentation truly put Malaysia on the pedestal, showcasing a highly effective, cost-saving model that other lower- to middle-income countries can follow.
It was also a proud moment to see Dr Mohd Fadzli Mohamad Isa from the Ministry of Health and Samantha Chong from the Malaysian Drug Policy Programme featured as panellists. They were part of a high-level panel discussing the advancement of drug policies around the world and the future of decriminalisation, including its specific application in Malaysia. They shared the stage with other key experts from Students for Sensible Drug Policy, the International Network of People who Use Drugs (INPUD), and the Open Society Foundation.
For my own work, two meetings were particularly vital:
- The team and I had a particularly productive discussion with the President of INHSU himself, Professor Dr Jason Grebely. It was an amazing opportunity; I have cited his work multiple times in my own studies, so to be able to discuss these topics with him directly was a true highlight. We explored concrete ways to foster future collaboration between INHSU and Malaysia. Our conversation focused on capacity building in hepatitis care for researchers and healthcare workers in Malaysia and strategies for establishing a stronger INHSU presence in the Asian region as a whole, which is a critical next step for our regional network.
I also connected with Professor Dr Peter Vickerman from Bristol University, an INHSU board member. Beyond just discussing his numerous works on Hepatitis C modelling and epidemiology, he offered crucial advice on my DrPH research. He provided clear guidance on how best to move forward with my experimental study design, which gives me a much stronger framework for the analysis phase of my research.
Conclusion and Personal Reflections
On a final note, the experience was made even more unforgettable by the stunning beauty of the host city. Being from Malaysia, I felt a special connection to Cape Town’s rich history, particularly the story of the Cape Malays, who were brought from Southeast Asia (including the Malayan archipelago) centuries ago by the Dutch East India Company. Exploring this shared heritage, alongside visiting iconic sites like Table Mountain, the Cape of Good Hope, and seeing the African penguins at Boulders Beach, made the trip deeply personal. Of course, a trip to Africa would not be complete without a safari, and I was fortunate to catch the ‘Big 5’ in the wild (sans the leopard!). It was a profound reminder of the diverse, interconnected world we are all working to protect.
Although the long flight journey—7 hours from Kuala Lumpur to Dubai, and another 9 hours to Cape Town—was exhausting, the entire experience was well worth it. I am immensely grateful to the INHSU scholarship committee for this incredible opportunity.
This reflection was prepared by Dr Nadhir Adi Azahar, DrPH Candidate, from the Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya.
You must be logged in to post a comment.