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27 Sep 2010

Dr Balaji Sadasivan, "a friend to Singapore's gay community," has passed away at 55

While many may remember Dr Balaji Sadasivan for putting the blame on gay men for the spread of HIV in Singapore, his political leadership and support to expand AIDS prevention programmes and increasing access to HIV testing and treatment has largely gone under the radar. (Updated)

Singapore Senior Minister of State for Foreign Affairs Balaji Sadasivan, who was battling colon cancer, died early on Monday morning. He was 55. Dr Balaji leaves behind his wife and two children.

The late Dr Balaji Sadasivan was appointed Chairman of the National AIDS Policy Committee in 2006 when he was at the Ministry of Health. He continued his role although he left the Health Ministry the same year until his death.

In 2005, Dr Balaji, who was then the Senior Minister of State for Health, attracted the ire of the gay community in Singapore when he blamed gay men's unsafe sexual practices as the primary contributor to the country's increasing HIV infection rates.

He quoted an unnamed epidemiologist who hypothesised that the spike in HIV infection rates might be linked to the annual Nation parties organised by Fridae from 2001 to 2004. He said the parties could have "allowed gays from high-prevalence societies to fraternise with local gay men, seeding the infection in the local community".

Nation 2004 was to be Fridae’s last party in Singapore. The same year, the police turned down Fridae’s application to hold a Christmas party, deeming it contrary to public interest.

Dr Balaji was a neurosurgeon until he entered politics in 2001. He earned his medical degree from the University of Singapore in 1979 and became a Fellow of the Royal College of Surgeons in 1984. He then trained in neurosurgery at the Henry Ford Hospital in Detroit, followed by a Fellowship at Harvard University.

In 2006, he was appointed Chairman of the National AIDS Policy Committee when he was at the Ministry of Health. He continued his role although he was appointed senior minister of state for foreign affairs and information, communications and the arts the same year. In April this year, his responsibility was confined to the ministry of foreign affairs.

Dr Balaji was known to have championed various initiatives to encourage early and regular HIV testing, the most notable of which was the implementation of universal antenatal testing. He was also a strong proponent of HIV education in schools and workplaces.

In 2007, Dr Balaji was the guest-of-honour of a concert in Singapore that was held to raise raise funds for Action for AIDS and raise awareness of HIV and AIDS in the gay community. The concert featured Los Angeles-based gay pop singers Jason and deMarco who were banned in 2005 from performing at a similar concert in Singapore. At the time, the Media Development Authority (MDA) rejected an application by the organiser, Safehaven, a gay-affirmative Christian support group, for an Arts and Entertainment Licence saying that "alternative lifestyles are against the public interest." He was the only minister known to have attended a predominantly gay event in Singapore.

The same year, the late former neurosurgeon led the first study trip of its kind comprising a delegation from the Health Ministry, and representatives from Fridae,  Action for AIDS and LGBT-affirmative counselling group Oogachaga to Sydney to study their prevention efforts.

Relating the "invaluable" lessons learnt in Sydney, Dr Balaji was quoted as saying by Today newspaper in 2007 titled When both hands work together...: "The health authorities supported the NGOs in the community, and in return the NGOs were sensitive to the conservative majority.

"This cooperation between NGOs and the health authorities – reach out to the MSMs, but at the same time, don't upset the conservative majority – is the key to their success."

The "Sydney model" was so named after the Australian city became one of the few places where HIV infection rates amongst gay men had stabilised or fallen. The approach centres on several factors including continual and sustained investment by public health departments in targeted interventions for those most at risk for infection, especially men who have sex with men; and collaborative partnership with community based organisations which are in the best position to design, develop and deliver these interventions.

"Contrary to what many people believe, Dr Balaji was a friend to Singapore's gay community," said Dr Stuart Koe, CEO of Fridae who was part of the study team to Sydney in 2007.

Under Dr Balaji’s leadership, the strategy has since been adapted and applied in Singapore, resulting not only in a significant increase in funding of MSM-targeted HIV programs, but also succeeded in involving gay community leaders in the strategic planning process, said Dr Koe.

"Dr Balaji was never afraid to speak his mind, but he had a great capacity to ask the right questions and listen to what people were telling him. His leadership is responsible for the significant progress we have made in HIV prevention in the Singapore gay community."

Dr Koe added that this collaborative approach has started to reap results in recent years – with infection and prevalence rates amongst MSM in Singapore falling for the first time in recent history.

Dr Roy Chan, President of Action for AIDS and director of the National Skin Centre, who had worked closely with the late Dr Balaji for many years after the latter took on the task of leading the government’s AIDS programme in 2002, said in an email to Fridae: "The late Dr Balaji rapidly became intimately familiar with all aspects of AIDS prevention, advocacy and support. He provided the greatly needed political leadership and support for Singapore's AIDS programme. Among his notable accomplishments were the support for school-based sexuality education, increasing access to HIV testing and treatment, and enhanced support for HIV-infected individuals." 

Dr Chan added: "He showed sincere personal commitment and concern for HIV-infected individuals and affected communities. He was always ready and willing to grace awareness and fund-raising events, conferences and gatherings to push the message of AIDS prevention and awareness. I think his greatest achievement has been the expansion of AIDS prevention programmes that were made possible by an increased budget and resources. 

"AIDS awareness and prevention advocates and activists in Singapore were fortunate to have Dr Balaji to champion our cause. His support and guidance will be sorely missed. We would like to extend our deepest condolences to his family."

The wake for Dr Balaji Sadasivan is being held at Cheng San community club, an area in the Ang Mo Kio GRC, where he was a Member of Parliament.



C. S. Zhou, founder of LGBT-affirmative Oogachaga’s counselling services, remembers Dr Balaji:

The gay community sometimes treated him as anti-gay but the little time I have had with him I learnt that he was a man of much magnanimity, a doctor to the end.

We were at lunch in Sydney where we had gone on a study trip. I made sure I sat beside him. In the middle of the lunch, I leaned over and said, "Dr Balaji, remember Jason DMarco? We are planning again to hold a concert." He looked startled and a little dismayed. I assured him that it will be done responsibly. He replied, "Ok. Go through the regular channels. Get in touch with me if you run into any hurdles." And that was it.

When Alf applied for the permit, it began to look like he wouldn't get it and the MDA wanted to meet. I wrote to Dr B. He replied, "Get Alf to meet the MDA and tell them I will be the guest of honor." The Hope Concert to pass out the message against HIV went out to 900 people that night. Jason & DMarco who were banned the last time, appeared and performed here. Safehaven delivered on its commitment to him and he to Safehaven.

In Sydney, he spoke about setting up a community centre for gay people. I don't fully understand why - perhaps people were afraid the move would ghettoize gay people - but the team did not seem keen. I have always thought it was an opportunity lost.

In another meeting the discussions became frank. I got into my assertive self. Later as we went for a toilet break, he thanked me. A lesser man would have felt my comments and argumentation disrespectful of a Minister. But he took the comments for what they were and did not let his ego get in the way. In that and other acts, I saw the true measure of this man. It was an honor.

I shall miss you Dr Balaji.

The above is republished with permission from the author.


Reader's Comments

1. 2010-09-27 19:35  
one of the fators in decreasing HIV infection in sydney may well be the fact many guys are now dropping out of being sexually available to all the scrags around and becoming more selective, they are often better educated about sexual health and more career orientated pehaps also having come from sound family back grounds, if U look on the Sydney 'dating' sites alot of guys now R saying they have no interest in 'hook ups', the trend amongst decent minded gay men as opposed to irresponsible poxy queers is towards greater selectivity and self restraint, I dare to say pnp (ice addiction) BB & the newer increasing untreatable gonorrhea are possibly major influences here,
Comment edited on 2010-09-27 19:37:37
2. 2010-09-27 20:05  
how about this, low sex drive in sydney cause there r so much drugs around. they r all too trash to be erected/horny.
3. 2010-09-27 21:40  
who appointed anyone to be a spokesman for the gay community? I don't think anyone really represents us and I doubt if we actually have a spokes person who really has integrity and merits the respect from average people.. i don't think this guy was a friend, just someone working to do the job he was paid to do and deal with health issues in a pragmatic way, but the numbers keep going up and up and up and until people start being more responsible, nothing is getting better
4. 2010-09-27 21:45  
thank you for the article, fridae. it is very well written. my condolences to dr balaji's family.
5. 2010-09-27 23:58  
"In 2005, Dr Balaji, who was then the Senior Minister of State for Health, attracted the ire of the gay community in Singapore when he blamed gay men's unsafe sexual practices as the primary contributor to the country's increasing HIV infection rates."

The truth hurts.
6. 2010-09-28 09:52  
I am so sorry but I am not as sympathetic towards this Doc as the writer and some of the posters. He was not only anti-gay, he was extremely insistent that gay men were the prevalent reasons why Singapore could not attained a ZERO HIV status. He squarely put the blame on us.
The fact that there were campaigns and testing was not because of his well intentioned fervor to help the gay community. It was to make sure that the perceived culprit, in this case, the gay community, be lynched and held accountable. He was practically holding a witch hunt.
So do not cry for this man. I am definitely not. I am dancing for joy that such a bigoted man is now unable to cast any influence upon us again. Thank goodness!
7. 2010-09-28 10:03  
It is also worth noting that we must not whitewash the truth, just because the person is dead.
You cannot decorate a lump of pooh with roses.
It may look like a wonderful floral arrangement but the stench would still be detectable.
In Singapore, we cannot criticise any living MP without getting in trouble.
Yet in death, we are again suppose to hold our tongue because it's supposed to be the polite thing to do.We shouldn't bring any grief to his family, the critics say.
But if he were really concerned about his own reputation, then he shouldn't have done what he did.
It is only in his death that we can finally examine in detail what the dead has done during his living years. This is not the time to sugar coat the truth.
8. 2010-09-28 10:15  
Please take a look at past fridae articles by Dr Stuart Koe:


"Dr Balaji's concern over the sharp increase of HIV infection amongst MSM is ironic. Even though MSMs have always represented a high-risk group, Singapore's public health service has systematically ignored and left MSMs out of all their public health messages. Focusing instead on abstinence and monogamy, the Ministry has rarely advocated the use of condoms, and never once addressed MSMs directly since its first education program against HIV/AIDS in 1985."

"In his speech, Dr Balaji made reference to a website, Fridae.com, where he came across an article that he felt was advocating a "promiscuous and reckless lifestyle." As CEO of Fridae, I would urge for this article to be considered in a larger context."

"Dr Balaji singled out Action for AIDS, an NGO dedicated to fighting AIDS, for criticism, citing that it was “not doing enough.” In fact, it is probably a direct result of AfA’s unceasing efforts that MSM transmission rates have been kept relatively low for the last 20 years. Yet, an AfA operated booth at the Nation party in August this year was asked to shut down by the local police jurisdiction who thought that giving out safer sex brochures and condoms was promoting gay sex. In another incident earlier this year, AfA was also stopped from circulating its new range of safer sex postcards by the Advertising Standards Authority of Singapore which objected to any reference to oral and anal sex on the grounds that such acts were illegal."

9. 2010-09-28 10:57  
I have to agree with Mssr. Lavashop. While I would never celebrate Dr. Balaji's death at such a young age, I think characterizing him as a "friend to the gay community" is completely erroneous.
10. 2010-09-28 12:44  
Stuart Koe obviously has had a change of heart about the late Dr B based on personal interactions and despite the doctor having caused quite a lot of harm to the Nation parties... so who's to say especially if one is not privy to what what doctor really thinks or has done to ensure that certain MSM projects get the go-ahead?

11. 2010-09-28 13:08  
Many of Dr Balaji's inflammatory remarks were made before the Sydney study trip in 2007. His views changed considerably as a result of that visit.

Not many people have the capacity to know when they have a knowledge gap, and actively go out to seek to close that gap. Fewer have the capacity to change directions in the face of new information. And it is even more rare if that person can effect change as Dr Balaji has done in the form of bringing gay NGOs to the table, and advocating for government funding of these NGOs.

Without Dr Balaji pushing for these reforms, we'd be mired in a very different situation. Singapore has now effectively halted what had appeared to be an explosion in HIV infections amongst gay men, something that few other communities have been able to do.

Having had the privilege of getting to know him personally, I have come to the conclusion that he sometimes makes controversial statements simply to ignite debate and engage people. He certainly is not narrow-minded as I once thought, and you cannot judge a person by the sound bytes that the media propagates.

Which is why I felt it was important that his legacy be corrected, lest everyone remembers him merely for being "anti-gay", which he wasn't.
12. 2010-09-28 18:03  
Now, if either S2 or Kellan had further reliable articles, media reports or any interviews on record to prove to us that the late Dr Balaji had a "change of heart" after the Australian trip, please show us links or the transcripts of the interview to show such change of heart.

Because I had extensively researched over these years on what our government's stance, not just Doc Balaji, towards PLUs and HIV patients and treatments.
I can assure all above that the only person who had a change of opinion is Dr. Koe. Why I believe there is such a softening of attitude is because the doctor has just died and Dr. Koe perhaps wished to be gracious to his colleague. That's all good and dandy but it still does not negate the fact the man left behind a slew of interviews and documents to paint a clear, concise portrait of bigotry and narrow mindedness.

I know for a fact that many gay Singaporeans, wanting to escape detection from the PAP, has gone to Bangkok for HAART treatment. They do not wish to fall victim to the witch hunt that Dr. Balaji's regime initiated. The HIV cases is a lot higher than we had previously been told, simply because the legacy Dr. Balaji left behind refused to give ample positive attention to the sexual practices of Singaporeans, specifically gay men.

Now, if we cannot rely on "sound bytes" to judge the recently deceased Dr. Balaji, then pray tell, what long-lasting positive influences has the doctor done for the gay community and HIV patients since 2004?
What policies or legislatures did Dr. Balaji helped craft to protect gay men from infection, help the sick with good solid medical treatments or pushed for more more empathy and less stigmatization.
I want examples, details, names, dates.
No obscure hearsay or ambiguous innuendos.
13. 2010-09-28 22:45  
1. Read Prof Roy Chan's comments on Dr Balaji. Prof Chan, who is Founder and President of AfA, has worked directly with Dr Balaji. Even though they have clashed on many occasions, Roy's views about Dr Balaji is also one of respect and acknowledge his contributions to bringing us to where we are today (these are reported in both Straits Times and the Fridae article).

2. Read Clarence Thomas' note in Facebook which echoes these sentiments (http://www.facebook.com/note.php?note_id=444716539850&id=630491467&ref=mf)

3. Formation of the MSM Working Group on HIV by the Ministry of Health in 2008 which consists of members of Ministry of Health, CDC, DSC, HPB, AfA, Fridae, Oogachaga and Trevvy to formulate a 5 year strategy and meets periodically to review our progress

4. Expansion of programs by AfA, OC, Fridae and Trevvy which targets different areas of research (including an annual prevalence study by AfA, and the annual Asia Internet MSM Sex Survey by Fridae), a very long series of prevention campaigns since 2008 to present, numerous workshops and consultations held by all the parties involved which follow the strategic plan and KPIs

5. Recent unpublished data from several sources show that the strategy is working: a) prevalence of HIV amongst gay men in Singapore has fallen for a 3rd year in a row (based on the AfA study); b) rate of infections amongst MSM has fallen at the DSC clinic despite more MSM being tested, and; c) percentage of MSM testing positive at the National level has fallen.

Much of this is unpublished and undocumented because of 377A. Our government has an uneasy and difficult time resolving how they can "officially" work with groups that are technically breaking the law. This puts the Ministry of Health in a quandry. But to their credit, and much of it due to Dr Balaji's personal commitment and advocacy, they have managed to put the public health needs ahead of their "legal obligations".
Comment edited on 2010-09-28 22:49:14
14. 2010-09-29 16:31  
Prof Roy Chan's comments on Dr Balaji came after the doctor died. Or perhaps he already knew the doctor was ill with cancer. Whatever the case,I am so sorry, but those are comments made out of politeness.

Now, Dr Balaji served the Ministry of Health (2001–2004);
and he was the Senior Minister of State for the Ministry of Health (2004–2006) after which he became the Ministry of Foreign Affairs and Ministry of Information, Communications and the Arts.

Which is why after his portfolio diversified, all these NGOs like Fridae, Oogachaga and Trevvy were able to conduct their surveys, workshops unobstructed. Dr. Balaji was the root cause of the the road block prior to him moving to the Information, Communications and the Arts.

I am unable to get http://www.facebook.com/note.php?note_id=444716539850&id=630491467&ref=mf to load.

"Recent unpublished data from several sources show that the strategy is working"
Then I am so sorry, but if it's unpublished, I cannot review it.
There is no proof that the strategy is working at all.
And please do not blame the penal code of 377A.
If it's published anywhere online, even if it's anonymous survey, conducted by a reliable source, I am eager to read it.

With anonymous testings widely available and HIV home-test kits available locally and abroad, there would be no need to go to the AfA anymore.
With the prevalent of budget airlines, anyone can easily fly to any other countries to pay for a HIV test. Thereby escaping detection from within Singapore and in effect, creating a false read in the data.
Whatever the case, I hope you are right that HIV infection rates in Singapore is falling.
But even if that were true, it cannot be wholly contributed to the lone efforts of Dr. Balaji. It was the combined efforts of a lot of hard working individuals, professionals who made the difference.
On the contrary, Dr. Balaji was always deemed to be the tripping-stone for HIV activists.
Every statement, press release he has made has been anti-gay, singling out gay saunas, parties and our "promiscuous lifestyles" as the root cause of the HIV infection in Singapore. If only it were as simple as that.

If you have anything directly from Dr. Balaji that he had a change of opinion towards gay men, like Fidel Castro did a few weeks ago, I would be most interested to read it. In early September, the Cuban octogenarian/dictator took blame for persecution of Cuban gays.
Now, if Dr. Balaji ever recanted his opinions about gay men in any form or manner, I would love to read it. Especially post 2007.
Anything at all.
Be it personal e-mails, Twitter, blogs, diary, anything from the man himself.
I am trying to keep an open mind.

But until further published evidence is shown, please, do not ever say that Dr. Balaji is a friend or the gay community.
He has never said or done anything to support us.
His only concern was to reduce the HIV infection, a nobel cause in itself but never out of concern for us. We were painted as the main culprits, despite the fact that there were more straight men who were infected. This man caused a huge backlash against the gay community. If only he bothered to take the time to know us better, our psyche in deeper details, my opinions towards the late Doc would be more favourable.

15. 2010-09-29 21:24  
lavashop, fully on board with you on this one.

2 close Singapore friends shared their experiences with disgust on how their government health policies demonstrated ill regard for privacy and respect to one and all. They were hospitalized (different times) some years back in Singapore's General Hospitals for mild ailments; ie, body rash and stomach flu and they were given blood tests, including HIV, when NO consent was requested nor given. They were shocked and enquired why their approvals were not sought before conducting their "normal" standard tests. The doctors simply brushed the negligence aside and said it was normal admission procedure and even sarcastically said no big deal since they tested negative anyways.

So much for world class medical professionalism. Zzz.
16. 2010-10-01 14:48  
so what if he was or wasnt a friend to the gay community. even though i only met him once at a family reunion, he seems like he has accomplished alot.
17. 2010-10-07 02:19  
Well-said, lavashop! :-)
18. 2010-10-07 02:28  
@ Post #1 - That's WONDERFUL!!! ;-)

Now its the heteros who are the skanky ones...maybe Mother Nature's playing a trick with self-righteousness XDD

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