It's thirty years since HIV AIDS was identified and recognised as a global health threat.
Thirty million people have died since the first AIDS case was reported on 5th
June 1981. World leaders gather in New
York on Monday, to look at the way forward, even
though the latest United Nations report says the response to the global
HIV-AIDS epidemic has resulted in a significant fall in new infections.
Asia and the Pacific registered some of the
best results in stopping new HIV infections, but the region remains extremely
vulnerable.
Presenter: Sen Lam
Speaker: Jane Wilson, acting director, UN AIDS, Asia and the Pacific
WILSON: The number of people living with HIV remains stable and new infections are actually twenty percent lower than they were in 2001. So I think that's a very important message to get across. They've turned their epidemics around, and they're providing quality services to their most at risk populations, so really making a very big difference. Cambodia's one of only eight countries worldwide, to have reached eighty percent universal access to anti-retroviral therapies, so that's a real success story.
Thailand also has a coverage of eighty percent for prevention of parent to child transmission services. India's really making quite significant strides, particularly South India. Compared to 2001 to 2009, overall, the average is that rates of infection have fallen by twenty-five percent globally, but India's rate of new infections has fallen by over fifty percent. And when you consider the population scale in India, that's a very, very significant finding. And I think what we say is, alot of this has been achieved by scaling up. You perhaps have heard of some of the very large programmes that are operating there. Many more points of service delivery, very strong partnership with the community and the government. This is the way these things have been achieved.
LAM: And Jane, can you give us a quick snapshot of what's happening in the
Pacific?
WILSON: The
Pacific, we're talking about very different numbers, as you'd know. I mean, we
have between 2001 and 2009, from 28-thousand people living HIV, to 57-thousand.
So if you compare with Asia, these are not
large numbers, but for the Pacific, these are very significant numbers. And it
can have a very major impact on their specific societies. It's a very diverse
region. if you look over all, Papua
New Guinea has the region's largest
epidemic, with the prevalence rate of point-nine per cent but that is gradually
starting to level off, so there is some progress being made in the Pacific. It
is largely being driven by sexual transmission, particularly in Papua New Guinea
and over all, but we are seeing injecting drug use, which is described as a
small but significant factor, as becoming apparent in some communities, in some
countries in the region.
LAM: And Jane, given the socio-economic factors and the uneven levels of
development in Asia, may we assume then, that
if gains have indeed been made, that the region is still extremely fragile?
WILSON: That's a really, really good question, because while we can talk about
coverage rates, for example of treatment of thirty-one percent overall, and in
Southeast Asia of forty-three percent, maintaining these treatment rates,
maintaining the progress that we've reached is extremely important. Over all,
the communities that are the most vulnerable to HIV, that is sex workers,
people who inject drugs, men who have sex with men and transgender people, we
really need to make sure that programmes aimed at prevention and treatment are
maintained, and that challenges for treatment are dealt with. For example, some
of the current free trade agreements being negotiated at present, really have
tangible threats to accessible drugs, which would have an appalling effect on
the region.
LAM: You touched a little on social and cultural factors, that many Asian
countries have strict anti-drug and anti-gay laws, and also a tough stance
against sex work. do these factors pose a huge challenge to HIV sufferers?
WILSON: They're
absolutely massive. And I think governments are gradually becoming much more
aware of these factors, and you've got significant changes of policy in
countries like China, like Vietnam, like Indonesia, where methadone
programmes, and needle exchange programmes are being rolled out. I think public
health officials are overall, aware that sex work is a profession that's been
around as long as man has been on the earth. But there're still in many cases,
outdated laws. In many cases, handed down from colonial pasts, in some cases
not, but these kinds of laws and policies really need to be overtaken so that
people can move around the region freely, those people living with HIV and also
access treatment, care and support and prevention, without experiencing
discrimination.
LAM: And Jane, I understand that many of these countries don't spend their own
money; that much of the funds for treatment and other programmes come in the
form of foreign aid. Is that likely to be an issue in the future?
WILSON: It's extremely worrying, particularly in
some countries - we take Vietnam,
which is becoming a middle income country and they're very reliant on
international donors and then, can't access donor funding in the same way.
People when they go on anti retroviral therapy need to maintain it for the
whole of life, and if they stopped taking drugs, of course their health
suffers, they become resistant, and if they have to start taking drugs, they
have to go to more expensive second-line drugs, so it's extremely important
that drug regimes, anti retroviral regimes are maintained and that people can
continue treatment, because that's also a very good way of preventing HIV
infection.
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