An estimated 4.9 million people in Asia and the Pacific living with HIV in 2009, a figure that has remained relatively stable since 2005
BANGKOK (AlertNet) – The decline in new HIV infections across Asia Pacific is “very fragile” as most states rely on shrinking donor funds and prevention programmes fail to reach those most in need, the head of the U.N. agency for HIV/AIDS said in an interview.
“This is a moment of truth in Asia,” Michel Sidibe, executive director of UNAIDS, told AlertNet ahead of the 10th International Congress on AIDS in Asia and the Pacific in Busan, South Korea.
According to a report launched at the meeting , an estimated 4.9 million people in Asia and the Pacific were living with HIV in 2009, a figure that has remained relatively stable since 2005.
“This report is coming at a time when we are seeing a decline in new infections, but at the same time we are seeing a potential risk because that progress is very fragile,” Sidibe said.
Despite a 20 percent decrease in new infections since 2001, and a three-fold increase in access to lifesaving antiretroviral therapy (ART) since 2006, more than three out of five people who need treatment still cannot access it, the report said.
Asia Pacific could provide universal access to ART, Sidibe said. “It’s just (a case of) prioritisation and certainly, political will,” he added.
FUNDING SHORTFALL
One problem is that funding for HIV/AIDS responses in the region - both from domestic and international sources – remains inadequate. Apart from China, Malaysia, Pakistan, Samoa and Thailand, countries rely largely on international assistance - for up to 95 percent of their HIV budgets in some cases.
In 2009, an estimated $1.1 billion was spent in 30 countries across the region, approximately a third of the funding needed to achieve universal access to HIV services, according to the Commission on AIDS in Asia.
Funding cutbacks led to a decline in international support for AIDS programmes globally for the first time in 2010. That threatens the sustainability of ART, which is almost entirely funded by donors in many countries, Sidibe told AlertNet from Busan.
Governments need to start looking at paying for their own programmes, he said. Middle-income countries that spend less than 0.5 percent of gross national income on HIV/AIDS could help close the funding gap, he added.
“It is possible, it’s a matter of redefining where our priorities are,” the U.N. official said. “If we don’t invest today we will continue to pay forever.”
SEX WORKERS’ CLIENTS MISSED OUT
Another obstacle is that existing HIV programmes do not target the groups who need them most, and tend to be aimed rather at the general population.
As a result, they have minimal impact on reducing the rising number of HIV infections in the highest-risk groups - people who inject drugs, men who have sex with men and transgender people, and people who buy and sell sex - despite consuming the bulk of resources, Sidibe said.
Most HIV prevention programmes do not reach the male clients of sex workers, according to the report. They number an estimated 75 million across Asia Pacific, and are “the largest single population to transmit HIV to their regular intimate partners”.
Sidibe also pointed to the Philippines , where after 20 years of a low-level epidemic, infection is spreading rapidly among vulnerable groups. Prevention programmes reach less than 40 percent of their members, according to the latest Philippines’ country report.
As a result, HIV prevalence among people who inject drugs in the city of Cebu jumped from 0.6 percent in 2009 to 53 percent in 2011, fuelling concerns the virus could start spreading faster among the general population.
“The major challenge is the tendency to feel that those people are living in isolation, but they are interacting with the rest of the population and then the risk is their partners also become infected,” Sidibe said.
“This shows that… if we don’t pay attention to specific communities where prevalence can grow quickly, we could miss the boat in dealing with this epidemic.”
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