20 November 2013
Guest Contributor

ICAAP11 Day One: Setting The Agenda

By Dr Timothy West, Pacific Friends of the Global Fund Representative at ICAAP11

ICAAP11-opening-cultural-performance

BANGKOK – Day one of the 11th International Congress on AIDS in Asia and the Pacific (ICAAP11) featured keynote addresses from senior government officials and NGO representatives from some 80 countries, including Mr Pradit Sintavanarong, Public Health Minister of Thailand representing Ms Yingluck Shinawatra, Prime Minister of Thailand, Mr Ratu Epeli Nailatikau, President of Fiji, Ms Jan Beagle, Deputy Executive Director of UNAIDS, Mr Mechai Viravaidya, Chairman of the Population and Community Development Association (PDA) and also known as “Mr Condom” in Thailand, and Professor N.M. Samuel, President of the AIDS Society of Asia and the Pacific (ASAP). Video messages from Aung San Suu Kyi, UNAIDS Global Advocate for Zero Discrimination and Michel Sidibe, UNAIDS Executive Director were also screened.

There were strong recurring themes in presentations which set the tone and agenda for the remainder of the conference, which runs until Friday 22 November.

Most importantly, there was recognition that the United Nations Millennium Development Goals (MDGs) expire in 2015 and that post-2015, HIV may receive less attention than it has over the last thirteen years. In his video message, Mr Sidibe argued that in light of this, there were three critical questions that the conference should address. Firstly, it should determine how to meet the specific aims of MDG 6, which sets specific goals for HIV treatment and prevention, before the MDGs expire. Second, it should re-kindle HIV/AIDS activism in the community to prepare for advocacy in the post-2015 world. Third, it should start the process of defining what goals should be set in the post-2015 world. These issues should be discussed with the understanding that neither a cure nor vaccine for HIV/AIDS are on the horizon and that therefore long-term plans must be based on currently implementable policies such as treatment as prevention.

The need to focus on key at-risk groups, as well as the generalised epidemic, was also a common theme of the first day. These groups are well-recognised and in the Asia-Pacific context consist of men who have sex with men (MSM), intravenous drug users (IVDU), those who buy and sell sex, transgendered people and migrant workers. The focus should consist both of engaging and empowering these communities to represent themselves, and societal and legal change to remove discriminatory law and customs. Furthermore, discrimination against people living with HIV/AIDS (PLWHA) must also be addressed. Daw Suu Kyi said, “You and I can make a difference by reaching out and letting people lead a life of dignity regardless of their HIV status or sexual orientation. We need an Asia-Pacific community of compassion to end discrimination.”

There was a strong emphasis on the need for rational, evidence based policy. In particular, there is a need to provide anti-retroviral (ARV) therapy to all people with HIV, regardless of their CD4 cell count. Known as “early test/treat”, this policy is backed by strong scientific evidence but within the Asia-Pacific region only Cambodia has made significant headway in its implementation. Barriers to its implementation include uncertainty of long-term funding for ARV therapy. Ms Beagle pointed out that at present 62% of funding for ARV therapy within the Asia-Pacific region was from government sources, and that the maintenance of this level of domestic funding is critical to continuing and extending the delivery of ARV therapy across the region. Presently, only half of those eligible for ARV therapy receive it.

Finally, there was recognition that young people are critical to the fight against HIV/AIDS. There is a need to engage and educate young people throughout the Asia-Pacific region, and to ensure that they are able to access HIV testing and ARV therapy. For example, Thailand is presently planning law reform to allow minors to access these critical services without parental consent. In describing previous successful campaigns of youth engagement, Mr Viravaidya gave a humorous and highly informative presentation in which he described Thailand’s successful education program. This program began in the late 1980s and involved sex education across all of society, in schools at all levels, and broad distribution of condoms in such places as shopping centres, bars, toll booths, gas stations and McDonalds. Police also distributed condoms in a program Mr Viravaidya described as the “cops and rubbers” programme.

The remainder of the conference will examine these issues in detail. As Mr Sintavanarong said in the closing address for the day, “We have the capacity, and now we need to demonstrate how the Asia-Pacific region can lead the world to zero HIV, zero discrimination and zero AIDS related deaths”.

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Pacific Friends operates as a program within the Kirby Institute at the University of New South Wales.

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Bill Bowtell AO
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Pacific Friends of the Global Fund to Fight AIDS, Tuberculosis and Malaria is a high-level advocacy organisation which seeks to mobilise regional awareness of the serious threat posed by HIV & AIDS, tuberculosis and malaria to societies and economies in the Pacific. In pursuing its goals Pacific Friends has a specific interest in highlighting the need to protect the rights of women and children in the Pacific.

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