20 November 2013
Shawn Clackett

Zero New Infections in the Asia-Pacific: Possible or Impossible Dream?


icaap-plenary-day-two

BANGKOK – The 11th International Congress on AIDS in Asia and the Pacific (ICAAP11) today conducted the first of three plenary discussions focussing on the first of the UNAIDS Getting to Zero goals. The theme for today was ‘Getting to Zero New HIV Infections in Asia and Pacific: Possible or Impossible Dream?’

The discussion was moderated by James Chau, United Nations Goodwill Ambassador and CCTV Anchor in China, and keynote speeches were delivered by Timothy Mastro, Group Director for Global Health, Population and Nutrition of FHI 360 and Steve Kraus, Director of the UNAIDS Regional Support Team for Asia and the Pacific. Commentators were Professor Tjandra Yoga Aditama, Director General of the Ministry of Health in Indonesia representing Dr Nafsiah Mboi, Health Minister and Chair of the Global Fund, Anan Boupha from Purple Sky Network Foundation, Baby Rivona from the Indonesian Positive Women Network, and Aradhana Johri from the National AIDS Control Organisation in India.

Mr Kraus stated that as at 2012 there were 4.9 million people living with HIV in the Asia-Pacific region, of which 1.7 million (34%) were female. There were 350,000 new infections in the area and 270,000 AIDS related deaths in 2012. Between 2001 and 2008 there had been a 26% decline in the annual HIV infection rate, but since 2008 there had been no further progress in the fight against the disease. Progress was unevenly distributed across the region. Countries such as Cambodia, Myanmar, Nepal, India and Thailand experienced large falls in HIV infections. However, the infection rate is rising in other countries including Indonesia, Pakistan, The Philippines and Malaysia.

While Mr Kraus showed that progress has recently stagnated, Mr Mastro was more optimistic. “We have the tools, we just need to learn how to use them,” he said. Mr Mastro was confident that achieving zero new HIV infections is possible, but would require more work. In summarising the challenges faced by the region, he said “we know a lot, but we do not do a lot.”

The commentators each had varying opinions on whether or not a zero new infection rate is possible. Aradhana Johri was optimistic, but cautioned that the implementation of HIV policies must account for the specific features of the epidemic in each country. She said, “What works in one country may not work in toto in another.”

Anan Boupha emphasised the need for partnership between key at-risk populations and policy makers in order to ensure that the policies were realistic and would make a difference. Baby Rivona stated that without specific policies on women affected by the epidemic, the goal would remain a dream and she would have to “keep dreaming”. She called specifically for the collection of epidemiological data on women within each key at-risk population group and policies to tackle issues such as violence against women.

Professor Aditama stated his view that progress was being made and this goal was certainly achievable. He described recent progress in Indonesia, including the implementation of treatment as prevention, a policy for HIV prevention that is backed by strong evidence. In particular, sero-discordant couples would now be eligible for anti-retroviral therapy (ARV) regardless of their CD4 levels. Coverage of testing has also been expanded in Indonesia, with particular focus on men who have sex with men (MSM).

The session was generally optimistic, but there was clear consensus that if the goal of zero new infections is to be achieved, it will require a redoubling of efforts throughout the region and massive scale-up of evidence-based approaches to prevention. HIV is too serious a problem to go out of fashion, and with the pending expiry of the Millennium Development Goals (MDGs) it is imperative that HIV is not lost amongst competing health priorities and strained national budgets. Zero new HIV infections may have been a dream yesterday but it is a hope today, and it will hopefully be a reality tomorrow.

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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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