ABC Radio Australia
The AIDS epidemic is at a critical juncture in the Asia Pacific region, according to the UN’s top body on tackling the disease, UNAIDS.
A new report launched at the 2011 International Congress on AIDS in Asia and the Pacific, ICAAP, found that while the region has seen impressive gains, there have also been setbacks.
The executive director of UNAIDS, Michel Sidibe says most countries in the region are a long way from giving all HIV sufferers full treatment and care.
The report card, it seems, is still mixed.
Presenter: Sen Lam
Speaker: Michel Sidibe, executive director, UNAIDS
Click here to listen to the audio program (Windows Media)
SIDIBE: We’re just realising that after ten years, the reduction of 20 percent of infection in this region, is very encouraging. But it’s encouraging, because we’re seeing a new policy reform in different parts of the region. a few years ago, it was not possible to think one second, that we’ll have methadone maintenance treatment in Indonesia, or in China. Today, it’s there. We’re seeing a growing interest for investing on HIV in many parts of the region – Thailand is almost financing the bulk of their epidemic, we’re seeing China taking more and more interest in financing their programs, but at the same time, it is not time for complacency. In the Philippines, just a few years ago, we were thinking an epidemic would never happen there. We were having zero-point-one per cent of prevalence, so it was very, very low. But in less than two years, in the city of Cebu, the prevalence rose from zero point six percent to 53 percent, amongst people who injected drugs.
LAM: So, as you say, there have been impressive gains in the Asia Pacific region in recent years, such a 20 drop in infections, a threefold increase in access to therapy. But are you saying also that the gains are pretty uneven across the region?
SIDIBE: The gain is uneven across the region, because if you look at your other region, in other countries, which already reached universal access on treatment. But you have the big countries, where you still have only 30 to 35 percent of people in need of treatment, having access to treatment. And we know today, with the new discovery, that if we put people on treatment early, we could reduce infection by 96 percent. The biggest challenge for us today, is the quality of the program in the region, the allocation of resources are not necessarily directed to areas where we can have the maximum of return.
LAM: And Cambodia, I understand, is one of the surprise packages. Cambodia’s one of only eight countries worldwide, that provide drug therapy to the majority of its HIV sufferers. That’s pretty impressive, for a country that not so long ago, was seen as a basket case. How did Cambodia achieve this?
SIDIBE: I think Cambodia is a very interesting case, because again, Cambodia is one of the countries able to apply systematically, the concept of knowing your epidemic, and acting on it. They developed a clear situation analysis and from point of view, they managed to develop a plan with a strategy which targeted people in need of services. And they identified people who were at risk and they provide the services for testing, and they increased the coverage on treatment. And that is very encouraging, and we’re seeing that also in Malaysia, where you have more than 80 percent of coverage in the region. But Cambodia, definitively, has a very interesting program.
LAM: China of course, is one of the countries cited in the UNAIDS report, and it’s a huge country, with a population to match. Does that mean that China also has a very uneven picture, where AIDS and success in tackling AIDS, is concerned?
SIDIBE: Yes, China is for me, a very encouraging case because the political leadership is there. And a strategy that’s well-defined to create a space, that’s more and more for community-based participation in service delivery, which was major challenge for us. I was in Chengdu and I saw a very interesting program linking provincial government and particularly community-based organisation, to provide services to men having sex with men, and I saw also, rehabilitation centres managed by community-based organisations and health-workers. It’s amazing – ten years ago, it was zero tolerance. And today, it’s a very open policy, in terms of targeting most-at-risk populations. They realised that 33 percent of their new infections, just two years ago, occurred amongst men having sex with men. And now, they’re putting in place a huge program to reach men having sex with men. So we’re seeing a signal in the region, which is a very encouraging one to support and to continue.
LAM: What about the Pacific region? Tell us about the situation there, and also, which is the country that’s still grappling with this huge problem?
SIDIBE: The Pacific is a very interesting case because we’re seeing major political commitment from Fiji – just last week,they’ve been able to remove travel restrictions for all HIV-related people. And now we’re seeing also Samoa, which are investing in their AIDS response. i’ve been myself in Papua New Guinea. We’re seeing with the effort of your country, because with a partnership with Australia, we’ve seen a change happening there also. We’re seeing a reduction in new infections, but we’re seeing a new debate being opened around the status of women, look at the violence against women – all those elements seem for me a very important to address, with the region.
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