BANGKOK, Thailand – The Asia Pacific region urgently
needs increased funding and strong leadership to
prevent a drastic increase in HIV infections and a
subsequent economic downturn, according to several
reports presented at the XV International AIDS
Conference last month.
One report, by the Joint United Nations Program
on HIV/AIDS (UNAIDS) and the Asian Development Bank
(ADB), entitled “Asia Pacific’s Opportunity:
Investing to Avert an HIV/AIDS Crisis,” found that
if prompt action is not taken in Asia by the end of
the decade, 10 million additional people could
acquire HIV, according to a statement.
Last year alone, an estimated 1
million people acquired HIV, bringing the total
number of people in Asia currently living with
HIV to more than
Likewise, the Monitoring the AIDS Pandemic (MAP)
Network, a group of epidemiologists and public
health specialists who independently analyze the
global HIV epidemic, presented a report called “AIDS
in Asia: Face the Facts.” It found that HIV is
spreading rapidly throughout several Asian
countries. In parts of China, Indonesia and Vietnam,
a huge leap in HIV rates among drug injectors is now
sparking a rise in HIV among sex industry workers,
MAP said in a release.
Another report presented at the conference, by
the Asia Pacific Leadership Forum on HIV/AIDS and
Development (APLF), states that while most of the
Asian Pacific population remains free from HIV
infection, low prevalence figures mask pockets of
severe, localized epidemics.
Last year alone, an estimated 1 million people
acquired HIV, bringing the total number of people in
Asia currently living with HIV to more than 7
million, according to an APLF release. South Africa
still stands as the country with the largest number
of HIV cases, with 5.3 million people living with
HIV according to the South African Department of
Health, and India is close behind, with 5.1 million
people living with HIV.
The UNAIDS/ADB report states that the economic cost
of an increase in HIV cases could escalate to $17.5
billion annually. Millions of more people would be
thrown into poverty as a result.
Resource needs are expected to reach at least $5.1
billion per year between 2007 and 2010, according to
the joint report. However, last year, when the
region’s countries required $1.5 billion to finance
a comprehensive response, only $200 million was
available from all public sector sources,
governments and donors combined.
The report stressed that regional leaders must give
top priority to ending the enormous – and increasing
– shortfall in finances required to build
comprehensive prevention and care responses.
“Governments in Asia and the Pacific can still avert
a massive increase in infections and deaths, limit
economic losses and save millions of people from
poverty if they are willing to finance comprehensive
AIDS programs,” said Peter Piot, MD, PhD, UNAIDS
executive director and a member of MAP, in a MAP
release. “The role of political leadership is more
critical at this point than ever before.”
A call for leadership
“In the face of an HIV/AIDS epidemic, good
governance and responsible political leadership mean
talking publicly about sex,” said Chandrababu Naidu,
former chief minister of India’s Andhra Pradesh
state, in the APLF release.
Leadership extends beyond the bounds of government.
The APLF report highlights the need for leaders in
the realms of business, community and religion, as
well as female leaders, who can help to mobilize
action against HIV.
“We need leaders everywhere to demonstrate that
speaking up about AIDS is a point of pride, not a
source of shame,” United Nations Secretary-General
Kofi Annan said at the Conference opening
ceremonies. “There must be no more sticking heads in
the sand, no more embarrassment, no more hiding
behind a veil of apathy. Leadership means respecting
and upholding the human rights of all who are
vulnerable to HIV/AIDS – whether sex workers, drug
users or men who have sex with men.”
The APLF report points out that leaders can make
highly influential decisions that ensure access to
quality information. They can also encourage
prevention strategies such as condom use, promote
needle exchange programs and make access to care,
support and treatment available for those in need.
Steps to progress
According to the UNAIDS/ADB report, if Asia Pacific
leaders implement comprehensive prevention and care
programs immediately, the number of expected new
infections and the cost of the epidemic in the
region may be dramatically reduced.
“Those countries that have
chosen to tackle high-risk behavior openly are
beating HIV. Now it’s up to others to follow
— Peter Piot, MD, PhD
Nationwide programs to increase condom use among sex
workers, help drug injectors use clean sterilized
needles and cut risk-taking sexual behaviors are
methods suggested by leading scientists to assist in
reversing the epidemic, according to MAP.
Other experts at the conference suggested that
discrimination against people living with HIV and
gender inequality remain the two biggest challenges
to overcome in Asia, according to UNAIDS.
“Asian nations face a choice,” said Piot. “They can
act now or pay later ... those countries that have
chosen to tackle high-risk behavior openly are
beating HIV. Now it’s up to others to follow their