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“The only thing necessary for these diseases to the triumph is for good people and governments to do nothing.”


HIV in Asia: Act now or pay later, groups warn

Ten million more Asians may acquire HIV by 2010 unless urgent action is taken now, says report.

by Tara Grassia
Staff Writer
August 2004

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
7 million.

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.

Economic struggles

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 their lead.”
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 lead.”






















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