Universal access: target setting in Asia and the Pacific
27 October 2006
Less than six months after the United Nations Member States endorsed the 2006 Political Declaration on HIV/AIDS, countries across the world have started setting ambitious targets to significantly scale up their response to AIDS. This is the first step to moving towards the goal of universal access to comprehensive HIV prevention, treatment, care and support by 2010.
We asked Mr Prasada Rao, UNAIDS Regional Support Team Director for Asia and the Pacific to update us on progress in his region.
In June 2006 the UN Member States committed to significantly scale up their AIDS response in the bid to achieving the goal of universal access to HIV prevention, treatment, care and support by 2010. What can we say about this process in Asia and the Pacific?
Countries in Asia and the Pacific have made significant progress and taken concrete actions on the commitments made in New York. Since the first regional consultation that took place in February 2006 to identify obstacles to moving towards the goal of universal access by 2010, a number of national and regional consultations have been held to discuss the different aspects of this process and put in place mechanisms to move forwards, including developing targets, and updating and costing strategic plans. The consultation held on 25 August, immediately after the Toronto AIDS Conference, focused specifically on how to ensure civil society involvement in the universal access process in the region. More recently, a consultation took place between 24 and 27 October in Ulaanbaatar, Mongolia, which brought together government, civil society, bilateral and UN representatives from 11 low-prevalence countries in the region.
Can you give us concrete examples of what has happened in Asia and the Pacific after the 2006 Political Declaration was endorsed?
Countries such as Cambodia, India, Philippines, Nepal and Thailand have already agreed on targets. It’s important to note that they have set targets in three programmatic areas: prevention, treatment and care and support. It’s also important to note that these countries have assessed the resources needed to achieve the new targets.
Can you tell us how these targets have been set?
One of the specificities of the process of scaling up a comprehensive response to HIV towards the goal of universal access by 2010 is that it should be driven by local realities and should include all stakeholders, in particular civil society. This means that no two countries followed the same process. However, we worked with all countries and involved stakeholders to re-visit the targets set in the Declaration of Commitment in 2001, in light of their actual performance and their current capacity. The purpose of this exercise is to consider setting ambitious targets for countries making good progress and for countries which are not as successful, to explore the reasons why and identify the concrete obstacles that are hindering progress. This also gives countries an opportunity to improve harmonization and alignment of partners’ efforts with their national AIDS strategies, as recommended by the Global Task Team.
What about the other countries in the region?
Bangladesh , Indonesia, China, Laos, Viet Nam, Myanmar and Sri Lanka are making progress but at a slower rate. In these countries, governments are committed to moving forwards and UNAIDS is working with them, and with representatives from civil society, to evaluate if the targets are ambitious enough, while remaining realistic and feasible. We are expecting to complete this process by the end of 2006 as set out in the Political Declaration.
In other smaller, low prevalence countries in Asia and the Pacific, we are working closely with country representatives to accelerate the target setting process. The response from these countries has been extremely positive.
What are some of the challenges countries are facing in Asia and the Pacific in setting targets?
Harmonizing the target setting process with ongoing planning processes is definitely a challenge. However, I have to say that several countries have been able to overcome this. For example in Nepal, the National Strategic Plan for 2006/7-2010/11 is being developed and will contain quantitative targets for scaling up prevention and treatment towards universal access. India and Pakistan have also incorporated the target setting process in their national planning process.
In the Political Declaration, countries commit to setting the new targets through consultations with all stakeholders involved in the AIDS response, including people living with HIV. Can we see this happening in Asia and the Pacific?
Ensuring the significant contribution of civil society, particularly people living with HIV in the target setting process is another challenge in the region and a critical element of the commitment made in New York. While all countries are trying to involve civil society as much as possible, we feel that we can help countries perform better on this aspect.
In August 2005, we organized a civil society forum where more than 40 representatives from regional networks and NGOs working on HIV in the region and national civil society partners met to discuss how they can play a role in the development of national strategic plans and target setting at country level. They made very practical recommendations and proposed a framework for strong and meaningful civil society participation. The framework defines minimum standards for civil society involvement, as well as guidelines on systematic and equitable representation of civil society, including vulnerable groups,  in the official mechanisms, the target setting process, and in developing national strategic and operational plans. This consultation has in fact helped us to finalise and send a list of eight indicative targets, which are specific to countries with low and concentrated epidemics, to all stakeholders including the National AIDS Councils and National programme Mangers for adoption and integration into their national planning process.
They also made recommendations about building the capacity of civil society and developing indicators for monitoring civil society involvement. Many groups need to be informed in more detail about the concept, the implications of the process and what their role is. They also need to be trained to effectively advocate, negotiate and express their concerns and perspectives.
What are the next steps in your region?
It’s important to maintain the current momentum and to strengthen mutual accountability by all partners (this is why we think civil society involvement in scaling up national responses is critical). We are also providing funding and technical support, by engaging the country based UN teams and supporting countries to mobilize resources either internally or with external donors and the Global Fund. While continuing to support countries, we are working now to involve more regional intergovernmental bodies, to ensure that target setting remains on the agenda of regional high level meetings, to jointly address obstacles to scaling up towards universal access, as well as developing strategic information for advocacy purposes.