Challenges to universal access in low prevalence countries in Asia Pacific
03 September 2008
In countries with low HIV prevalence, that is, with less than 1% of the population reported to be living with HIV, there are specific challenges to an effective AIDS response. In order to assess these issues in the Asia Pacific region, the second regional consultative meeting on universal access to HIV prevention, treatment, care and support took place in Manila 26-28 August 2008.
Challenges for low prevalence countries
When a minority of the population is affected by HIV, a lower prioritization may be given to AIDS programmes alongside other competing development priorities. In addition, the epidemic can remain relatively “invisible” in a society where the main modes of HIV transmission are related to behaviours of unprotected paid sex, use of contaminated needles and syringes by people who inject drugs, and unprotected sex between men.
"Know your local epidemic"
Given these challenges, experts argue the importance for a country to understand what is specifically driving its epidemic and spends resources in a focussed way. So "knowing your local epidemic" and choosing the right combination of interventions would result in a more cost-effective and successful response.
Bringing services to where most needed
The report of the independent Commission on AIDS in Asia published earlier this year found that it is vital that national responses are evidence-based and bring services to where it is most needed. However an additional challenge for low-prevalence countries is to reach these people whose behaviour may marginalize them from mainstream society– these include men who have sex with men, people who inject drugs, sex workers and their clients.
Asia and the Pacific
Despite a few notable successes in containing the epidemic, infections continue to rise throughout the Asia Pacific region and infections have reached concentrated levels in a number of countries, which were previously termed as low prevalence. Low prevalence is not a cause for celebration, rather consistent with Millennium Development Goal 6; the call to action needs to be from low to zero prevalence.
Second regional consultative meeting on universal access to HIV prevention, treatment, care and support
In order to assess these complex issues in the Asia Pacific region, the second regional consultative meeting on universal access to HIV prevention, treatment, care and support took place in Manila 26-28 August 2008.
The three day meeting was hosted by the Department of Health, Republic of the Philippines and co-organized with support from UNAIDS and its Cosponsors. More than 100 delegates including health ministers, interim foreign affairs minister and experts from national governments, civil society and international agencies participated. The UN Secretary General’s Special Envoy on AIDS in Asia and Pacific Dr Nafis Sadik also attended, as did Dr Purnima Mane, Deputy Executive Director United Nations Population Fund (UNFPA) and Mr Prasada Rao, UNAIDS Asia-Pacific Regional Director.
The meeting reviewed the findings and recommendations of the Commission on AIDS in Asia, which included among others that Heads of Governments of Asian countries should assume stronger leadership role in national AIDS responses. It concluded with the adoption of the Manila 2008 Statement of Cooperation in which low prevalence countries in Asia and the Pacific commit to mobilizing the resources required to meet universal access targets, to scaling-up effective strategies informed by the evidence of the nature of the epidemics in these countries, and to designing context-specific programmes.