2009 ICAAP

The global economic downturn is having an adverse effect on migrants as they are excluded from stimulus packages and AIDS programmes are threatened, concludes a UN report released at ICAAP 09. Credit: UNAIDS/O.O'Hanlon

The global economic downturn is having an adverse effect on migrants as they are excluded from stimulus packages and AIDS programmes are threatened, concludes a UN report released at the 9th International Congress on AIDS in Asia and Pacific (ICAAP). As in the 1997 Asian crisis, negative impacts on health and migration are set to become graver as donor funding and government programmes are cut.

Entitled The threat posed by the economic crisis to Universal Access to HIV services for migrants, the report is issued by the UN Development Programme (UNDP), the International Labour Organization (ILO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS). It draws parallels between the current crisis and that of the Asian downturn of 1997 when the economies of Hong Kong, Indonesia, Japan, Korea, Malaysia, Singapore and Thailand were engulfed in turmoil after the collapse of Thailand’s stock market. The report argues that trends in migration policies and AIDS programmes now mirror those of 1997; a worrying development.

“It is critical that policy makers don’t make the same decisions that were made in ’97 vis-à-vis cuts to essential HIV/AIDS programmes, and adverse policies that worked against migrant workers. In contrast to the massive stimulus packages that countries are launching to boost their economies, AIDS spending for a comprehensive response represents a mere 0.01% of such programmes”, says Caitlin Wiesen, UNDP Regional HIV Practice Team Leader for Asia and the Pacific.

According to JVR Prasada Rao, Director of UNAIDS Regional Support Team, Asia and the Pacific, “Even before the financial crisis, HIV programmes and services for migrants and mobile populations often fell through the cracks in national programmes. Besides, we had seen from the past financial crisis that HIV prevention programmes were first to face budget cutbacks. Issues related to migrants are critical in a region with fast economic growth like Asia. We must strongly advocate with governments and donors not to cut resources on migrant HIV programmes.”

In the face of crisis, countries often introduce policies to cut migration, such as deporting workers or making migrant work permits more difficult to obtain. The 1997 downturn showed that this simply does not work. Instead, denied formal avenues for migration, many people find back door, unsafe channels that often make them vulnerable to HIV. According to the paper, governments have stopped issuing work permits, are cracking down on undocumented migrants (Malaysia) and many foreign workers in manufacturing and construction are being laid off (Indonesia, China). In a number of countries there are increasing reports of worsening working conditions (in Hong Kong, Malaysia and Singapore).

“In times of economic downturn, we cannot forget the needs and rights of migrant workers who are such an integral part of so many economies, especially in our region” says Dhannan Sunoto of the ASEAN Secretariat. “It is critical to ensure that potential migrants are not barred from working abroad based on their HIV positive status, and that migrants working abroad are not deported because of their positive status.”

As Dr Sophia Kisting, Director of the ILO Programme on HIV/AIDS and the world of work has it, “In the context of the current economic crisis we have reports of increased human rights violations, and pressure on migrant workers to move from formal to informal employment or to return to their countries of origin. These trends are likely to exacerbate vulnerability to HIV.”

She adds that her organization is moving forward with urgency in this area. “The ILO is in the process of formulating an international human rights instrument on HIV/AIDS and the world of work. If adopted in 2010, this standard…will give new impetus to anti-discrimination policies at national and workplace levels.”

The report outlines key recommendations:

1. Establish protective mechanisms like welfare funds, social insurance schemes and training programmes to help migrants returning home or to relocate on site;
2. Translate regional and national strategies for HIV that include migrants and mobile populations into budgets and services that are designed to reach people on the move;
3. Maintain prevention programmes and budgets: every $1 invested in prevention can save up to $8 in averted treatment costs;
4. Support civil society organizations to monitor the health-seeking behaviour of migrants so they do not have to sacrifice treatment for other basic necessities.

The paper was released at the symposium, The impact of the financial crisis on labour migration and HIV, organized by UNDP, ILO, UNAIDS and JUNIMA.

UNAIDS Goodwill Ambassador Salman Ahmad performing at the IX International Congress on AIDS in Asia and the Pacific (ICAAP), held in Bali, Indonesia from 9-13 August. Credit: UNAIDS/Donang Wahyu

Participants in a discussion on young people’s role in AIDS response at the 9th International Congress on AIDS in Asia and the Pacific (ICAAP) reached a clear and unanimous agreement: young people are essential to halting the spread of HIV.

“Young people need to be on board to turn the tide, as it is their decision-making over their bodies and their sexuality that will determine their future status,” said UNAIDS Goodwill Ambassador Salman Ahmad, a well-known rock star in South Asia, opening the first dialogue with young people at ICAAP’s Community Dialogue Space.

Co-chairing the event was James Chau, China Central Television (CCTV) talk show anchor from Beijing, who is also China’s UNAIDS National Goodwill Ambassador. “It is important that young people are empowered to participate and are given a seat in relevant forums and platforms to have their voice heard and be listened to.”

Under the theme “youth perspective on leaders' commitment about youth issues and involvement in the response”, the dialogue aimed at providing an opportunity for young people to discuss their roles in the AIDS response in Asia and the Pacific region.

Committed to advocating the involvement of youth in the AIDS response, UNAIDS Goodwill Ambassador Salman Ahmad emphasized that this kind of dialogue allows young people to prove their commitment and help shape policies and views that incorporate and represent young people. “This, in turn, can be aided by networks and networking,” said Salman. “Connecting young people, sharing knowledge and experience, building strong and sustained relationships will assist individuals to stand up and be engaged, and show leaders and decision makers that young people can and will make a difference,” he added.

Officially opened on 10 August 2009, the Asia Pacific Village provided a place where delegates can celebrate diversity as well as carry out small group discussions, informal education activities, art and dance performances, and cultural shows.

Besides directly talking and sharing views with local young people, Salman also participated in the AIDS Ambassadors meeting held on August 9. Sharing his own experience regarding youth as a resource on HIV prevention, Salman emphasized young people’s role in campaigning and advocating for the attainment of the Millennium Development Goals. “The leading question is how to harness and engage the energy and idealism of young people.”

Hosted by Ani Bambang Yudhoyono, Indonesia’s First Lady and National AIDS Ambassador, the AIDS Ambassadors and Champions Meeting aimed at addressing the need for leadership in the Asia and Pacific Region and the ways in which Ambassadors and Champions can have a greater effect in reducing the spread and impact of HIV. Promoting an agenda for youth was one of the objectives of this meeting.

As the lead singer and founding member of one South Asia's biggest rock bands "Junoon", Salman Admad became a UNAIDS Goodwill Ambassador in 2005 and has been assisting UNAIDS in its efforts to reverse the spread of HIV by raising awareness on AIDS issues.

The relationship between humanitarian crises and HIV was the key issue, at a satellite session sponsored by UNHCR and UNAIDS at the 9th International Congress on AIDS in Asia and the Pacific. Credit: UNAIDS/O.O'Hanlon

With millions of people around the world forced to move by conflict and natural disasters, examining the relationship between humanitarian crises and HIV is becoming increasingly critical. This key issue, and its implications for Asia, was highlighted in a satellite session at the 9th International Congress on AIDS in Asia and the Pacific sponsored by the United Nations High Commissioner for Refugees (UNHCR) and the Joint United Nations Programme on HIV/AIDS (UNAIDS).

The connection between humanitarian crises and the HIV epidemic is not straightforward. Emergencies can increase vulnerability to HIV transmission but this does not necessarily result in increased risk behaviors or higher HIV prevalence. People facing conflict or natural disasters often lose their source of income and some may have to resort to high-risk behaviour to meet their basic needs. Social and sexual norms can break down and women can be especially vulnerable as an increase in rape is often associated with conflict and with displacement. However, humanitarian crises can play a protective role, as population mobility is sometimes curtailed and access to quality health and other social services can be improved, especially in long-term displacement.

During the session, Opportunities and challenges in addressing HIV amongst diverse humanitarian populations, panellists working with displaced people or in other humanitarian contexts explored these vexed questions. They also argued that in every instance where a humanitarian crisis occurs, whether in a high or low prevalence setting, minimum interventions to prevent HIV and respond to it are necessary.

The aim of the meeting was to increase awareness of the HIV epidemic among key stakeholders, encouraging them to ensure that humanitarian populations have access to prevention, treatment, care and support services, whatever their situation. The panel and participants were also keen to exchange ideas and expertise, lessons learned, challenges faced and successes achieved in HIV programmes in humanitarian settings in the Asia region, with the aim of developing and strengthening partnerships between relevant actors in the field.

Speakers at the session were set to explore a wide range of ideas and information. Presentations included: an overview of the epidemiology and programmatic principles of HIV in conflict and experience to date in the Asia region; integrating HIV into China’s disaster response scenario; successes and challenges in HIV programmes among Afghan injecting drug users living as refugees in Pakistan; and treatment programmes in stable refugee settings in Thailand.

UNHCR is the lead UN agency for addressing HIV among refugees and people internally displaced as a result of conflict. It aims to ensure access to comprehensive programmes relating to HIV prevention, including prevention of mother-to-child transmission, voluntary counseling and testing, development and dissemination of information-education-communication materials, care, support and treatment and monitoring and evaluation.

UNAIDS organized a satellite session at ICAAP 09 entitled "Addressing the legal barriers and criminalization of at-risk populations". Credit: UNAIDS/O.O'Hanlon

Legal barriers and criminalization are blocking the empowerment of groups at high risk of HIV infection such as injecting drug users, sex workers and men who have sex with men by denying or obstructing the rights to live healthy and safe lives. To explore and address this global social issue, UNAIDS organized a satellite session at ICAAP on Wednesday 12 August.

Legislation can be a powerful tool in the response to AIDS. When based on human rights standards, and appropriately implemented and enforced, the law can support positive public health outcomes and enable individuals and communities to realize their rights. Many areas of law are critical to an effective AIDS response: public health law, anti-discrimination and equality of women, domestic relations and prevention of sexual violence, intellectual property, social security, laws governing drug use, sex work, prisons.

The ICAAP session brought together representatives from executive, legislative, judicial and law enforcement sectors to find out ways to break down law barriers and criminalization of most-at-risk populations in multiple contexts in Asia and the Pacific. This satellite symposium was an opportunity for legislators, law enforcers and people who have been affected to discuss possible and effective solutions.

“The regional situation regarding criminalization of most-at-risk populations and risky behaviours is not optimistic,” said Anand Grover, UN special rapporteur on the right to health, who is also the chair of the symposium. “The importance of human rights and their protection has become a core principle of the United Nations and in the world today.”

Besides exploring the implications of legal barriers and criminalization on HIV prevention efforts, participants also discussed the critical role played by law enforcers in determining the legal environment and in influencing access to HIV services. The enforcement of legal provisions, or perceived legal directives, by law enforcers is often done in ways that infringe on the human rights of affected populations and serve as additional barriers to access HIV prevention and treatment.

All the participants agreed that there is hesitation in changing existing legal provisions, and a degree of discomfort with possible outcomes. Also, the time required for changes is long, and time is a major factor in effective action against HIV. Thus, while working on change as a long-term solution, it is important to find space and opportunity for constructive action within existing structures.

The United Nations World Food Programme (WFP) and its partners explored the vital role of nutrition and food security for people living with HIV during a satellite session at ICAAP09. Credit: WFP/Jim Holmes

During a satellite session at the IX International Congress on AIDS in Asia and the Pacific (ICAAP), held in Bali, Indonesia, the United Nations World Food Programme (WFP) and its partners explored the vital role of nutrition and food security for people living with HIV. Participants examined models of integrating this key area into HIV treatment, care and support, as well as implementation opportunities and challenges.

The widespread recognition of food and nutrition as a critical component of the global AIDS response has come after prolonged advocacy by WFP and others. Optimizing the nutritional status of people living with HIV is a scientifically recognized best practice. Without proper nutrition, people living with HIV become malnourished and treatment is less effective. WFP is placing greater emphasis on the integration of nutritional care in the health sector.

Since each country’s HIV epidemic is different, national AIDS responses need to reflect reality and address the context of unique risks and vulnerabilities. For WFP, the UNAIDS advocacy message, “Know your epidemic, know your response” means that national AIDS responses will include a nutrition and food component when appropriate.

In Asia, there are an estimated 5.0 million people living with HIV. Viral transmission focuses on vulnerable populations susceptible to infection such as sex workers or injecting drug users. In this context, WFP’s action on AIDS reflects the epidemic trend with activities such as the inclusion of mitigation and safety nets for these most at risk populations in national action plans and poverty reduction strategies.

Dr Martin W. Bloem, Head of WFP’s Nutrition and HIV/AIDS Policy, led the satellite session, entitled ‘Models for integrating nutrition and food security into HIV treatment, care and support in the Asia region: Opportunities and challenges’. He was joined by three additional speakers: Professor Emeritus Praphan Phanuphak, Director, Thai Red Cross AIDS Research Centre; Dr Angela Kelly, Team Leader, Papua New Guinea Institute of Medical Research; and Ms Kaniz Fatima, Project Officer and HIV Focal Point, WFP Bangladesh.

They shared their expertise and knowledge on the impact of nutrition and food security for people living with the virus; opportunities and challenges related to nutrition programme design and the development of HIV nutrition guidelines; and priorities for future strategies.

A frame from the film Suee (Needle), unveiled during the satellite session, ‘Reforming treatment environments – How to make compulsory drug treatment HIV friendly’ at ICAAP09.

The lives of injecting drug users and the HIV-related stigma and discrimination they face was one focus of the IX International Congress on AIDS in Asia and the Pacific as the film Suee (Needle) was launched by Response Beyond Borders, the Asian consortium on drug use HIV, AIDS and poverty.

Unveiled during the satellite session, ‘Reforming treatment environments – How to make compulsory drug treatment HIV friendly’, the film gives a voice to this vulnerable group with anti-stigma messages conveyed by the injecting drug users themselves. It was directed by award-winning Indian movie director, author and screen-writer, Sai Paranjpye, who set out to present an uncompromising insight into a world where HIV prevalence is disproportionately high.

Ms Paranjpye, a Cannes Film Festival award winner, worked closely with injecting drug users on Suee and spent time interviewing them on location and involving them as actors in the film. They ‘own’ the project as much as is practically possible. She also consulted a full range of partners and obtained feed back on the script and other help from NGOs working in HIV prevention with injecting drug users, especially Sharan in Delhi and Sankalp in Mumbia. She also received input from the International Center for Research on Women and World Bank teams, among others.

Suee explores a number of areas in the lives of injecting drug users including treatment, care, peer and community support, rehabilitation and the workplace. It is intended to convey messages of hope and not to trigger reactions of pity or fear; empowering the audience by raising awareness and presenting facts in a non-judgmental way. Made for general consumption, the film can also be used in youth campaigns, providing education and information for young people to help prevent HIV and reduce both risk and vulnerability.

The film emerged from the South Asia Region Development Marketplace (SAR DM), an initiative spearheaded by the World Bank. It consists of a competitive grants programme that identifies and supports small scale projects demonstrating an innovative approach to reducing HIV stigma and discrimination in the region. 26 civil society organisations from across South Asia won grants of US$ 40,000 each to bring their ideas to fruition.

Ms Paranjpye has used her SAR DM award to produce not only the Suee film but another, called “The sound of the horn”, which deals with truck drivers.

Stigma and discrimination are seen as major barriers to scaling up HIV prevention services in the region. They marginalise those living with the virus and contribute to their social isolation and rejection. They also discourage vulnerable groups from accessing HIV treatment, care and support services.

It is hoped that Suee, once widely disseminated, will take its place among a range of interventions helping to reduce stigma and discrimination against South Asia’s injecting drug users.

The film was selected by the screening committee of the Congress and will be shown again on August 11.

Note: Partners and sponsors of the South Asia Region Development Marketplace include: UNAIDS, UNICEF, UNODC, UNDP, the Global Fund, the Government of Norway, the International Center for Research on Women, the International Finance Corporation, and the Swedish International Development Cooperation Agency (SIDA)

Credit: UNAIDS/O.O'Hanlon

In general, HIV prevention services in the Asia region are currently not reaching young people who are most at risk of infection, which include those who inject drugs, who engage in unprotected male to male sex and those involved in sex work and their clients. In order to address this situation the Asia Pacific Regional UN Coordination Group on Most at Risk Young People hosted a symposium at the IX International Congress on AIDS in Asia and the Pacific.

According to epidemic models presented in the 2008 AIDS in Asia Commission report, over 95% of all new HIV infections in the Asia region occur among such most at risk young populations. However, over 90% of resources for young people as a group are spent on low-risk youth, who represent less than 5% of infections.

Entitled "HIV prevention and most at risk young people", the event was sponsored jointly by UNFPA, UNICEF, UNESCO, UNAIDS, UNDP, WHO and is supported by 7Sisters, the Coalition of Asia Pacific Regional Networks on HIV/AIDS. It examined, among other issues, how the specific needs of most at risk young people should be addressed, what works and what doesn't and how partnerships between youth, NGOs and government can be strengthened.

The symposium discussed the nexus of unsafe sexual behaviours among most at risk young people where a number of such practices coexist in the same environment. Sex work, drug use and unprotected sex with multiple partners can all occur in the same social network. Therefore, participants looked at an approach which addresses a multiplicity of needs, meshing and coordinating previously implemented programmes and ensuring a youth-friendly approach.

A comprehensive, evidence-informed response, it was argued, requires firm commitment from donors and governments to address the specific needs of most at risk young people, and an examination of the contexts in which these risks occur. The engagement of this group in developing the policies, programmes and processes that directly affect and benefit them is seen as a prerequisite. Young people played an active and central role in this event as the practical aspect of exactly how to get youth involved in decision making was explored.

Specific objectives of the meeting also included promoting awareness among policy makers and programme planners on the urgent need for HIV prevention for most at risk young people and encouraging increased collection, analysis and use of data on this key group to support advocacy efforts and inform budget allocation priorities. Sharing experience of programming in this area, both positive and not so positive, was on the agenda too.

Among those taking part in the event were the UNFPA's Deputy Executive Director (Programme), Purnima Mane. UNESCO’s Jan de Lind van Wijngaarden, and UNICEF’s Margaret Sheehan spoke on behalf of the Asia Pacific Regional UN Coordination Group on Most at Risk Young People. James Chau, member of the AIDS2031 initiative, UNAIDS Goodwill Ambassador and Chinese television presenter facilitated the panel discussion. The panel also involved representatives of the medical profession, NGOs, health ministries and representatives of young people involved in sex work, drug use and male to male sex.

Michel Sidibé, UNAIDS Executive Director

More than a thousand people become infected with HIV in Asia each day. If only we had invested in reaching populations at higher risk and their partners, most of these infections could have been averted - at a cost of less than half a US dollar per person.

We are beginning to see success in some parts of the region, but not enough to break the trajectory of the epidemic.

The Commission on AIDS in Asia has recommended that the AIDS epidemic in the region be redefined. We must transform the AIDS response so that it works for people—especially for those who are marginalized and without a voice. This means protecting sex workers, men who have sex with men, transgender, injecting drug users and women.

How can we do this?

1. Decriminalize consensual adult sexual behaviour and drug use.
2. Address HIV transmission among intimate partners.
3. Invest in evidence-informed HIV prevention, treatment, care and support programmes.
4. Adopt an ‘AIDS plus Millennium Development Goal’ approach.

Decriminalize consensual adult sexual behaviour and drug use

Many countries are changing laws that criminalize consensual adult sexual behaviour (including sex work) and drug use, and courts are helping to clarify bad laws. In Indonesia, the Supreme Court ruled that drug users need care, not prison. In Nepal, the highest court has established that transgender and men who have sex with men have equality under the constitution. And in India, the Delhi High Court has restored dignity to millions, by reading down an archaic law that discriminated against men who have sex with men. New Zealand has legalised sex work and reaped the dual benefits of public health and public safety. Australia has demonstrated that law enforcement and public health goals can go hand in hand while dealing with drug use. We can remove punitive laws and policies that block effective responses to AIDS.

But the real transformation has to be in the hearts and minds of people. Courts and parliaments can only create an enabling environment. Societies and communities have to change the social norms that allow stigma and discrimination.

In India, a pregnant woman was recently branded on her forehead as being HIV positive by hospital staff during a routine check-up. This inhumane treatment of the woman triggered protests by the local community and by human rights activists, which led the Gujarat government to open an investigation. It is this sort of community mobilization that is needed to put an end to such discriminatory acts.

Address HIV transmission among intimate partners

Bad laws and a discriminatory society have had a severe impact on women. Many women in Asia become infected because their husbands or male partners contracted HIV through drug use or through sex with another man or with a sex worker. In India, being monogamous is the only risk factor for an estimated 90% of women living with HIV.

In 2008, 35% of adults living with HIV in Asia were women, and most of them were in steady relationships.

Invest in evidence-informed HIV prevention, treatment, care and support programmes

HIV prevention programmes must be scaled-up. Political leaders must ensure that existing HIV services are expanded to reach the most vulnerable. This includes starting needle exchange programmes and offering oral substation therapy to drug users (great strides in these areas have been made in Bangladesh, China, Malaysia, India and Viet Nam), increasing access to antiretroviral drugs, distributing condoms and offering voluntary HIV counselling and testing services to those at higher risk. It is heartening that requests to the Global Fund to Fight AIDS, Tuberculosis and Malaria for such programmes have increased substantially in recent years. However, we need US$ 7.5 billion in 2010 to reach country targets, but only 10% of this was available in 2007. We must therefore invest wisely and equitably, especially now in the midst of an economic crisis.

Adopt an ‘AIDS plus Millennium Development Goal (MDG)’ approach

Unlike Africa, where the AIDS epidemic can overwhelm development efforts, the Asia and Pacific region can combine development and the AIDS response. Reducing poverty, increasing education and investment in health must become the foundations for sustainable economic growth in the region. This is what I call the ‘AIDS plus MDG’ movement.

Recently I read about Nisha, a person living with HIV in Nepal. She lost her husband in 2004, when there was no access to treatment. Today, she is on antiretroviral therapy. She is staying healthy, has gone back to work and can look after her three children. Her family has come to accept her, and her children go to school, where they are being taught how to protect themselves. Access to treatment has given her an opportunity to fulfil her dreams—this is hope becoming reality.

The President of the Republic of Indonesia, H.E. Hj. Dr Susilo Bambang Yudhoyono (right) officially opened the 9th International Congress on AIDS in Asia and the Pacific (ICAAP), which takes place in Bali, Indonesia from 9-13 August. Credit: UNAIDS/Donang Wahyu

The President of the Republic of Indonesia, H.E. Hj. Dr Susilo Bambang Yudhoyono has officially opened the 9th International Congress on AIDS in Asia and the Pacific (ICAAP), which this year takes place in Bali, Indonesia from 9-13 August under the theme “Empowering people, strengthening networks”.

At the opening ceremony, Mr JVR Prasada Rao, Director, UNAIDS Regional Support Team, Asia and the Pacific, has delivered a speech on behalf of UNAIDS Executive Director, Mr Michel Sidibé calling for the establishment of enabling environments and supportive social norms necessary to deliver a future generation free of HIV.

The Congress has drawn thousands of people together for five days of discussion around the AIDS response in the Pacific and across Asia. Together they will discuss a wide range of issues and contexts for the AIDS epidemic in these regions including mobility and migration, injecting drug use, human rights as well as gender.

Mr JVR Prasada Rao, Director, UNAIDS Regional Support Team, Asia and the Pacific delivered a speech during the opening ceremony on behalf of UNAIDS Executive Director, Mr Michel Sidibé. Credit: UNAIDS/Donang Wahyu

According to Mr Rao “There will be evidence-based discussion on whether Universal Access can be an achievable goal by 2010 for many countries in Asia and the Pacific. Every facet of the epidemic and the region’s responses are featured in the wide array of session and activities.”

Mr Rao continued, “What is really impressive is that the conference will showcase the immense progress made by community groups, working together and in partnership with government and other partners, in spearheading the response in many countries in the Asia Pacific region.”

Congress Programme

The event, which takes place every two years, is broad in scope as it includes 24 symposia, 32 skills-building workshops, and 75 satellite meetings. Some 349 abstracts have been accepted by the programme committee for 64 sessions of oral presentations, and 1932 abstracts accepted for poster presentations.

The other main goals of the event are to empower individuals and strengthen networks in the regions to effectively respond to AIDS.

Young people and women

The Bali Youth Force (BYF), a coalition of youth networks and organizations that has collective representation in all Asia & Pacific countries, encouraged significant youth participation in the 9th ICAAP.

UNAIDS Secretariat and its Cosponsors will participate and lead a wide number of events including the launch of a new report, HIV Transmission in Intimate Partner Relationships in Asia, that highlights the increased risk of HIV infection by women engaged in long-term relationships.

HIV epidemic in Asia and Pacific

According to the Independent Commission on AIDS in Asia (2008), AIDS remains the most likely cause of death and loss of work days among people aged 15 to 44.

An estimated 5 million people in Asia were living with HIV in 2007 according to 2008 report on the global AIDS epidemic. The several modes of HIV transmission present in the region, via sex work, injecting drug use, and unprotected sex between men; make Asia’s epidemic one of the most diverse in the world. The Pacific region’s epidemics are relatively small with an estimated 74 000 people living with HIV across Oceania in 2007.

The AIDS Ambassadors discussed ways in which to strengthen their roles to contribute to the achievement of the Millennium Development Goals. Credit: UNAIDS/Donang Wahyu

Ahead of the official opening ceremony of the 9 th International Congress on AIDS in Asia and the Pacific (ICAAP), a high-level meeting of AIDS Ambassadors took place in Bali. The gathering was co-hosted by the First Lady and National AIDS Ambassador of Indonesia, Mrs Ani Bambang Yudhoyono, and AIDS Ambassador of Australia, Mr Murray Proctor.

The AIDS Ambassadors meeting addressed the need for leadership in the Asia and Pacific Region and the ways in which Ambassadors can have a greater effect in reducing the spread and impact of HIV.

The AIDS Ambassadors discussed ways in which to strengthen their roles to contribute to the achievement of the Millennium Development Goals. They also discussed ways to address challenges, including better donor coordination, programs to address gender power imbalances, promoting an agenda for youth and recognition of the development impacts of the epidemic.

The UN Secretary-General’s Special Envoy for HIV/AIDS in Asia and the Pacific Dr Nafis Sadik also participated in the event together with, among others, the First Lady of Cambodia, Madame Bun Rany Hun Sen, Lady Roslyn Morauta, AIDS Ambassador and Former First Lady of Papua New Guinea , the AIDS Ambassador from the Netherlands, Dr Wijnroks, UNAIDS Director, Regional Support Team for Asia and the Pacific, Mr JVR Prasada Rao, UNFPA Deputy Executive Director, Purnima Mane and UNAIDS Goodwill Ambassador Salman Ahmed whom participated in the dialogue as an advocate for youth, emphasizing the role they can play in leading HIV prevention efforts.

The high-level meeting of AIDS Ambassadors was co-hosted by the First Lady and National AIDS Ambassador of Indonesia, Mrs Ani Bambang Yudhoyono (in the image), and AIDS Ambassador of Australia, Mr Murray Proctor. Credit: UNAIDS/Donang Wahyu

In order to translate their commitment to reducing the spread and impact of HIV into action, delegates endorsed a joint statement that was then delivered by Indonesia’s First Lady, H.E. Ibu Ani Bambang Yudhoyono at the 9th ICAAP Opening Ceremony.

In the statement, AIDS Ambassadors called on Governments, donor organizations and all community partners to support and maintain HIV programmes with the goal in mind of reaching universal access to comprehensive prevention, care, support and treatment for as well as sustaining progress in implementing the Declaration of Commitment adopted at the UN General Assembly Special Session on AIDS in 2001, despite the pressures of the global economic crisis.

HIV epidemic in Asia and Pacific

According to the Independent Commission on AIDS in Asia (2008), AIDS remains the most likely cause of death and loss of work days among people aged 15 to 44.

An estimated 5 million people in Asia were living with HIV in 2007 according to 2008 report on the global AIDS epidemic. The several modes of HIV transmission present in the region, via sex work, injecting drug use, and unprotected sex between men; make Asia’s epidemic one of the most diverse in the world. The Pacific region’s epidemics are relatively small with an estimated 74 000 people living with HIV across Oceania in 2007.