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HEALTH-ASIA: Report Faults Gov’t Complacency on AIDS

Nergui Manalsuren

UNITED NATIONS, Mar 26 2008 (IPS) - Some 10 million Asian women sell sex, and at least 75 million men buy it regularly, while male-to-male sex and drug injecting add another 20 million or so to the number of those at high risk of HIV infection, says the first report by the Commission on AIDS in Asia.

Chakravarthi Rangarajan, the chair of the commission, said Wednesday at the United Nations that these are the main causes of new HIV infections that regional governments need to address through targeted policies.

The independent commission of nine members was set up in June 2006 and given an 18-month mandate to study and assess the impact of AIDS in Asia, and to recommend strategies for a stronger response to HIV and AIDS.

Nearly five million people are living with HIV in Asia, with 440,000 people dying each year, and an additional eight million people will become newly infected by 2020, warns the report, “Redefining AIDS in Asia”.

However, the current inadequate response by governments suggests that number will rise to about 20 million in the next five years, concluded the commission.

“The glass is half full in the sense that in June there will be a high-level meeting in the General Assembly on reviewing progress – and there’s progress everywhere, but it is very variable,” the executive director of UNAIDS, Peter Piot, said in response to a question by IPS. “There are three million people on antiretroviral therapy [worldwide], but there are well over six million who need it.”

“I think it is achievable in most countries, but I’m not optimistic for countries that are in conflict, because if there’s no peace, there’s no progress,” he added.

Although there are examples of effective and focused HIV responses in Asia, in many cases, the response has lagged behind or faltered for long periods.

Political engagement and support are vital prerequisites for setting the agenda and driving a potentially effective response. When dealing with issues of stigma and discrimination, and overcoming taboos against the public discussion of sex and sexuality, the role of leaders cannot be underestimated, experts on the commission stressed.

In response to the commission’s report, U.N. Secretary-General Ban Ki-moon noted that Asia is home to some of the fastest-growing economies in the world, but that “we will never see equitable progress if some parts of population are still denied basic health and human rights – people living with HIV.”

He said that Asian governments should amend outdated laws criminalising the most vulnerable sections of society, and take all the measures needed to ensure they live in dignity by implementing the recommendations of the commission.

According to the report, some far-sighted politicians have increased their own commitment and started lobbying others in power to push for more resources and accountability. However, only in two Asian countries has a head of state played a prominent role in the response and officially provided leadership to the national AIDS programme.

Frika Iskandar, a member of the commission and AIDS activist in Asia, who is herself living with HIV, told IPS that in her native Indonesia, with about 200,000 HIV-positive people, the disease is extremely low on the government’s agenda, with just a fraction of the national budget invested in AIDS programmes.

“The Indonesian government is more and more responding to AIDS now, but it is not enough, we need more internal funding, not only external,” she said.

She pointed out that the report of the commission defines a new role for civil society irrespective of the political structure in Asian countries. Community organisations of people living with HIV and marginalised groups like sex workers, drug users, men who have sex with men and transgender people must be involved not just in delivery of services but at the policy-making level.

By spending 50 cents to one dollar per capita, 80 percent coverage of HIV prevention, treatment, and care and livelihood security programmes can be achieved, the commission said.

The report says that Asian countries have the resources, the technology, and organisational capacity for a vastly scaled up response to the AIDS epidemic. What is required is greater political will by the governments in Asia and meaningful involvement of community-based organisations in the response.

“We need to take a long-term view of the AIDS epidemic, which is not going to go away,” Piot said. “It’s been around for 26 years since [the HIV virus was first discovered],” he said. “That’s why we need to continue investing in R&D. So how we do it needs to be redefined.”