Closing the gap by putting key populations at the heart of the Asia-Pacific response to HIV/AIDS

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Media release from WHO

On World AIDS Day, the World Health Organization regional offices for South-East Asia and the Western Pacific are calling on Member States to recognize that in order to achieve the UNAIDS fast-track targets by 2020 with the aim of ending AIDS by 2030, key populations most vulnerable to HIV must be reached urgently. This implies that the communities most vulnerable to HIV are equal partners with governments in responding to the epidemic.

Nearly five million people were living with HIV in the Asia-Pacific region in 2013–about one-sixth of the global burden.  The regional HIV burden is the second highest after Sub-Saharan Africa with an estimated 350 000 new HIV infections in 2013. “Although HIV numbers have fallen in some countries, the epidemic is rising quickly in many others and is concentrated in key populations,” said Dr Shin Young-soo, WHO Regional Director for the Western Pacific. “Less than half of all HIV positive people across Asia and the Pacific are aware of their status and less than half of those who need antiretroviral drugs are taking them. Closing the HIV testing and treatment gaps can improve support and access to lifesaving medicine for those in need. Otherwise, we may not aspire to the global goal of ending AIDS by 2030.”

“We’ve seen that effective partnerships between health systems and key populations lead to greater access to HIV testing and lifesaving treatment, increased domestic resources for HIV/AIDS programmes and reduced stigma and discrimination,” said Dr Poonam Khetrapal Singh, WHO Regional Director for South-East Asia. “A collaborative approach results in better health outcomes. A prime example is WHO’s consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations, where significant input was provided by the key populations themselves.”

The guidelines, launched at the 20th International AIDS Conference in Melbourne in 2014, show the linkages between key populations, thereby helping governments and health-care providers strategize HIV programmes. Roll out of the guidelines across the Asia-Pacific region was recently discussed at a bi-regional meeting of government representatives, WHO, UNAIDS and community partners in Manila.

“HIV is devastating our communities, and the statistics are frightening” explained Midnight Poonkasetwattana, Executive Director, Asia Pacific Coalition on Male Sexual Health (APCOM), which advocates greater resources, research and a rights-based approach to HIV and other issues affecting men who have sex with men (MSM).  “Nine out of ten new HIV cases in Manila involve MSM. One out of three MSM in Bangkok is HIV positive. Most of China’s new HIV cases are MSM. Young people are especially at risk. This scenario is repeated elsewhere.  But even now, we don’t see adequate investment in most countries.” MSM and other key populations continue to be persecuted and stigmatized, driving the epidemic underground. “APCOM is pleased to collaborate with WHO in advocating for the consolidated guidelines to be adopted and implemented, but we hope that governments finally wake up to the crisis and address reality.”
WHO has long called for greater national, regional and global commitment to ensure adequate funding and resources to address HIV in key populations. Renewed focus and investment in the HIV response needs to be articulated in the post-2015 health and development agenda.

“Ultimately, we can only reach the fast-track targets by 2020 in Asia and the Pacific if 90% of key populations on treatment have suppressed viral loads,” said Dr Ying-Ru Lo, Coordinator, HIV, Hepatitis and Sexually Transmitted Infections, at the WHO Regional Office for the Western Pacific.  “Currently, we are far from reaching those targets. HIV testing is the entry point for treatment, but only around a third of key populations know their HIV status.”

“Reaching fast-track targets would avert almost 5 million new HIV infections and 3.5 million AIDS-related deaths in Asia and the Pacific between 2015 and 20130,” said Dr Razia Narayan Pendse, Advisor for HIV/STIs, WHO Regional Office for South-East Asia. “WHO is working to close the gaps and improve the continuum of HIV prevention, treatment and care. And we are doing so hand in hand with the key populations at the heart of the epidemic, to help safeguard the health and well-being of millions of people now and in the future.”

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