It began with an honest self-assessment from a member of the Nepalese Parliament, Hon. Rajeev Shah, who told the audience gathered at a UNAIDS led Community Dialogue Space at the AIDS2014 conference in Melbourne, Australia, that leadership must be open and willing to listen to challenging subjects.
“We are Members of Parliament but we don’t know everything,” said Minister Shah. “MPs must listen and work with civil society to bring about rights-based changes to end HIV AIDS.”
In one of the most encouraging sessions at the AIDS2014 conference, Asia Pacific leaders demonstrated that the AIDS leadership movement has begun, with many leaders committing to championing the change needed to bring an ending of AIDS in their country.
Many traits make a good leader; brave and fearless; compassionate and thoughtful; forthright and directive; flexible and consultative. If Asia and the Pacific is to see an ending of AIDS as a public health threat by 2030, it requires brave and bold leadership to break down stigma and discrimination; to decriminalize punitive laws; to scale up testing and treatment programmes; and to work with community on targeted prevention and harm reduction strategies.
Being a champion of change can be seen as risky for politicians but for Papua New Guinea’s Health Minister, Hon. Michael Malabag, it’s an opportunity.
During the same UNAIDS led session, Minister Malabag publicly committed to introducing legislation to decriminalize sex work as a key reform to tackling HIV/AIDS in his nation.
The Minister’s forthright commitment to “remove the colonial era sodomy laws” and stand up for the rights and health of sex workers and men who have sex with men was applauded by the audience, which included politicians, activists and HIV researchers. “We must remove the stigma,” declared Minister Malabag. “We are all equal.”
Evidence shows that punitive laws push health issues underground and out of the reach of prevention, treatment and care programmes. According to the latest data, 19% of female sex workers and over 14% and 24%, respectively, among men and transgenders who sell and/or exchange sex in Port Moresby, PNG, is HIV positive.
By decriminalizing sex work and removing sodomy laws that outlaw gay sex, these key affected populations will be able to get tested, treated and cared for without the fear of persecution and discrimination, and help reduce the spread of new infections amongst their intimate partners and/or their clients.
A great leader is able to work with groups from opposing ideological positions and find a way forward for the betterment of the people. Religious leaders, parliamentarians, NGOs and the private sector need to work together as HIV is nondiscriminatory and knows no boundaries. Dialogue, inclusivity and partnerships can breakdown even the most politically sensitive issues, such as drug use.
Asia remains on the front line in The War on Drugs and has some of the toughest laws in relation to the use and possession of drugs in the world. Many offenses carry heavy consequences including life in prison and, in some cases, the death penalty. 11 countries in Asia and the Pacific enforce a mandatory detention policy for drug users and 15 countries impose the death penalty for some drug related offenses.
Even with the threat of heavy penalties, drug use continues across Asia, especially in urban centers. Evidence also shows where a zero tolerance policy is in effect; HIV prevalence amongst injecting drug users is very high. For example, in Kunming, China, over 25% of injecting drug users is HIV positive; while over 56% in Jakarta, Indonesia; and 48% in Hai Phong, Viet Nam.
The lack of real drug law reform in the region poses a major hurdle in reaching dug users that are at risk of HIV and drug resistant Hepatitis C with effective harm reduction and prevention programmes.
Indonesian MP Hon. Dr Okky Asokawati is fully aware of the challenge ahead to convince her parliament that drug law reform is in the national interest. Nevertheless, Dr Asokawati has made the commitment to work with evidence-based information to develop better drug users legislation to help the estimated 219,000 drug users in Indonesia access appropriate health care and harm reduction programmes. “I will keep up the fight to lift Indonesia’s health expenditure from the current 2.1% of national budget to the agreed 5%”, announced Dr Asokawati.
Promises are easy to make and much harder to deliver. We need to encourage and support our leaders who make commitments so they are able to realize the vision, and we are able to live in an equitable, safe and healthy society.
We have a fragile five-year window of opportunity. If we show leadership and act fast in our efforts by 2020, we will be on track to ending AIDS by 2030.