In Asia and the Pacific 300 000 people were newly infected with HIV and 160 000 died of AIDS-related illnesses in 2019. Key populations and their partners accounted for an estimated 98% of new HIV infections, and more than one quarter of new HIV infections were among young people (aged 15 to 24 years).The response could be set back further if the COVID-19 pandemic results in severe disruptions to HIV services.

Bangkok, Thailand, 7 July 2020—A new report by UNAIDS shows highly unequal progress in Asia and the Pacific region. Because the achievements have not been shared equally within and between countries, the global HIV targets set for 2020 will not be reached. The report, Seizing the moment, warns that even the gains made could be lost and progress further stalled if we fail to act. It highlights just how urgent it is for countries to double down and act with greater urgency to reach those that are still left behind.

In Asia and the Pacific, 3 countries, including Australia, Cambodia and Thailand, have achieved the 90–90–90 HIV treatment targets (with a minimum of 73% of people living with HIV having suppressed viral loads).

Thousands of lives and new infections have been saved by the scale-up of antiretroviral therapy. However, 160 000 people died of AIDS-related illnesses last year and 3.5 million of the 5.8 million people living with HIV were accessing the life-saving treatment.

The region is far behind in preventing new HIV infections. Some 300 000 people were newly infected with the virus. There has been progress in the region, where new HIV infections have reduced by 12% since 2010, with reductions in Cambodia, Myanmar, Thailand and Viet Nam. However new HIV infections are on the rise in Pakistan and the Philippines.

The new report shows unequal progress, with too many vulnerable people and populations left behind. In Asia and the Pacific 98% of new HIV infections occurred among key populations and their sexual partners, including gay men and other men who have sex with men, transgender people, sex workers, and people who inject drugs, despite them constituting a very small proportion of the general population. More than one quarter of new HIV infections were among young people (aged 15 to 24 years).

“Key populations continue to be insufficiently served by HIV prevention programmes,” warns Eamonn Murphy, UNAIDS Regional Director for Asia and the Pacific. “Some progress has been made in introducing innovative prevention tools, such as pre-exposure prophylaxis (PrEP) and a small minority of countries have both high coverage of needle–syringe programmes and moderate coverage of opioid substitution therapy. But we need to do more. Countries need to listen to the evidence, step up and bring innovation to scale,” he stresses. About half of key populations living with HIV are not aware of their HIV status, but assisted testing and self-testing could increase the rates of HIV diagnosis.

Stigma and discrimination, together with other social inequalities and exclusion, are proving to be key barriers. Marginalized populations who fear judgement, violence or arrest struggle to access sexual and reproductive health services. Stigma against people living with HIV is still commonplace.

The COVID-19 pandemic is impacting the AIDS response and could disrupt it more. COVID-19 lockdowns have had a big effect on women and girls and key populations. Sex workers, transgender men and women, people who use drugs and gay men have lost livelihoods, faced violence and often are scapegoated as the transmitters of COVID-19. There have been reports of gay men and other men who have sex with men being scapegoated or harassed in the Philippines and South Korea. India reported double the usual number of domestic abuse cases in the first week of the nationwide movement restrictions, according to the country’s National Commission for Women. These challenges are creating even greater barriers to services for HIV and other health needs.

But community resilience and innovation has shown the way in mitigating the impact of COVID-19 on HIV. “Community-led innovations are helping to resolve issues related to HIV service interruptions in many parts of the region. Community organizations must be included and supported in national COVID-19 responses,” says UNAIDS Regional Director for Asia and the Pacific. In Cambodia, female members of the Antiretroviral Users Association maintained their counselling services for their peers during the lockdown. In Nepal, community organizations and people living with HIV delivered HIV medicines directly to homes during the lockdown. Adherence support was provided virtually via social media apps. COVID-19 spurred the implementation of multimonth dispensing of antiretroviral medicines in Thailand.

UNAIDS is also urging countries to increase investments in both diseases. All international sources of HIV funding declined by 63% from 2010 to 2019, including a 14% fall in United States Government bilateral funding, a 28% decline in Global Fund contributions and a 28% decline in funding from other international sources. These declines mostly affect HIV prevention services for key populations, which are heavily dependent on international funding, while domestic resources often prioritize funding for HIV treatment and care.

“The AIDS epidemic remains a global crisis fueled by inequalities that demands that we double down, build on our successes and act with greater urgency to reach the millions still being left behind,” states Eamonn Murphy, UNAIDS Regional Director for Asia and the Pacific.

Contacts

UNAIDS Regional Office for Asia and the Pacific | Michela Polesana | tel. +66 9445194092 | polesanam@unaids.org

About UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

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