Asia and the Pacific can end AIDS by equalizing access to rights and services
BANGKOK, 1 December 2022—The 2022 UNAIDS World AIDS Day report reveals that inequalities are obstructing the end of AIDS. On current trends the world will not meet agreed global HIV targets. However, urgent action to tackle inequalities can get the AIDS response on track.
Dangerous Inequalities unpacks the impact on the AIDS response of gender inequalities, inequalities faced by key populations, and inequalities affecting children. It also sets out how worsening financial constraints are making it more difficult to address those challenges.
“What world leaders need to do is crystal clear,” said Winnie Byanyima, UNAIDS’ Executive Director. “In one word: Equalize. Equalize enjoyment of rights, equalize access to services, equalize access to the best science and medicine. Equalizing will not just help the marginalized. It will help everyone.”
Status of the epidemic in Asia and the Pacific
In 2021 there were an estimated six million people living with HIV in the Asia Pacific region. Last year there were an estimated 260,000 new infections and 140,000 AIDS-related deaths. In 2021 three-quarters (76%) of people living with HIV in Asia Pacific were diagnosed. Two-thirds (66%) of all people living with HIV were on treatment and 60% of all people living with HIV were virally suppressed. Despite scale-up in treatment coverage, the region lags behind the global average (75%). A key priority for many countries is closing the gap between the number of people who have been diagnosed and those on treatment.
Between 2010 and 2021 new HIV infections in the region declined by 21%. However, this masks huge variations between nations. While the epidemic is declining in several Asia Pacific countries, there are rebounds in others (Afghanistan, Bangladesh, Fiji, Malaysia, Papua New Guinea, the Philippines and Timor-Leste).
In 2021 96% of new infections were among key populations (gay men and other men who have sex with men, sex workers, transgender people, people who use drugs) and their partners. Most of these cases were in gay and other men who have sex with men (46%). Additionally, 26% of new HIV cases in the region last year were among young people ages 15 – 24, mostly key populations.
Highlights of regional report launch
“When we address epidemics, it is important to look at sub-categories of the population to see who is being left behind and remove inequalities so we can ensure the epidemic remains under control,” said Taoufik Bakkali, Regional Director a.i. of UNAIDS Asia Pacific at the regional launch of the report in Bangkok yesterday. “You cannot achieve the HIV testing and treatment targets when you have high levels of criminalization, gender-based violence and policies that are discriminatory or do not allow people at risk to access services.”
His Excellency Ieng Mouly, Senior Minister and Chair of the Cambodia National AIDS Authority, noted that the Cambodian Policy to Eliminate AIDS includes a raft of measures including increased national investments, deepened community engagement, international cooperation to close prevention gaps and increasing access to social security and healthcare for vulnerable people.
Mr Mouly also expressed support for the Association of Southeast Asian Nations (ASEAN) recent Declaration on Ending Inequalities and Getting on Track to End AIDS by 2030.
“This Declaration can strengthen our ASEAN cooperation with exchanges and learning from each other about how to invest efficiently using domestic financing,” he said.
Doan Thanh Tung, Executive Director of Lighthouse Social Enterprise, emphasized the importance of community leadership in the design, delivery and monitoring of HIV prevention, testing, treatment and care services.
“We have to understand the key problems and barriers that are affecting access and people’s experiences when using services. We serve the person, not treat a disease. Because of that, we need to involve the key populations and people living with HIV in all service delivery,” he said.
Chief Executive Officer of the Scarlet Alliance in Australia, Jules Kim, stressed that removing legal and structural barriers is an important aspect of ensuring key populations have access to prevention, treatment, care and support.
“There is a long history of successful key population- and community-led responses in HIV, but these are poorly resourced and poorly engaged with,” Ms Kim explained. She called for increased investment in community advocacy and change-making work.
Kathryn Johnson, Law, Policy and Health Advisor for the UNDP Bangkok Regional Hub, called for more broad engagement to reduce harmful laws.
“We need a bottom-up approach. We need members of communities to inform the law and policy work and for all the different actors to be involved so we have diverse perspectives, including people’s lived experiences,” she said.
To end inequalities affecting the HIV response in Asia Pacific and get the response back on track to end AIDS by 2030, UNAIDS has four strategic priorities:
- Renew and intensify the focus on key populations in policies and programmes
- Modernize HIV service delivery
- Eliminate the barriers to equitable programme coverage for the most marginalized communities
- Mobilize sustainable domestic financing for prevention