Suvendrini Kakuchi* – IPS/TerraViva
COLOMBO, Aug 19 2007 (IPS) – The 8th International Congress on AIDS in Asia and the Pacific (ICAAP) opened here with a strong message of hope, anchored on the fact that the world s most populous region still has relatively low prevalence rates of HIV despite problems of poverty, discrimination and stigma.
Some 2,500 participants from 70 countries are in the capital of this South Asian island nation for the congress, which runs from Aug. 19 to 23. Academics, health experts, activists and people living with HIV and AIDS will focus on assessing the pandemic in the region, sharing lessons learned and looking at efforts to contain it.
Speaking before a packed Bandaranaike Memorial International Conference Hall on Sunday evening, Sri Lankan President Mahinda Rajapakse said that the region can take heart in the fact that high literacy rates in some countries, social welfare programmes and increased understanding have contributed to success stories in containing the pandemic.
At first glance, it may seem that there is no threat to us, he said. But low prevalence does not mean no threat, he cautioned, referring to the case of Sri Lanka.
Sri Lanka has a low prevalence rate of 0.1 percent in a population of 20 million. Up to June 2007, 886 persons had been diagnosed as HIV-positive, official figures say, although estimates of the number of people living with HIV in the country was 4,500 at end-2005. Comparatively small as this figure is, in the international context of this great menace, we will not pat ourselves on our backs. For every death is one too many. Every victim is one too many, said Rajapakse.
But Sri Lanka will not have a general epidemic and HIV/AIDS in the country, although it has all the factors normally conducive to a high escalation of AIDS victims , he added.
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I invite all leaders in Asia-Pacific region to join together in harmonising our leadership approaches across the Asia and Pacific region and improve the lot of all our people in the face of the advancing danger of HIV and AIDS, Rajapaksa said. The challenge of HIV/AIDS is so great that we as political leaders must give it the highest priority, because denial of the crisis can have serious consequences on economic development, social advancement and very future of our societies.
Both UNAIDS executive director Peter Piot, whose remarks were read by hid deputy Deborah Langley, and Michel Kazatchkine, head of the Global Fund To Fight AIDS, Tuberculosis and Malaria, agreed that political will is a vital element in Asia-Pacific s handling of the pandemic.
A purely health-centred approach is not adequate in tackling HIV and AIDS, Langley said in an afternoon media briefing before ICAAP opened. She said that the Asia-Pacific, given its relatively low prevalence rates, must focus on keeping these rates low, provide treatment to those who need it, and combine this with strengthening health systems as well. According to World Health Organisation (WHO) figures, between 2.8 and 9.8 million people were living with HIV in Asia in 2006. Between 140,000 and 610,000 people died from AIDS-related illnesses that same year.
But at the same time, it said that the number of people receiving antiretroviral therapy has risen by more than three-fold since 2003 and had reached some 235,000 people by June 2006. This is about 16 percent of the total number of people in need of antiretroviral treatment in Asia.
Still, many said, complacency must not become a barrier to the urgent need for further prevention work ahead.
Speaking in Sinhala, HIV-positive activist and president of the Lanka Plus group, Princey Mangalika, attested to the host of issues that still need to be overcome to make the region a real success story in dealing with the pandemic.
Managlika pointed to the lack of hospitals in Sri Lanka that can treat patients living with HIV and also asked for increased free treatment, especially in rural areas. These problems are common in Asia and governments need to step-up better programmes, she said.
Yet another issue facing sufferers is discrimination and stigma, still rampant in Asian societies. Experts pointed out how such attitudes contribute to the spread of the disease, because people avoid testing in order to protect themselves from social ostracism. They also outlined the importance of focusing on groups of people vulnerable to HIV, ranging from migrants to married women.
Infrastructure development in the transport sector, for example, has encouraged the movement of people who, in search of better paid jobs, migrate and leave their families behind. This situation contributes to HIV infection when men visit sex workers and return home to pass on the disease to their wives.
The movement of women such as from Sri Lanka and the Philippines, where around 60 percent or more of migrant workers are female, leaves this sector at high risk.
Langley also noted some positive trends in HIV and AIDS in the past few decades. While funds going into HIV and AIDS used to be just 250 million US dollars a year in 1996, the amount to be spent on AIDS in 2007 is expected to reach 10 billion dollars for low and middle-income countries. Still, this figure is far from the estimated 18 billion dollars needed in the global response to the pandemic, she said.
She added that countries in the region must get to know your epidemics at the national level, adding that beyond national average figures, there is a need to address trends that show higher prevalence rates in some regions of a country, or among specific groups of people.
For instance, 39 percent and 46 percent of new infections in Cambodia and Thailand, respectively, are among married women. Sometimes, prevalence rates are rising for what we thought were low-risk groups, Langley explained.
In Vietnam, the HIV prevalence rate is low but the pandemic is present in all 64 provinces and is higher in some communities than in others, Langley added.
(*Terra Viva is an IPS publication)
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