Publications

From July 2001 to November 2002, the Asia Pacific Network of People Living with HIV/AIDS (APN+) conducted the first regional documentation of AIDS-related discrimination in Asia. The project is an action-based, peer-led study that aimed to develop an understanding of the nature, pattern and extent of AIDS-related discrimination in several Asian countries. The project was designed and implemented by people living with HIV (positive people) and received ethical approval and funding from UNAIDS. This study generated quantitative and qualitative data. Trained positive people interviewed 764 of their positive peers in four countries (India 302; Thailand 338; the Philippines 82; Indonesia 42). Findings indicate that AIDS-related discrimination is prevalent in every sector of society.

Thailand has shown that a well-funded, politically supported and shrewdly-implemented response can change the course of the HIV/AIDS epidemic. After peaking at 143,000 in 1991, the annual number of new HIV infections has fallen to about 19,000 in 2003 – making Thailand one of a handful of countries to have reversed a serious HIV/AIDS epidemic. The national adult HIV prevalence continues to edge lower, with the latest estimates pegging it at a little over 1.5 percent at the end of 2003. This astounding achievement translates into millions of lives saved. This report is a powerful account of how Thailand has managed to achieve Millennium Development Goal 6 – to halt and begin to reverse the spread of HIV/AIDS by 2015 – well in advance of schedule, and what now needs to be done to sustain this extraordinary achievement.

In two decades HIV/AIDS has evolved from a medical curiosity to a worldwide human tragedy and an international emergency. It is a development disaster and a security crisis with social impacts more devastating than any war. It has reduced life expectancy by 15 years in sub-Saharan Africa and created more than 14 million orphans. Its impact is wide-reaching, and even in those parts of the world where the epidemic has been relatively slow to evolve, there are worrying signs of its gathering strength. It has spread nearly everywhere beyond the first so-called high-risk groups, today principally affecting vulnerable populations: the poor, the marginalized, young women and children. It both thrives on and fuels inequalities. Although there are signs of hope — some evidence that political commitment and energetic multisectoral programmes can slow the progression, some encouraging developments in the supply of treatment and care — measures to contain the epidemic or mitigate its effects take time. The effects of HIV/AIDS, even if the situation improves in the near future, will be with us until the end of this century.

Lao PDR is currently experiencing a period of rapid social change associated with the transition to a market economy and closer regional integration. A number of significant child and youth protection issues have emerged in recent years, including child trafficking, sexual exploitation and abuse, HIV/AIDS, children in conflict with the law, substance abuse and street children. While it is difficult to make accurate projections, the indications are that the number of vulnerable children in Lao PDR will increase over the next five to ten years. In this context, it is imperative that immediate action is taken to identify effective strategies for the care and protection of vulnerable children.

In facing up the scourge of HIV/AIDS, the Malaysian Government has initiated actions well before the first case of HIV was detected in 1986. An inter-sectoral committee chaired by the Director-General of Health, known as the National HIV/AIDS Task Force was formed in 1985, to be the body responsible for formulating policies, strategic action plans as well as coordinating the HIV/AIDS prevention and control programs in the country at that time.

AIDS is one of the priority diseases of the National Health Plan of Myanmar. The National Health Committee has laid down clear guidelines to fight AIDS as a national concern. The National AIDS Committee, founded since 1989 is an active multisectoral body for formation of National Strategic Plan to prevent and control HIV/AIDS in Myanmar.

The Long-Term Strategic Framework of the Asian Development Bank (ADB) commits it to supporting the pursuit of Millennium Development Goals (MDGs) in the region and in ADB’s developing member countries (DMCs). MDG 6 is to halt and begin to reverse the spread of human immunodeficiency virus (HIV) and acquired immune deficiency (AIDS) by 2015. However, progress in this direction has not been encouraging and there is great concern that the number of people infected in the Asia and Pacific region and in particular countries, including Viet Nam, could still significantly grow. The Government of Viet Nam has requested ADB's support for an HIV/AIDS focused activity that will focus on youth and behavior change communication (BCC) strategies. The proposed activity is a key part of the Government's national AIDS strategy that to date is not well-supported by national or international financial resources. The proposed targeting of the youth, capacity building, and leadership advocacy using innovative approaches according to the national strategy is consistent with ADB’s proposed strategic directions in HIV/AIDS and fits in ADB’s country strategy.

HIV prevalence in the country during the period January-December 2004 based on sentinel surveillance data.

Generally, national HIV prevalence in China remains low, but clusters of high prevalence exist, both geographically and among specific sub-groups. By the end of 2003, the cumulative number of HIV cases was estimated 840,000, corresponding to a total prevalence rate of 0.07%. By the end of September 2004, the cumulative number of reported HIV positive cases was 89,067, with significant increases in reported infections since 2002. On December 1, 2003, the China Ministry of Health and the UN Theme Group on HIV/AIDS jointly issued an Assessment of HIV/AIDS Prevention, Treatment and Care in China. Given the rapid changes that have occurred since that date, it was decided that an update of the Joint Assessment Report would be prepared by representatives of the State Council AIDS Working Committee Office and the UN system, covering the period to December 1, 2004.

In 2003, more than 5 million people were newly infected with HIV – as many as 700,000 (13%) of them were children. Six hundred and thirty thousand (95%) of these new infections were caused through mother-to-child transmission, and 90% of the infected children live in sub-Saharan Africa. AIDS case reporting is unreliable, however it is estimated that 500,000 children are currently in need of antiretroviral therapy (ARV) world wide. In 2003 some 490,000 child deaths under age 14 were due to AIDS, and an estimated 17% of all AIDS deaths were among children. There are 7 countries where AIDS accounts for more than 10% of the under five mortality. The best way to address paediatric HIV infection is to significantly reduce the proportion of children acquiring infection as has happened in most developed countries to date. UNICEF and WHO convened a meeting of technical experts to urgently identify ways and mechanisms to overcome the key obstacles to access of appropriate, acceptable, and affordable ARV formulations for children.