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Prescription for HIV/AIDS Pandemic
| Re: International Congress on AIDS in Asia & the Pasific
9-13 August 2009
From Australia.To News |
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| BALI, Aug 13 (IPS) - The prescription that thousands of participants effectively issued at a just-ended AIDS conference here was clear: It is time to fight social and political
inequities so that the medical gains in curbing HIV and AIDS can work with
maximum efficacy.
The recognition that it is time to look far beyond the medical and scientific
dimensions of the region's battle against HIV and AIDS is the theme that
flowed through the more than 200 sessions at the 9th International
Conference on AIDS in Asia and the Pacific (ICAAP).
There were many more sessions in the Aug. 9-13 conference addressing
issues such as stigma and discrimination, sexuality and gender, resource
shortages, community involvement, harm reduction, human rights, men who
have sex with men, drug users, and laws that criminalise behaviour by certain
groups - rather than medical therapies.
In closing ICAAP at the Bali International Convention Centre, World Health
Organisation Regional Director for Southeast Asia Samlee Plianbangchang,
dedicated more time to the social aspects of the epidemic rather than the
biomedical ones during his remarks.
”Equity and social justice are of paramount importance for responding to the
HIV/AIDS epidemic,” Samlee told the some 3,600 participants at the
conference. His remarks reflected how HIV is as much as social and
development disease as it is a medical one.
”HIV remains one of the most formidable public health challenges of our
times. In the Asia-Pacific region, HIV affects mostly vulnerable and difficult-
to-reach populations, especially sex workers, men who have sex with men
and injecting drug users,” he said.
It is because of this characteristic of the epidemic - there are 5 million people
living with HIV and AIDS in the region - that special efforts need to be made
to change societal attitudes so that hard-to-reach groups get the same
opportunity to know about and be treated for the infection.
”The main message has been that to address AIDS, we need to tackle the
socio-political and economic inequities that drive the epidemic and restrict
access to information, treatment and care,” Rosalia Sciortino, professor at
Thailand's Mahidol University and the chairwoman of the social track of
ICAAP, said in an interview.
Addressing the ”structural conditions” of the epidemic would help reduce the
gaps between North and South, rich and poor, women and men, among
diverse sexual communities, majority and minority populations, among
citizens and non-citizens, and among migrants and refugees, she said.
”Social change is needed to control AIDS,” Sciortino pointed out. ”Groups are
not born vulnerable, but are made vulnerable by societies that marginalise
and exploit them.”
Groups like drug users, sex workers and men who have sex men - often
stigmatised as not deserving of attention or treatment or as bring social ills -
have been falling through the cracks, despite major gains made over the last
decade in increasing the numbers of people with HIV who have access to
anti-retroviral therapy.
The discussion around HIV and AIDS used to be more along the lines of
'access for all,' which was the theme of the International AIDS Conference in
Bangkok, Thailand in 2004.
Overall, the Asia-Pacific has seen the number of people getting anti-
retrovirals increase more than threefold from 2003 to some 565,000 today,
according to Joint United Nations Programme on HIV/AIDS (UNAIDS) figures.
Worldwide, the number of people on anti-retroviral therapy stands at 4
million.
Many U.N. officials stressed this week that the region is poised to meet by
next year the targets of universal access to treatment - agreed upon by the
world's governments in 2006.
Among the better performers are countries like Thailand, Laos and Cambodia,
where more than 80 percent of the people who need anti-retrovirals get
them.
In many countries too, Samlee explained, progress in national response to the
AIDS epidemic over the last two decades is being reflected in declines or
levelling off of HIV prevalence, and longer life spans among those with the
virus.
But, alongside the positive overall figures, statistics also show worrisome
trends. These include increasing infections especially among men who have
sex with men, and also among intravenous drug users.
About a third of men who have sex men report having been harassed in some
way, studies say, making it difficult for them to be reached by prevention and
treatment campaigns. In Asia, Indonesia has the highest proportion of drug
users infected with HIV, at 60 percent, followed by Burma at nearly 50
percent.
Then there are groups like women, especially those in intimate relationships
whose partners engage in risky behaviour and infect them.
Women make up 35 percent of all new infections among adults in Asia, up
from 17 percent in 1990. UNAIDS also says that more than 90 percent of
women living with HIV acquired the virus from their partners in long-term
relationships.
Looking ahead, Samlee encouraged HIV researchers to be aware of social
gaps in working on responses to the pandemic. ”Research addressing equity
and benefitting marginalised populations should receive high priority,” he
added.
ICAAP also saw discussions around conservative approaches to religion and
gender biases that make it even more difficult to reach and address the needs
of the weakest, most shunned groups.
However, there were not many representatives from conservative religious
groups at the conference, or many representatives from the pharmaceutical
sector - which drew a lot of flak here this week. For instance, activists staged
lightning protests Wednesday to demand a stop to patents on HIV drugs.
For future conferences, Sciortino proposed a more open and ”more daring”
discussion of sexuality and touchy issues such as condoms and safe sex.
But participants like Monica Abo from Fiji said that AIDS conferences over the
years have already done a lot of talking, referring to past ICAAPs such as the
last one in 2006 in Colombo, Sri Lanka, where the theme was 'Waves of
Change, Waves of Hope.'
From the theme of this year's ICAAP here in Bali, which is 'Strengthening
Movements, Empowering Networks,' she suggested that perhaps the next
ICAAP should have the slogan 'Less Talk, More Action.”
Held once every two years, the next ICAAP will be held in Busan, South
Korea. |
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