Urgent efforts needed to end AIDS in Asia Pacific

Jakarta—Ending AIDS as a public health threat in the Asia-Pacific region by 2030 can be achieved only if leaders take rigorous actions now to ensure necessary resources for human immunodeficiency virus responses and human rights protection, according to the global AIDS update from Joint United Nations Programme on HIV/AIDS (UNAIDS).

In the report, “The Urgency of Now: AIDS at A Crossroads,” the progress of some countries in reducing HIV infections and AIDS cases was acknowledged, but significant treatment gaps and the stigma still faced by people living with HIV were also highlighted.

With a new HIV infection every two minutes, governments in Asia-Pacific countries must urgently invest in prevention programs and community-led initiatives, the report suggested. Asia Pacific, home to 6.7 million people living with HIV in 2023, has the largest HIV epidemic in the world outside eastern and Southern Africa, according to Eamonn Murphy, UNAIDS director of regional support teams for Asia Pacific, Eastern Europe, and Central Asia.

“We must do more, and do it faster,” Murphy said during the regional launch of the 2024 global AIDS update.

The Asia-Pacific region accounted for a quarter of new HIV infections in the world in 2023, with 300,000 new infections. Men having sex with men, drug users, sex workers, and transgender people are among those at risk for HIV infection.

Progress to halt new infections have stalled since 2010, with the region seeing just a 13-percent decline in new infections, one-third the 39 percent global average. While AIDS-related deaths in the region has declined by half since 2010, it still translates to 17 people dying from an AIDS-related illness every hour. Nine youths aged between 15 and 24 lose their lives every day in what could be avoidable outcomes, UNAIDS suggested.

The 2024 estimates for the region indicate no significant change in the figures of both new infections and deaths between 2022 and 2023, “a serious warning sign that momentum has been lost, and that more has to be done,” Murphy said.

The report also found that six countries with increasing infections—Afghanistan, Bangladesh, Fiji, Laos, Papua New Guinea, and the Philippines—recorded growing death rates, while Indonesia, Mongolia, and Pakistan recorded an increase in AIDS-related deaths.

It also suggested that the “Undetectable = Untransmittable” (U=U) campaign had been a game-changer in lower viral transmissions, even though it was largely unknown to policymakers, health workers, and people living with HIV. The concept means that a person living with HIV who continues treatment and has an undetectable viral load cannot sexually transmit the virus.

Most cases of transmission involve people who do not know they have HIV. In some cases, transmission occurs among people with diagnosed HIV but who are not on treatment, and people who are on treatment but have not reached viral suppression.

Only 78 percent of people living with HIV globally were aware of their status in 2023, according to UNAIDS. Two-thirds of people with HIV were on antiretroviral treatment last year, with the remaining third not receiving the care and support they needed to stay healthy and prevent virus transmission.

In Indonesia, only 31 percent of people living with HIV were receiving treatment, higher than Pakistan (15 percent) but lower than the Philippines (43 percent) and Bangladesh (49 percent).

“We have a moral and a public health imperative to help people learn their status, provide testing, start them on treatment right away if they are positive, and to ensure that the treatment works completely and they’re able to access treatment throughout their lives,” Murphy said.

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Funding shortfalls were a key factor impeding progress, said Harry Prabowo, program manager at the Asia Pacific Network of People Living with HIV/AIDS and a representative of the Seven Alliance consortium of people living with HIV in the region.

“We need to sustain and increase investments to ensure that no one is left behind in this fight,” he said, as he called for renewed commitments to end the epidemic.

These efforts could include scaling up access to testing and treatment services, improving the services of HIV prevention programs for key populations, and ensuring comprehensive and sustained funding to close the resource gap.

“We need to address stigma and discrimination, and we do this by addressing the legal and society barriers. This includes implementing legal protections against discriminatory policies,” said Cecilia Oh, program adviser of the HIV, health, and development group of the United Nations Development Programme. The Jakarta Post/Asia News Network

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Elly Burhaini Faizal is a staff writer at The Jakarta Post.