Linked with Nafis Sadik – Pakistan.
By Nafis Sadik – THE HIV/AIDS response in Asia Pacific has gained real momentum over the last year and a half. We have seen a change in the attitude of leaders in the region. It seems to me that there is an increasing acceptance that there is a problem, which needs to be addressed, and it is no longer enough just to look at HIV in terms of vulnerable groups.
However, this is not enough and we still need leaders to speak out more, and more loudly, about the HIV/AIDS epidemic. It is a difficult issue to talk about, but leadership at all levels needs to overcome their reluctance if a serious impact on this epidemic is to be made.
As the UN Special Envoy on HIV/AIDS, my role is to convince leaders to speak out. I want to support leaders across the region to identify the issues that need attention and to address these. For instance, the issue of vulnerability of women and girls – an issue, for which I have a special passion – in this region, where arranged marriage is very common. We face unique challenges in addressing the vulnerability of women to HIV. We need to ask, how do we address women’s needs? How do we protect them?
I want to encourage the leadership across Asia Pacific to look seriously at the needs of the most marginalised and most vulnerable groups – Men who have sex with Men (MSM), sex workers, intravenous drug users (IDU), and others. Even though in many countries the activities of these groups are illegal, we cannot ignore them. I am pleased to say that
governments are increasingly recognising that these groups need support. However, in many cases it remains difficult for NGOs and others to reach out to them. Therefore, I believe that we do need to look seriously at decriminalisation, in order to draw these groups into the HIV response.
Stigma and discrimination are very serious problems across our region. An issue of great concern is getting PLWHA voices heard at the policy level and within planning processes. The valuable contribution of PLWHA is being recognised to some extent, but they have not yet been given a full and active role.
Recently, we have seen a lot of press reporting around the world on access to treatment. But we need to be sure that we are not giving people the wrong impression about what is possible, and that we build an understanding that treatment and prevention must go together in a holistic programme. Many countries in Asia, as elsewhere, are now embarking on providing anti retroviral treatment to PLWHA in a serious way. This is a welcome move. But my role is to advise governments that any care or treatment must be part of larger prevention programmes. Providing treatment is not easy, and leaders should not present it as easy. There are significant cost implications; need of establishing health care infrastructures instituting good counselling and testing facilitates; and support for drug adherence. Leaders need to understand the complexity of treatment issues.
At the country level, my role is to advise governments and others on particular issues of national concern. For example, in India there is a need to focus more on condoms and condom promotion, and I am happy that there is an increasing move in that direction. My work is also to support the achievement of the 6th HIV/AIDS Millennium Development Goal, and to help countries measure and evaluate their progress towards this goal.
It is good to see that resources are coming into the region. We need to support countries to implement their programmes and use these resources effectively. This means improving international coordination to ensure that we do not place a burden on countries in administering international support. I am hopeful that with these increased resources, coordination and leadership, we will see some real results here in Asia Pacific. (Read on this UNDP page).