COMMUNITY networks tackling rising HIV infections in four Asia- Pacific countries are discussing innovative strategies and solutions to explore how they can accelerate progress and achieve sustainable results.
The Indo Pacific HIV Prevention programme aimed to lower new infections and address inequalities that were slowing progress toward ending AIDS in Cambodia, Indonesia, Papua New Guinea and the Philippines.
Last week, the Joint United Nations Programme on HIV/AIDS (UNAIDS) supported the teams to improve project implementation by leveraging lessons learned and strategising to address challenges in the final year of the three-year initiative.
The Australian department of foreign affairs and trade (DFAT) had allocated AU$11.65 million (about K27.12 million) over three years from 2021 to 2023 for the project led by UNAIDS to catalyse and accelerate separate investments by the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) in the region.
Among the strategies that the countries had used were community-led monitoring, pre-exposure prophylaxis, virtual interventions, self-testing and community testing.
Teams had also engaged in political advocacy and community capacity building to create a more enabling environment for people to access HIV services.
In Papua New Guinea and the Philippines, there were rising new HIV infections among key populations in the 15 to 24 age group.
Since 2010, new infections among young people had increased by 51 per cent in Papua New Guinea and 216 per cent in the Philippines.
A significant proportion of new infections in Cambodia (42 per cent) and Indonesia (48 per cent) were also among the young key populations.
This relatively new epidemic among young people stood alongside older, more established epidemics and required distinct approaches.
The Philippines had the fastest rising HIV epidemic in the region with new infections more than quadrupled since 2010.
New infections in Papua New Guinea had increased by 45 per cent since 2010 and there were acute challenges with respect to access to antenatal care and therefore, prevention of mother to child HIV transmission.
In Indonesia, more than two-thirds of people living with HIV were not accessing treatment.
The country also faced significant legal and policy challenges to expanding a human rights-based HIV response.
Cambodia had achieved almost universal treatment coverage for diagnosed people living with HIV.
It is now working to ensure that the remaining 14 per cent of people living with HIV became aware of their status.
“We have different countries, different epidemics and different intervention mix needs, but we need collective results,” UNAIDS regional director for Asia-Pacific Eamonn Murphy said.
“Epidemics don’t recognise borders and each country needed to respond to HIV in order to protect all the countries in the region.
“Strategic funding such as this makes larger investments work better.
“Let’s focus on the theory of change, ensuring we are not duplicating but complementing or accelerating other programmes.”
DFAT health adviser Joshua Metcalf-Wallach emphasised that the grant was intended to support a comprehensive approach across the region with knowledge of what work was being shared among the countries.
This would include coordination with broader national programmes and approaches supported by UNAIDS, the Global Fund and the US president’s emergency plan for AIDS relief (PEPFAR).
“We are working together to build something greater than the sum of its parts,” he said.
“I challenge you to question whether what was being proposed was just at the level of service delivery or whether you were focusing on achieving policy shift or change at a higher level.
“This was about finding the niche location where we can invest funding to create structural level changes.”
Global Fund’s senior disease adviser on HIV Treatment, Dr Vindi Singh reiterated that the project should have been synchronised with the countries’ Global Fund grants.
“As funding declines let us make sure that we are strategic,” she said.
“The Global Fund Strategy 2023 to 2028 called for us to speed up access to precision HIV prevention for those at highest risk.
“Over two days in Bangkok, Thailand, country teams and regional networks of people living with HIV and key population communities would review programmatic achievements and revise implementation plans for year three.
“They would also discuss the support required to improve grant implementation and enhance south-south collaboration between the countries.”
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