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REVIEW

What will it take to end AIDS in Asia and the Pacific region by 2030?

Eamonn Murphy A , Ye Yu Shwe https://orcid.org/0000-0003-2732-9810 A C , Reeta Bhatia A , Taoufik Bakkali A and Ravipa Vannakit B
+ Author Affiliations
- Author Affiliations

A Joint United Nations Programme on HIV/AIDS (UNAIDS), Regional Support Team, Asia and the Pacific, 9th Floor, Block A, United Nations Building, Rajadamnern Nok Avenue, Bangkok, 10200, Thailand.

B Independent researcher.

C Corresponding author. Email: shwey@unaids.org

Sexual Health 18(1) 41-49 https://doi.org/10.1071/SH20204
Submitted: 18 November 2020  Accepted: 18 January 2021   Published: 3 March 2021

Abstract

The 2016 global commitments towards ending the AIDS epidemic by 2030 require the Asia–Pacific region to reach the Fast-Track targets by 2020. Despite early successes, the region is well short of meeting these targets. The overall stalled progress in the HIV response has been further undermined by rising new infections among young key populations and the unprecedented COVID-19 pandemic. This paper examines the HIV situation, assesses the gaps, and analyses what it would take the region to end AIDS by 2030. Political will and commitments for ending AIDS must be reaffirmed and reinforced. Focused regional strategic direction that answers the specific regional context and guides countries to respond to their specific needs must be put in place. The region must harness the power of innovative tools and technology in both prevention and treatment. Community activism and meaningful community engagement across the spectrum of HIV response must be ensured. Punitive laws, stigma, and discrimination that deter key populations and people living with HIV from accessing health services must be effectively tackled. The people-centred public health approach must be fully integrated into national universal health coverage while ensuring domestic resources are available for community-led service delivery. The region must utilise its full potential and draw upon lessons that have been learnt to address common challenges of the HIV and COVID-19 pandemics and achieve the goal of ending AIDS by 2030, in fulfillment of the United Nations’ Sustainable Development Goals.

Keywords: Asia, Asia–Pacific region, community interventions, health services, HIV/AIDS, HIV treatment and prevention, key populations, public health, policy.


References

[1]  UN General Assembly. Political declaration on HIV and AIDS: on the fast track to accelerating the fight against HIV and to ending the AIDS epidemic by 2030. 2016. Available online at: https://www.unaids.org/sites/default/files/media_asset/2016-political-declaration-HIV-AIDS_en.pdf [verified 19 January 2021].

[2]  UNAIDS. Fast-track: ending the AIDS epidemic by 2030. 2014. Available online at: https://www.unaids.org/sites/default/files/media_asset/JC2686_WAD2014report_en.pdf [verified 19 January 2021].

[3]  UNAIDS. The gap report. 2014. Available online at: https://www.unaids.org/sites/default/files/media_asset/UNAIDS_Gap_report_en.pdf [verified 19 January 2021].

[4]  UNAIDS. Seizing the moment: tackling entrenched inequalities to end epidemics. 2020. Available at: https://www.unaids.org/sites/default/files/media_asset/2020_global-aids-report_en.pdf [verified 19 January 2021].

[5]  UNAIDS. UNAIDS data 2020. 2020. Available online at: https://www.unaids.org/sites/default/files/media_asset/2020_aids-data-book_en.pdf [verified 19 January 2021].

[6]  UNAIDS. UNAIDS terminology guidelines. 2015. Available online at: https://www.unaids.org/sites/default/files/media_asset/2015_terminology_guidelines_en.pdf [verified 19 January 2021].

[7]  UNAIDS. Fast-track commitments to end AIDS by 2030. 2016. Available online at: https://www.unaids.org/sites/default/files/media_asset/fast-track-commitments_en.pdf [verified 19 January 2021].

[8]  Vannakit R, Janyam S, Linjongrat D, Chanlearn P, Sittikarn S, Pengnonyang S, et al Give the community the tools and they will help finish the job: key population-led health services for ending AIDS in Thailand. J Int AIDS Soc 2020; 23 e25535
Give the community the tools and they will help finish the job: key population-led health services for ending AIDS in Thailand.Crossref | GoogleScholarGoogle Scholar | 32602660PubMed |

[9]  LINKAGES. Social network outreach – for HIV programs reaching at-risk populations online. 2019. Available online at: https://www.fhi360.org/sites/default/files/media/documents/resource-linkages-social-network-outreach.pdf [verified 19 January 2021].

[10]  Phanuphak N, Sungsing T, Jantarapakde J, Pengnonyang S, Trachunthong D, Mingkwanrungruang P, et al Princess PrEP program: the first key population-led model to deliver pre-exposure prophylaxis to key populations by key populations in Thailand. Sex Health 2018; 15 542–55.
Princess PrEP program: the first key population-led model to deliver pre-exposure prophylaxis to key populations by key populations in Thailand.Crossref | GoogleScholarGoogle Scholar | 30249317PubMed |

[11]  Macdonald V, Verster A, Baggaley R. A call for differentiated approaches to delivering HIV services to key populations. J Int AIDS Soc 2017; 20 21658
A call for differentiated approaches to delivering HIV services to key populations.Crossref | GoogleScholarGoogle Scholar | 28770592PubMed |

[12]  PATH. Improving access to HIV testing through lay providers and self-testing in Vietnam: bringing testing services closer to the communities that need them most. 2016. Available online at: https://path.azureedge.net/media/documents/ID_hm_hiv_cs.pdf [verified 19 January 2021].

[13]  Green K. HIV self-testing in Viet Nam: from pilot to program. The IAS Educational Fund Meeting – Overcoming Challenges in HIV with Science, Innovation and Collaborations in Southeast Asia; 4–5 October 2019; Kuala Lumpur, Malaysia. 2019. Available online at: https://www.iasociety.org/Web/WebContent/File/EduFund/Malaysia/08_KGreen.pdf [verified 22 January 2021].

[14]  Grimsrud A, Bygrave H, Doherty M, Ehrenkranz P, Ellman T, Ferris R, et al Reimagining HIV service delivery: the role of differentiated care from prevention to suppression. J Int AIDS Soc 2016; 19 21484
Reimagining HIV service delivery: the role of differentiated care from prevention to suppression.Crossref | GoogleScholarGoogle Scholar | 27914186PubMed |

[15]  National AIDS Control Organisation, Indian Council of Medical Research National Institute of Medical Statistics. India HIV estimates 2019 report. 2020. Available online at: http://naco.gov.in/sites/default/files/INDIA%20HIV%20ESTIMATES.pdf [verified 11 February 2021].

[16]  Reza-Paul S, Steen R, Maiya R, Lorway R, Wi TE, Wheeler T, et al Sex worker community-led interventions interrupt sexually transmitted infection/human immunodeficiency virus transmission and improve human immunodeficiency virus cascade outcomes: a program review from South India. Sex Transm Dis 2019; 46 556–62.
Sex worker community-led interventions interrupt sexually transmitted infection/human immunodeficiency virus transmission and improve human immunodeficiency virus cascade outcomes: a program review from South India.Crossref | GoogleScholarGoogle Scholar | 31295225PubMed |

[17]  Thai Red Cross AIDS Research Centre and FHI 360. Differentiated HIV-service delivery along the cascade for men who have sex with men and transgender women in Thailand: lessons learned from LINKAGES project. 2018. Available online at: https://differentiatedservicedelivery.org/Portals/0/adam/Content/ZrutobOVxk-Fze9x6KfQTA/File/1%20Thailand%20-%20Thai%20Red%20Cross%20AIDS%20Research%20Centre.pdf [verified 19 January 2021].

[18]  Shangani S, Escudero D, Kirwa K, Harrison A, Marshall B, Operario D. Effectiveness of peer-led interventions to increase HIV testing among men who have sex with men: a systematic review and meta-analysis. AIDS Care 2017; 29 1003–13.
Effectiveness of peer-led interventions to increase HIV testing among men who have sex with men: a systematic review and meta-analysis.Crossref | GoogleScholarGoogle Scholar | 28150501PubMed |

[19]  UNAIDS. Communities at the centre: defending rights, breaking barriers, reaching people with HIV services. 2019. Available online at: https://www.unaids.org/sites/default/files/media_asset/2019-global-AIDS-update_en.pdf [verified 19 January 2021].

[20]  World Health Organization. Consolidated Guidelines on the use of antiretroviral drugs for treating and preventing HIV infection. 2016. Available online at: https://apps.who.int/iris/bitstream/handle/10665/208825/9789241549684_eng.pdf?sequence=1&isAllowed=y [verified 19 January 2021].

[21]  García M, Duong Q, Mercer L, Meyer S, Ward P. ‘Never testing for HIV’ among men who have sex with men in Viet Nam: results from an internet-based cross-sectional survey. BMC Public Health 2013; 13 1236
‘Never testing for HIV’ among men who have sex with men in Viet Nam: results from an internet-based cross-sectional survey.Crossref | GoogleScholarGoogle Scholar | 24373483PubMed |

[22]  Green KE, Vu BN, Phan HT, Tran MH, Ngo HV, Vo SH, et al From conventional to disruptive: upturning the HIV testing status quo among men who have sex with men in Vietnam. J Int AIDS Soc 2018; 21 e25127
From conventional to disruptive: upturning the HIV testing status quo among men who have sex with men in Vietnam.Crossref | GoogleScholarGoogle Scholar | 30033557PubMed |

[23]  World Health Organization. WHO global strategy on people-centred and integrated health services-Interim report. 2015. Available online at: https://apps.who.int/iris/bitstream/handle/10665/155002/WHO_HIS_SDS_2015.6_eng.pdf?sequence=1 [verified 19 January 2021].

[24]  Pantelic M, Stegling C, Shackleton S, Restoy E. Power to participants: a call for person-centred HIV prevention services and research. J Int AIDS Soc 2018; 21 e25167
Power to participants: a call for person-centred HIV prevention services and research.Crossref | GoogleScholarGoogle Scholar | 30334609PubMed |

[25]  UNAIDS. COVID-19 and HIV: 1 moment, 2 epidemics, 3 opportunities – how to seize the moment to learn, leverage and build a new way forward for everyone’s health and rights. 2020. Available online at: https://www.unaids.org/sites/default/files/media_asset/20200909_Lessons-HIV-COVID19.pdf [verified 19 January 2021].

[26]  Vannakit R, Andreeva V, Mills S, Cassell MM, Jones MA, Murphy E, et al Fast-tracking the end of HIV in the Asia Pacific region: domestic funding of key population-led and civil society organisations. Lancet HIV 2020; 7 e366–72.
Fast-tracking the end of HIV in the Asia Pacific region: domestic funding of key population-led and civil society organisations.Crossref | GoogleScholarGoogle Scholar | 32386723PubMed |

[27]  UNAIDS, Stop AIDS Alliance. Communities deliver: the critical role of communities in reaching global targets to end the AIDS epidemic. 2015. Available online at: https://www.unaids.org/sites/default/files/media_asset/UNAIDS_JC2725_CommunitiesDeliver_en.pdf [verified 19 January 2021].

[28]  Partnership to Inspire Transform and Connect the HIV response (PITCH), BridgingTheGaps, aidsfonds. Fast-track or off track: how insufficient funding for key populations jeopardises ending AIDS by 2030. 2020. Available online at: https://aidsfonds.org/assets/resource/file/Fast-Track%20or%20Off%20Track%20report-final.pdf [verified 19 January 2021].

[29]  UNAIDS. HIV and universal health coverage: a guide for civil society. 2019. Available online at: https://www.unaids.org/sites/default/files/media_asset/hiv-uhc-guide-civil-society_en.pdf [verified 19 January 2021].

[30]  UNAIDS. Legal and policy trends: impacting people living with HIV and key populations in Asia and the Pacific 2014–2019. 2021. Available online at: https://www.unaids.org/sites/default/files/media_asset/legal-and-policy-trends-asia-pacific_en.pdf [verified 22 January 2021].