Reassesing HIV/AIDS Prevention In Asia

Introduction –

Since its establishment in 1996, UNAIDS has supported comprehensive approaches to HIV prevention, applying a combination of strategies that respond to actual needs. Countries should determine the right combination of HIV prevention interventions through an analysis of the current epidemic and the state of the national response. Part of this analysis should include an understanding of the effectiveness in the relevant populations and settings. This approach was endorsed by the member states when they adopted the UNAIDS policy position paper on intensifying HIV prevention in June 2005.

UNAIDS advocates that countries implement HIV prevention programmes that will be truly effective in reducing new HIV infections. This requires a strategic combination of interventions that address populations that are at risk or vulnerable for transmission and that utilize behavioral and social change methods that are appropriate and informed by the latest evidence.

The word “only” doesn’t work for AIDS—whether it’s for treatment only, HIV prevention only, condoms only, abstinence only or male circumcision only. In reality we need it all—a truly comprehensive approach. For UNAIDS, the three pillars of a comprehensive and effective AIDS response, as we move towards universal access, are HIV prevention, treatment and care and support.

The risk of HIV infection and its impact feeds on violations of human rights, including discrimination against women and marginalized groups such as sex workers, people who inject drugs and men who have sex with men. HIV also frequently begets human rights violations such as further discrimination and violence. Over the past decade the critical need for strengthening human rights to effectively respond to the epidemic and deal with its effects has become evermore clear. Protecting human rights and promoting public health are mutually reinforcing.

Several countries still have policies that interfere with the accessibility and effectiveness of HIV-related measures for prevention and care. Examples include laws criminalizing consensual sex between men, prohibiting condom and needle access for prisoners, and using residency status to restrict access to prevention and treatment services. At the same time, laws and regulations protecting people with HIV from discrimination are not enacted, or fully implemented or enforced.

Reforming laws and policies that are based in deeply-rooted social attitudes and norms such as gender inequality requires multisectoral collaboration. Although not sufficient to change social attitudes, legislation is important for addressing acts of discrimination. Civil society, including organizations of people living with HIV, as well as other parts of society, including police and justice systems, have a critical role to play. International organizations and donors can also play a positive role in support of local and national actors.

The protection of human rights, both of those vulnerable to infection and those already infected, is not only right, but also produces positive public health results against HIV. In particular, it has also become increasingly clear that:

  • National and local responses will not work without the full engagement and participation of those affected by HIV, particularly people living with HIV.
  • The human rights of women, young people and children must be protected if they are to avoid infection and withstand the impact of HIV.
  • The human rights of marginalized groups (sex workers, people who use drugs, men who have sex with men, prisoners) must also be respected and fulfilled for the response to HIV to be effective.
  • Supportive frameworks of policy and law are essential to effective HIV responses.

Reaching the Millennium Development Goal on HIV/AIDS – to halt and reverse the spread of the epidemic by 2015 – requires far greater access to HIV prevention services and AIDS treatment, care and support than is currently available.

A United Nations General Assembly resolution adopted on 23 December 2005 requested UNAIDS and its co-sponsors to assist in “facilitating inclusive, country-driven processes, including consultations with relevant stakeholders, including non-governmental organization, civil society and the private sector, within existing national AIDS strategies, for scaling up HIV prevention, treatment, care and support with the aim of coming as close as possible to the goal of universal access to treatment by 2010 for all those who need it.”

As per the commitments made in the Political Declaration on HIV and AIDS adopted in June 2006, countries around the world are currently in the process of revising their national AIDS plans and targets so as to significantly scale up their response to AIDS towards universal access to HIV prevention, treatment, care and support by 2010.

Gender comprises widely held beliefs, expectations, customs and practices within a society that define ‘masculine’ and ‘feminine’ attributes, behaviours and roles and responsibilities. Gender is an integral factor in determining an individual’s vulnerability to HIV infection, his or her ability to access care, support or treatment, and the ability to cope when infected or affected by HIV.

Gender inequality both fuels and intensifies the impact of the HIV epidemic and is most effectively addressed on the national and community level. In the context of HIV prevention, treatment, care and mitigation, this reinforces the need for interventions that are directed at individual people. Reducing gender inequality requires changing social norms, attitudes and behaviours through a comprehensive set of policies and strategies.

At the 2006 High Level Meeting on AIDS, all member states of the United Nations have pledged “to eliminate gender inequalities, gender-based abuse and violence” and to “increase the capacity of women and adolescent girls to protect themselves from the risk of HIV infection, principally through the provision of health care and services, including, inter alia, sexual and reproductive health, and the provision of full access to comprehensive information and education.”

Every minute of every day, a child under the age of 15 becomes infected with HIV. Children under 15 account for one in six AIDS-related deaths worldwide and one in seven new HIV infections – the vast majority through mother-to-child transmission, which can occur in the womb, during birth or through breastfeeding. Ninety percent of the more than 5 million children who have been infected were born in Africa.

And the number of children becoming infected with HIV is rising in other parts of the world. In the worst-affected countries, AIDS is now the biggest single cause of death among the under 5s, and is threatening to reverse years of hard-won progress in reducing child mortality.

Other causes of HIV infection in children are contaminated blood products or syringes and, particularly in the case of young girls, sexual abuse.

Prevention of childhood HIV, therefore, requires action on numerous levels, starting with HIV prevention and family planning for women of childbearing age.

In many areas of the world, the HIV epidemic has had a serious effect on human development, undermining progress towards the United Nations Millennium Development Goals, particularly those related to poverty reduction, achieving universal primary education, promoting gender equality, reducing child mortality and improving the health of mothers. This, in turn, has left people who are already vulnerable, such as women and girls, young people and children, refugees and internally displaced persons, and people who migrate among others, at even higher risk of acquiring HIV.

The global and national response to HIV must address the underlying social and structural issues that increase the vulnerability of people and also scale-up HIV-related programmes and services for the most affected communities.

Thus the broad sub-topics covered under the agenda are –

1) Discussion on Programmes currently in place in Asian countries aimed at prevention of HIV/AIDS and their effectiveness.

2) Providing Universal Access to medicines, treatment and care to all those affected.

3) Discussing why HIV/AIDS has such a high presence amongst women & children in Asian countries

4) Discussing the problems faced by AIDS orphans in Asian countries.

Though this agenda looks at the problems of Asian countries, it would be advised that all delegates must be aware of the magnitude of the problem in their own countries as well. Many programmes which have been implemented in African countries would have a good chance of success in Asian countries as well.

Also, though we say that there is a special focus on women & children, it does not mean that a resolution should not contain clauses which aim to provide solutions to problems faced by men.

In conclusion, we would like to re-iterate that the AIM of the committee would be to adopt a resolution which looks to solve each of the given problems through a holistic approach.

Mitali Nikore Sukrit Khatri

Chair Director

Human Rights Council Human Rights Council