SE Asia should focus on keeping kids HIV-free: WHO

HIV/AIDS is shifting profile from a “life-threatening emergency to a manageable chronic disease,” finds an annual report on the Global Response to HIV/AIDS.

The report was released in honor of World Aids Day on December 1, 2011 by World Health Organisation (WHO), United Nations Children’s Fund (UNICEF) and Joint United Nations Programme on HIV/AIDS (UNAIDS) in collaboration with international partners.

The report analyses the health sector’s prevention, treatment and care to those infected in low- and middle- income countries using data through 2010. Among the recommendations for South East Asia was to eliminate childhood infection by 2015.

“We must learn from our experiences, and work to ensure that no child born gets infected with HIV,” Dr Samlee Plianbangchang, WHO Regional Director for South-East Asia, said in a press statement.

As of 2010, 16 million people out of South East Asia’s population of 593 million had been diagnosed with HIV/AIDS. But statistics suggest a synchronized solution. Over the preceding decade infection rates in South-East Asia declined by a sharp 34 percent while the number of people receiving treatment increased ten-fold.

“We are coming out of a transformative decade for the HIV/AIDS epidemic. With innovative treatment regimens, improved health services as well as political commitment, HIV-positive people who are on treatment are living longer and better lives,” Plianbangchang said.

As WHO pushes South-East Asia to eliminate the disease it makes children a priority. Towards that end, an initiative to eliminate new paediatric HIV infections and congential syphilis by that date was launched this year.

Meanwhile, less than one in five pregnant women in the region do not have access to testing facilities, and two out of three infected pregnant women do not receive anti-viral prophylaxis.

Historically the Maldives has been minimally affected by HIV/AIDS, however social trends are putting the population at risk.

Between 1991 and 2006 only 13 HIV cases were reported among Maldivians, compared to 168 among expatriate workers. Of the Maldivian cases 10 were sailors, two were spouses, and one was a resort worker who had traveled abroad; 11 cases were male, and all patients cited heterosexual transmission as the cause.

Yet the country’s geographical constraints have made it highly dependent on foreign imports. This has been shown to include human trafficking for purposes including sexual entertainment. In 2010, an HIV-positive prostitute was arrested locally.

Late last month, human trafficking was reported a growing industry. In 2008, a World Bank report listed mobility, sexual practice, commercial sex work and drug use as leading risk factors. Although HIV is not prevalent within the Maldives, the report claims travel, work and education abroad open opportunities for transmission.

The Maldives also has the world’s highest divorce rate, indicating a high rate of shared partners within the country. Without any formal sexual education in schools and a general stigma around purchasing a condom, the basic defenses against HIV transmission are low.

The report also cites drug use as a risk factor for two reasons. “Drug users may resort to selling sex to earn money, and injecting drug users (IDUs) may share needles/syringes.”

In Awareness, the Maldives scored in the middle-range. While 99 percent of Maldivians polled had heard of HIV/AIDS and 91 percent knew at least one mode of HIV transmission, only 50 percent said condoms can protect against HIV and 34 percent did not know that a healthy looking person can carry the virus.

Currently, the government and independent organisations provide support and awareness within the Maldives. The National AIDS Council, established in 1987, oversees the National AIDS Program (NAP) which coordinates and monitors a multi-sectoral response to the issue.

United Nations’ Development Program (UNDP) is also running a project, active in the Maldives until 2012, with several local NGOs. It aims to support preventative efforts and improve treatment.

Among the conclusions drawn in WHO’s 2011 report on Asia are:

  • Cambodia was the only country to achieve universal ART access
  • 39 percent infected children had access to paediatric HIV treatment
  • 49 percent of people living with HIV are in India
  • Infections among children declined by 23 percent in Asia, but increased by 31 percent in East Asia
  • Asia’s death toll from AIDS-related causes in 2010 was the largest outside sub-Saharan Africa; approximately 310,000 people died
  • Half of the 4.5 million people in Asia who inject drugs live in China
  • Homosexual transmission is highest among men in Indonesia, India and Myanmar

Officials at the Ministry of Health and Family and WHO Maldives were unavailable for comment at time of press.

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