On World AIDS Day, the World Health Organization Regional Office for the Western Pacific calls on Member States to accelerate efforts to end AIDS by 2030. By providing for HIV prevention, testing, and treatment to all to reach the 2030 goal, countries will be making a smart investment that will avert AIDS-related deaths and new HIV infections, especially among children.
"We must all work even harder to address the critical gaps in HIV services, prevention, testing and treatment, especially among populations at risk," said Dr Shin Young-soo, WHO Regional Director for the Western Pacific. "WHO will continue to provide robust support for countries to scale up HIV services in order to achieve the 90-90-90 targets by 2020."
The 90-90-90 targets are: 90% of people living with HIV should know their status; 90% of diagnosed people should receive treatment; and 90% of treated people should have achieved viral suppression by 2020.
What is HIV?
The Human Immunodeficiency Virus (HIV) targets the immune system and weakens people's defence systems against infections and some types of cancer. As the virus destroys and impairs the function of immune cells, infected individuals gradually become immunodeficient. Immunodeficiency results in increased susceptibility to a wide range of infections and diseases that people with healthy immune systems can fight off.
The most advanced stage of HIV infection is Acquired Immunodeficiency Syndrome (AIDS), which can take from 2 to 15 years to develop depending on the individual. AIDS is defined by the development of certain cancers, infections or other severe clinical manifestations.
HIV can be suppressed by combination antiretroviral therapy (ART) consisting of three or more antiretroviral (ARV) drugs. ART does not cure HIV infection but controls the virus's ability to reproduce itself within a person's body, and allows an individual's immune system to strengthen and regain the capacity to fight off infections. ART has the potential both to reduce deaths and ill-health among HIV-infected people, and to improve their quality of life.
HIV/AIDS in the Western Pacific Region
In the Western Pacific, the estimated number of people living with HIV reached 1.4 million in 2015, with 96 000 people newly infected with HIV. Forty-four thousand people died from AIDS-related causes in 2015. Meanwhile, only 47% (680 000) of people living with HIV had access to antiretroviral therapy.
While the Region is making progress in HIV treatment, challenges remain in relation to stigma and discrimination and ensuring access to both, prevention and treatment services, especially for populations at risk. Cambodia, China, Malaysia, Papua New Guinea, the Philippines and Viet Nam together make up approximately 94% of the regional HIV burden, based on 2015 estimates.
Furthermore, many of the HIV prevention, testing, treatment and care services fail to reach those at greatest risk, such as men who have sex with men, sex workers, transgender people, people who inject drugs and people in prisons and closed settings. Reaching these groups requires innovations in HIV services delivery that is beyond health facilities, including access to self-testing. They must be fully included in AIDS responses, and services and care should be made available to them.
Studies showed that self-testing more than doubles the uptake of HIV testing among men who have sex with men. The tests provide results within 20 minutes and can be used in a setting that is private, discreet and convenient.
HIV prevention
Individuals can reduce the risk of HIV infection by limiting exposure to risk factors. Key approaches for HIV prevention, which are often used in combination, include: (1) male and female condom use; (2) testing and counselling for HIV and STIs; (3) voluntary medical male circumcision; (4) antiretroviral use for prevention; and (5) harm reduction for people who inject drugs.
WHO response
WHO has developed evidence-based recommendations to guide country actions, including consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection, HIV testing services, comprehensive services for key populations, and HIV strategic information.
WHO is focusing its support to 35 "fast-track" countries which have the highest burdens of HIV and where the greatest impact can be achieved. In the Western Pacific Region, China and Viet Nam have been identified as "fast-track" countries. Between 2014 and 2016, WHO supported over 90% of 'fast-track' countries to adapt their testing and treatment policies; over 80% in strategic information and accelerate their services for key populations, such as such as men who have sex with men, sex workers, transgender people, people who inject drugs and people in prisons and closed settings.
"Together we can and should work towards ending AIDS by 2030. We are on the right path. So we must never waver in our determination to achieve this noble goal. Let's continue this journey with all our partners and realize a day when the scourge of AIDS
can finally be ended," said Dr Shin.