Excellencies, programme managers and staff of ministries of health from across the South-East Asia Region; Executive Director, UNAIDS, Geneva; Director, HIV, viral hepatitis and STI programmes, WHO Headquarters; community, civil society, UN and other development partners; distinguished experts, participants and colleagues,
Warm greetings and welcome to this World AIDS Day commemoration. It is a pleasure to host you.
Today, we unite in solidarity and support of people living with HIV. We remember the many lives lost globally due to AIDS-related illnesses – 40.1 million and counting. We take stock of where we are and where we need to be in national, Regional and global responses. And we recommit to achieve our targets and goals: namely, to end the AIDS epidemic as a public health threat by 2030.
It has been a tough few years.
The COVID-19 pandemic, which in some countries disrupted HIV services by up to 50%. Shrinking resources, partly on account of COVID-19, but also from ambivalent donor interest. Persistent inequalities – in access to HIV prevention, testing and treatment; in legal rights; and in the social and economic determinants that keep the epidemic alive.
I therefore join you in today’s Call to Action to ‘Equalize’ and address all inequalities to end AIDS, and also eliminate hepatitis and sexually transmitted infections (STI) as public health threats by 2030.
So where are we today, just eight years shy of the 2030 deadline?
At the end of 2021, an estimated 3.8 million people in the Region were living with HIV, accounting for around 10% of the global burden.
Between 2010 and 2021, new HIV infections declined by 42%, and HIV-related deaths by 63%.
Between 2010 and 2020, TB-related deaths among people living with HIV reduced by 72%.
Whereas in 2010, coverage of anti-retroviral treatment in the Region was just 17%, by 2020 it had increased 3.6 times, to 61%.
In 2019, Maldives and Sri Lanka were certified to have eliminated mother-to-child transmission of HIV and congenital syphilis, which Thailand achieved in 2016 – the first country in Asia to do so.
By the end of 2020, 75% of people in the Region living with HIV knew their status, 61% were on anti-retroviral treatment, and 58% were virally suppressed, meaning that as a whole, the Region fell short of the global 90-90-90 targets.
We have people and populations to reach, and progress to achieve.
Across the Region, we know that 94% of new infections are among key populations such as sex workers, people who inject drugs, men who have sex with men, and transgender people.
Just 22% of young people have knowledge about HIV prevention, and coverage of testing for people who inject drugs remains unacceptably low, as does access to and awareness of the need to use condoms to prevent disease transmission.
For pregnant women and people living with HIV who are co-infected with TB, coverage of anti-retroviral treatment is just 56% and 44% respectively.
Access to game-changing innovations such as HIV self-testing and pre-exposure prophylaxis remains poor, and highly uneven, both within and between countries. This is a missed opportunity that is – let us be honest – leaving many behind, prolonging the epidemic.
The data are crystal clear: We must ‘Equalize’ to end the AIDS epidemic, for which I call on policy makers, programme managers and all HIV stakeholders to:
First, rapidly and aggressively increase the availability, quality and sustainability of services for HIV prevention, testing and treatment, ensuring that everyone – especially key populations – are well-served and actively included in service provision.
Second, immediately and unequivocally reform laws, policies and practices that facilitate both direct and indirect discrimination, stigma, and exclusion, ensuring that the human rights of key populations and affected groups are respected, protected and fulfilled.
Third, accelerate access for all countries and communities to the best HIV science, technologies and tools, which must be accompanied by evidence-based information on how best to deliver them, including through increased South-South collaboration and learning.
And fourth, implement concrete actions to engage and empower communities, civil society and affected populations, whose experiences must inform both policy and service delivery, and who should also be included in programme monitoring.
These are our priorities, and they are priorities that are laid out in detail in our new Integrated Regional Action Plan for viral hepatitis, HIV and STI (I-RAP), which covers all three disease areas in one plan, recognizing their common determinants and modes of transmission.
The I-RAP strives to increase quality and efficiency, while leveraging the full power of primary health care, universal health coverage and health systems for impact.
It promotes equity and innovation, and advances people-centred and community-driven approaches.
It draws on the many lessons learned from the HIV, hepatitis and STI responses, accelerating a synergistic and integrated public health approach along the entire continuum of care.
It is aligned with the Region’s Strategy for Primary Health Care, as well as new WHO Global Health Sector Strategies on HIV, viral hepatitis and STI.
I urge all HIV stakeholders to familiarize yourself with the Plan, and to take it forward in full, and with maximum accountability, without delay.
I once again thank and commend you for your hard work, commitment and resolve throughout the COVID-19 response.
We have had a tough few years, but nothing worth achieving has ever been easy.
And I am certain you agree: Ending the AIDS epidemic – leaving no person or community behind – is not easy, but it is most certainly worth the effort.
Together, let us accelerate towards our targets and goals, to end the AIDS epidemic, and to eliminate hepatitis and STI as public health threats by 2030.
Thank you.