By Dr. Arvind Mathur, WHO Representative to Timor-Leste
In January of this year, the World Health Organization partnered with the Ministry of Health and a local nonprofit organization, Asosiasaun Komunidade Progresiva, to launch a pilot project for HIV Self-Testing and Pre-exposure Prophylaxis (PrEP) medication. The pilot project is successfully led by the key population community and has conducted nearly 1000 HIV self-tests and initiated PrEP medication for over 200 individuals. As we commemorate World AIDS Day, this pilot project in Timor-Leste demonstrates a strong commitment to this year’s theme: let communities lead.
Communities play a vital role in influencing the response to HIV/AIDS, not only within Timor-Leste but also on a global level. Individuals living with HIV and community health workers serve crucial roles in steering and improving the HIV response. Communities dedicated to addressing HIV-related issues often act as vocal advocates in advancing the primary healthcare agenda, sharing principles that include a commitment to ensuring access and leaving no one behind. Timor-Leste's initiatives to actively involve the community in the national HIV/ AIDS response are therefore steps in the right direction.
The UNAIDS had set the 95-95-95 as the global target- where 95% of people living with HIV are aware of their status, 95% of those aware are on treatment, and 95% of those on treatment achieve suppressed viral loads. Timor-Leste currently stands at 78-86-42, thus signaling a need for intensified efforts in testing, treatment, and prevention strategies.
In Timor-Leste, key populations, which include men who have sex with men (MSM), transgender individuals, sex workers, and their clients, bear a disproportionate burden, with HIV prevalence rates 10 to 20 times higher than the general population. Similar trends are observed in the South-East Asia and Pacific Region, where these key populations and their partners accounted for a staggering 96% of all new HIV infections, with MSM leading the statistics.
Despite these challenges, the Ministry of Health’s commitment is evident in the numerous measures undertaken to curtail HIV transmission among key populations. Comprehensive HIV prevention services and testing tailored to the specific needs of these groups are being implemented. Introduction of the HIV self-testing and PrEP pilot project for the key population groups are significant milestones in this ongoing battle.
The WHO has been closely collaborating with the Ministry of Health to further improve the programme outcomes by developing guidelines on Anti-Retroviral Treatment (ART), Elimination of Mother to Child Transmission (EMTCT) of HIV, HIV testing and Integrated Costed National Strategic Plan for HIV, Hepatitis, and Sexually Transmitted Infections, 2022-2026.
The recent launch of the Integrated Case-Based Electronic Surveillance System for Tuberculosis, HIV, and Malaria built on the District Health Information Software 2 (DHIS2) will also play a critical role in enhancing data and planning targeted interventions.
If we continue the momentum of our collaborations and collective dedication, by meaningful engagement of community organizations for service delivery and implementation of innovative initiatives, strategies, and guidelines for combating against HIV/ AIDS, eliminating the disease from this island nation will not just be a target on paper, but a reality.