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Indian nursing students hold a vigil on World AIDS Day in Amritsar
Indian nursing students hold a vigil on World AIDS Day in Amritsar late last year. India has reduced new HIV infections by more than 50 per cent since 2001. Sunday is World AIDS Day. AFP

HIV/AIDS: no one left behind

This year, World AIDS Day, celebrated worldwide on December 1, directly follows the International Congress on AIDS in Asia and the Pacific (ICAAP, 18-22 November, Bangkok).

The buzzwords heard along the ICAAP halls, where about 3,000 people mingled to discuss HIV strategies, were: Focus on sex workers, men who have sex with men, injecting drug users, transgender people and people living with HIV.

The global and regional updates on the HIV epidemic were sobering: though sustained progress against HIV is noted globally, the pace is slow and impact still limited. In the Asia-Pacific region over the past five years, the number of new infections has remained largely unchanged.

While some countries have reduced new HIV infections by more than 50 per cent since 2001(Cambodia, India, Myanmar, Nepal, Papua New Guinea and Thailand), the epidemic is still growing in others (Pakistan, Indonesia and the Philippines).

The strategies agreed at the ICAAP were clear: Focus programs and investments on key areas and populations at higher risk; Optimize investment; Innovate service delivery; Keep the community at the centre; Reduce stigma, discrimination and gender issues.

Cambodia can be proud. Its sustained commitment and vision on AIDS, high level of treatment coverage and innovative approaches to testing and treatment remain an inspiration to others.

And 2013 has been a pivotal year for a further leap forward: the Cambodia 3.0 framework to eliminate new HIV infections by 2020 is being rolled out by the National Center for HIV/AIDS, Dermatology and STD, including new approaches for more targeted outreach to key population groups.

Cambodia is among the first countries to pilot voluntary community-based HIV testing.

Many existing services are being improved, including simpler HIV testing, the use of antiretroviral treatment to prevent new infections, better collaboration with other programs such as tuberculosis and intensified efforts to integrate sexual and reproductive health services for key population groups into HIV programming.

However, progress is not success yet. An alarming new trend is the small rise in AIDS-related deaths as the number of people living with HIV has increased and lifelong retention on treatment is not easy.

Silence has been broken around gender-based and sexual violence, but more action is urgently needed.

A recent review of the national HIV-related legal framework led by the National AIDS Authority with UNAIDS highlighted some good protective laws, but also others that still hamper peoples’ rights and access to services.

Indeed, a normal night at work for an entertainment worker can easily go wrong and end with harassment, detention or violence. A normal day might seem hopeless for a person who injects drugs and lives on the street with no strength left to find harm reduction services.

A normal day can turn into a day of rejection for a transgender person trying to find work, or a shorter life for a prison detainee living with HIV with no access to treatment.

A normal evening out can be risky for a young man who has sex with men. The birth of a child remains a miracle, but no child should start life with HIV, as parent-to-child transmission is now easily preventable.

Too often, HIV affected people remain marginalised and face social exclusion, limiting their access to health, education, employment and other services. This can change.

Change comes through policies and programs, but importantly also mostly from the HIV community groups who have their feet on the ground. They are creative and increasingly contribute to program development, service delivery and key policy decisions.

They advise on solutions that work for them and help thousands of Cambodians affected by HIV make it through their days and nights.

HIV affected populations have the right to equal opportunities and a healthy life free from stigma and discrimination, with sustained access to prevention, treatment, care and support, employment opportunities and social protection.

The HIV community reminds us repeatedly how it is possible to overcome HIV-related stigmatisation and discrimination and live with dignity and pride.

Very symbolically for World AIDS Day this year, members of the HIV community will show us again their courage and determination and inspire us all with their feet on the ground at the Angkor Wat International Half Marathon.

They march alongside the Royal Government of Cambodia, other community groups, NGOs and development partners, including the Joint UN Team on HIV/AIDS, on Cambodia’s journey towards Zero new HIV infections, Zero AIDS-related deaths and Zero discrimination.

The journey includes known and still unknown hills to climb, but one day, Cambodia will reach those Three Zeros. HIV/AIDS affects everyone.

We can all be part of the solution to make days and nights safe and healthy for everyone in Cambodia, with no one left behind.

Claire Van der Vaeren is the United Nations Resident Coordinator on behalf of the UN Country Team and Joint UN Team on HIV/AIDS.

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