Thirty years after the first reported case of human infection with the HIV virus, the profile of HIV/AIDS is undergoing a transformation from a life-threatening emergency to a manageable chronic disease.
New strategies and initiatives have ensured that fewer people are becoming infected with the virus, and more infected people are receiving treatment and living longer.
On World AIDS Day 2011, the World Health Organisation urges countries in Southeast Asia to focus on eliminating the disease, particularly among children, by 2015.
Between 2001 and 2010, the number of people newly infected with HIV declined sharply by 34 per cent in the World Health Organisation’s Southeast Asia region.
The number of people living with HIV and receiving anti-retroviral treatment (ART) also increased tenfold. This indicates that more people are gaining access to treatment.
With the expansion of facilities providing testing and counselling services, approximately 16 million across the region people have been tested for HIV.
“We are coming out of a transformative decade for the HIV/AIDS epidemic,” Dr Samlee Plianbangchang, the World Health Organisation’s regional director for Southeast Asia, says.
‘‘With innovative treatment regimens and improved health services, as well as political commitment, HIV-positive people who are on treatment are living longer and better lives.
“We must learn from our experiences, and work to ensure that not a singlle child born bcomes infected with HIV.”
To achieve this, the World Health Organisation, along with UNICEF, UNFPA, UNAIDS and countries in the Asia-Pacific region, launched an initiative in 2011 with the goal of eliminating new pediatric HIV infections and congenital syphilis by 2015.
Also making this possible is “Treatment 2.0”, a recent initiative recommended by the World Health Organisation and UNAIDS.
It operates on the principle that high-quality drugs that are easy to take, easy to monitor and affordable are needed to achieve universal, sustainable access to treatment.
Serious challenges remain, however. According to the World Health Organisation's latest progress report on HIV/AIDS in Southeast Asia, an estimated 3.5 million people – 140,000 of them children – were living with HIV/AIDS in 2010.
Women accounted for 37 per cent of this total.
The HIV/AIDS epidemic is still on the rise in Indonesia, although the number of new infections is showing a downward trend in India, Myanmar, Nepal and Thailand.
Each year, there are an estimated 210,000 new HIV infections in the region (chiefly transmitted through sexual intercourse and injecting drug use) and 230,000 deaths from AIDS.
The overall prevalence of HIV is low in the region (0.3 per cent), but sex workers and their clients, men who have sex with men (MSM), transgender individuals and people who inject drugs are disproportionately affected.
Protective behaviour such as consistent condom use is increasing among sex workers, but not among MSMs and injecting drug users.
The majority of people living with HIV are unaware of their HIV status.
Fewer than one in five pregnant women has access to HIV testing and counselling, and two out of three HIV-infected pregnant women do not receive anti-viral prophylaxis.
Only a third of those with advanced HIV infection are receiving anti-retroviral treatment.
On the positive side, however, more than four out of five people who have begun treatment are alive and on treatment 12 months after the beginning of therapy.
Access to HIV testing for all pregnant women, and anti-retroviral treatment for those who have tested positive, are essential to prevent children becoming infected in the womb or through breast-feeding.
In order to achieve this, the World Health Organisation recommends that HIV services be integrated into related health services, such as maternal and child health services.
Reducing HIV-associated stigma and discrimination in community and health-care settings is also vital.
The World Health Organisation continues to advocate for a reduction in the prices of anti-retroviral drugs and investment in building health systems and human resources so that countries can scale up their HIV/AIDS interventions.
The Regional Health Sector Strategy on HIV, 2011-2015, which has been endorsed by all member states of the World Health Organisation's Southeast Asia region, envisages “zero new HIV infections, zero AIDS-related deaths and zero discrimination in a world where people living with HIV are able to live long, healthy lives”.