Inter Press Service - July 30, 2008
Marwaan Macan-Markar

Cambodia and Laos are among the "best performers" in the region, in addition to similar success by their more affluent neighbour Thailand, say officials from the Joint United Nations Programme on HIV/AIDS (UNAIDS). "They have all reached over 60 percent ARV (antiretroviral) coverage."

They have helped the Asian region secure a "record increase in ARV treatment," added Sun Gang, advisor for the UNAIDS regional support team for the Asia-Pacific region, at a press conference here. "Overall the national coverage in the region is 20 percent."

By 2007, there were 26,000 Cambodians on ARV treatment of the 29,000 people living with HIV/AIDS who needed it, says UNAIDS. It places the country among 20 others across the developing world where ARV coverage is between 50 to 75 percent. In 2005, only 12,000 people were receiving ARVs.

In Laos, close to 700 were receiving ARV treatment by 2007 of the 1,182 people with the killer disease who needed it, adds the U.N. agency. That placed it among 16 developing countries across the world where ARV coverage was greater than 75 percent. In 2005, only 104 Laotians were on ARV treatment.

Cambodia has 34.7 percent of its 14.3 million people below the poverty line, and where 130,000 people live with HIV and some 16,000 die every year due to AIDS. Laos has 32.7 percent of its 5.85 million people living below the poverty line, and where 3,700 people live with HIV and less than 100 die every year from the disease.

Thailand, however, has been the star performer in South-east Asia in ARV coverage, revealed the '2008 Report on the global AIDS epidemic', which was released this week. Nearly 200,000 Thais are receiving ARV treatment of the 600,000 people living with HIV, placing the country, like Cambodia, among the 20 nations where ARV coverage is between 50 -70 percent.

Thailand's achievement stems from the progressive move by successive governments to offer cheaper generic versions of the expensive, brand name anti-AIDS drugs. In November 2006, Bangkok broke the patent of two ARVs by applying the "compulsory licensing" option, which enables developing countries to break patents of expensive drugs for public health emergencies under world trade rules.

What is more, in Thailand, "more women are receiving (ARV) treatment than men," says Gwi-Yeop Son, U.N. resident coordinator for Thailand, at a press conference to launch the UNAIDS annual report. "There is 75 percent coverage to stop mother-to-child transmission."

While the ARV treatment in Cambodia, Laos and Thailand reflect a broader commitment to stall the spread of HIV -- including prevention campaigns like 100 percent condom use among sex workers -- the region's achievements have not been all rosy. HIV prevalence rates remain high in Indonesia, the giant of South-east Asia.

"The HIV epidemic in Indonesia is among the fastest-growing in Asia," states the report. "An HIV epidemic that initially centred largely on people who inject drugs in Bali, Jakarta and West Java now encompasses many of their non-injecting sex partners, as well as prisoners, sex workers and their clients."

The killer disease has currently "spread to 32 provinces" in the archipelago, adds the report. "In 2000, only half as many provinces reported HIV or AIDS cases."

And in Vietnam and Malaysia, the most worrying sign is the high prevalence of HIV among injecting drug users (IDU), due to unclean needles used. "The HIV epidemic in Malaysia is concentrated mainly around unsafe injecting drug use practices, and it is estimated that more than two thirds of HIV infections to date have been in people who inject drugs."

In Vietnam, the HIV prevalence rate among IDUs is 28.6 percent across the nation, but far higher in urban centres like Ho Chi Minh City, which has 54.5 percent HIV prevalence among its IDUs, and in Hai Phong, where there is a 47.61 percent HIV rates among IDUs.

The UN agency is equally worried about HIV transmission among men who have sex with men (MSM) in the region. "As in other parts of the world, unprotected sex between men is a potentially significant but under-researched aspect of the HIV epidemics in Asia," the report notes. "Recent study data from several major cities in the region, from Bangkok to Ho Chi Minh City, show increasing HIV prevalence among men who have sex with men."

According to UNAIDS, countries like Cambodia and Thailand will face increasing hurdles to reduce poverty rates due to the epidemic. "HIV will slow the annual rate of poverty reduction by 60 percent in Cambodia (and) by 38 percent in Thailand between 2003 and 2015."

In Asia, an estimated five million people were living with HIV in 2007 out of the 33 million across the world, states the report. The estimated number of new infections and people who died from AIDS-related illnesses across the continent were "equal in 2007 - 380,000 and 380,000 respectively."

"National HIV infection levels are highest in South-East Asia," it added.

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