This is the plenary presentation of Mr Eamonn Murphy, Regional Director, UNAIDS, Asia and the Pacific, on "Solidarity and Accountability: HIV, SRHR and the COVID response”, which was made as part of the 12th session of 10th Asia Pacific Conference on Reproductive and Sexual Health and Rights (#APCRSHR10) Virtual. This session was held in lead up to #WorldAIDSDay and #16DaysofActivism against sexual and other forms of gender-based violence, on the theme of "HIV/AIDS and sexual and reproductive health and rights (SRHR) in Asia and the Pacific".
Chair: Jennifer Butler, Director, UNFPA Pacific Sub Regional office based in Fiji
Plenary Speaker: Eamonn Murphy, Regional Director, UNAIDS, Asia and the Pacific | “Solidarity and Accountability: HIV, SRHR and the COVID response”
Abstract Presenters:
-------------------------
* Jude Tayaben | Successes, Pitfalls, and Moving Forward: Adivayan Youth Health Center- A school-based program addressing Adolescent Sexuality, and Reproductive Health Issues in Benguet, Philippines
* Samreen, Manisha Dhakal | Integrating transgender health into HIV and SRHR programming in Indonesia, Nepal, Thailand and Vietnam
* Harjyot Khosa | Stigma, sex work and non-disclosure to health care providers: Exploring dynamics of anal sex through community led monitoring to bridge gaps in HIV care continuum services
* Angela Kelly Hanku, Agnes K. Mek | I can, I want, I will and Young & Positive: Two visual method projects with young women living with HIV in Papua New Guinea
For more information on the session, please visit
www.bit.ly/apcrshr10virtual12
Official conference website: www.apcrshr10cambodia.org
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APCRSHR10 Virtual plenary presentation of Eamonn Murphy, Regional Director of UNAIDS Asia Pacific
1. UNAIDS 2020
Solidarity and Accountability: HIV, SRHR and
the COVID-19 response
Eamonn Murphy, Regional Director – UNAIDS Asia and the Pacific
23rd November 2020
2. Source: Prepared by www.aidsdatahub.org based on UNAIDS 2020 HIV Estimates and National AIDS Control Organization & ICMR-National Institute of Medical
Statistics (2020). India HIV Estimates 2019: Report. New Delhi: NACO, Ministry of Health and Family Welfare, Government of India
Percentage change in new HIV infections by country, Asia and the Pacific, 2010-2019
New HIV infection and AIDS-related death trends vary greatly in Asia
and the Pacific countries
-81%
-12%
207%
-100%
0%
100%
200%
300%
Percentage change in AIDS-related deaths by country, Asia and the Pacific, 2010-2019
-66% -29%
405%
-150%
0%
150%
300%
450%
3. Source: Prepared by www.aidsdatahub.org based on UNAIDS 2020 HIV Estimates
Distribution of new HIV infections by
population, 2019
9
17
44
7
21
2
98%
of new HIV
infections among
key populations and
their partners
Distribution of new HIV infections among
young people (15-24 yr) by population, 2019
99%
of new HIV
infections among
key populations and
their partners
Men who have sex with menPeople who inject drugs
Rest of population
TransgenderSex workers
Clients of sex workers and
partners of key populations
Need for focused response:
Epidemic mostly affecting key populations and their partners
10
10
52
8
19
1
5. Prepared by www.aidsdatahub.org based on UNAIDS 2020 estimates and Global AIDS Monitoring 2020
Regional overview: Treatment target and gaps
HIV testing and treatment cascade, Asia and the Pacific, 2019
75%
60%
55%
90
81
73
0
20
40
60
80
100
PLHIV who know their
status
PLHIV on
treatment
PLHIV who have
viral suppression
%
Progress (%) Gap Target
0.88 million
1.2 million
1.1 million
3.2
million
4.4
million
3.5
million
ACHIEVED
Australia
ACHIEVED
Australia; Cambodia;
New Zealand
ACHIEVED
Australia; Cambodia;
Thailand
Note: India and China data not available
72 - 65 - 54
78 - 64 - 59
73 - 57 - 52
90-81-73 target
6. Laws and regulations that allow adolescents (10-19 years) to seek services
without parental/spousal consent, countries where data is available, 2013-2019
Yes
No
No information
Source: Prepared by www.aidsdatahub.org
based on information from countries that
responded to the Global Maternal, Newborn,
Child and Adolescent Health Policy Indicator
Surveys (2009-10, 2011-12, 2013-14, 2016)
undertaken by Department of Maternal,
Newborn, Child and Adolescent Health; World
Health Organization -
http://www.who.int/maternal_child_adolescent/
epidemiology/policy-indicators/en/ (accessed
04 Sept 2019); and National Commitments
and Policies Instrument of Global AIDS
Monitoring (GAM) 2017,2018, and 2019
Country
(reporting period)
Contraceptive
services except
sterilization
Emergency
contraception
Harm reduction
intervention for people
who inject drugs
HIV testing and
counselling services
Afghanistan (Apr 2016, 2019)
Bangladesh (Feb 2014, 2019)*
Bhutan (Jan 2016)
Brunei Darussalam (Feb 2014, 2019)
Cambodia (Mar 2016, 2019)**
China (2019)
Fiji (2018)
India (Feb 2014, 2019)*
Indonesia (Apr 2016, 2018)***
Kiribati (Jun 2014)
Lao PDR (Mar 2016, 2017)**
Malaysia (Mar 2016, 2019)*
Maldives (Jan 2010)
Marshall Islands (Apr 2016)
Micronesia (Federated States of) (Mar 2016)
Mongolia (Mar 2016, 2019)*
Myanmar (Apr 2016, 2019)
Nepal (Jan 2014, 2019)***
Pakistan (Dec 2016, 2019)*
Palau (Apr 2016)
Papua New Guinea (Jan 2014, 2019)*
Philippines (Mar 2014, 2019)*
Solomon Islands (Mar 2016)
Sri Lanka (Apr 2016)
Timor-Leste (Apr 2016)
Vanuatu (Dec 2013)
Thailand (2018)
Viet Nam (Jan 2014, 2019)***
Note: Asterisks refer to HIV testing and
counseling services
*for adolescents younger than 18 years
**for adolescents younger than 14 years
*** for adolescents younger than 16 years
7. 2% 1%
5%
6% 5%
4%
2% 3% 3%
6%
8%
4%
0%
5%
10%
15%
20%
First 6 months of 2019
First 6 months of 2020
Comparison of net treatment scale-up in the first 6 months of 2019 and 2020 by country
The ‘new normal’- continued efforts are needed to ensure access to
HIV services
0
5000
10000
15000
20000
Sex workers Men who have
sex with men
People who
inject drugs
Transgender
people
Cambodia
0
15000
30000
45000
60000
Sex workers Men who have
sex with men
People who
inject drugs
Transgender
people
Indonesia
Key populations reached by HIV prevention programme in Cambodia and Indonesia, January and June 2020
June 2020January 2020
Prepared by www.aidsdatahub.org based on UNAIDS 2020 HIV estimates, Global AIDS Monitoring 2020 and HIV Services disruptions Tracking Tool https://hivservicestracking.unaids.org
9. • A country-level survey of people living with HIV found that
- more than a third (37%) could not access contraception
services,
- 22% were unable to obtain condoms,
- some respondents expressed the need for access to
medications for opportunistic infections.
Examplesfrom Asia Pacific region: Cambodia I
10. • According to a survey on key populations’ needs and
challenges:
- 19% of respondents do not have information on
condoms and lubricant,
- 35% do not have information on diagnosis and treatment
of sexually transmitted infections,
- 50% lack information on psychosocial support,
- 53% do not have information on pre-exposure
prophylaxis.
Examplesfrom Asia Pacific region: Cambodia II
11. Examplesfrom Asia Pacific region: women living
with HIV
More than eighty percent of women living with HIV
reported that they lacked access to sexual and
reproductive health and rights, including
contraception, during COVID-19 lockdowns.
12. Examplesfrom Asia Pacific region: young key
populations
27
14
26
30
19
0
10
20
30
40
50
Condoms PrEP HIV testing Psychological
support
Mental health
medications
Proportion of young key populations who experienced delays or disruptions
when accessing health services
13. • Laws that criminalize sexual orientation, gender identity and
expression, exacerbate negative health outcomes as people
may avoid accessing health-care services for fear of arrest or
violence.
• Transgender women reported difficulties or delays in accessing
hormone replacement therapy in Myanmar, the Philippines
and Viet Nam.
Examplesfrom Asia Pacific region: LGBTI people
14. • Explore alternative ways to provide sexual and reproductive
health services, particularly diagnosis and management of
sexually transmitted infections, and hormonal therapy for
transgender people.
• Expand availability of HIV and STI prevention and
contraceptive services through pharmacies, drug shops,
online platforms and other outlets.
• Promote innovative solutions and non-traditional condom
outlets to improve access for all, particularly sex workers and
other key populations.
Going forward I
16. Community solidarity and resilience in time of COVID-19 pandemic
Regional community networks amplify the impact of community-led responses to COVID-19
• Report on community led best practices by ANPUD, and best practices community-led supports in advocacy and
service delivery document by APN+
• Youth-friendly crowdsourcing website that pools available information and guidance on COVID-19 by IATT-YKP
• APCOM’s newsletter serving as a virtual announcement board of available resources for community members
• A series of six feature stories - Dignity Amidst COVID-19: Trans youth leading the response - by APTN and Youth LEAD
Community-led innovations on DSD and MMD
• Home ARV Refill Delivery & Pick-up Assistance Service by “Oplan ARVayanihan” and diversified PrEP services through
telemedicine and PrEP delivery by PrEP Pilipinas in Philippines
• Adapting service delivery to meet the needs for PrEP by Center for Applied Research on Men and Community Health
(CARMAH) in Viet Nam
• Community ARV dispensing in India, Nepal, PNG, Philippines, and Thailand
• KP-led PrEP service delivery and PrEP MMD in Thailand and Viet Nam
Source: UNAIDS Regional Office for Asia and the Pacific (2020). A rapid assessment of multi-month dispensing of antiretroviral treatment
and pre-exposure prophylaxis in the Asia-Pacific region; UNIADS Philippines (2020). Innovations Amid COVID Crisis and Beyond: The
Philippine Experience – Presentation at UNAIDS Quarterly Programme Branch Meeting on 7th October 2020; and https://unaids-
ap.org/2020/10/28/key-population-networks-in-asia-and-the-pacific-amplify-the-impact-of-community-led-responses-to-covid-19/
17. Universal Health Coverage (UHC)
IS NOTIS
1. “systems for health” not “health
systems”, including multisectoral
responses.
2. Covering the spectrum not only
treatment
3. equity, development priorities and
social inclusion.
4. focused at the community level.
1. Just about health financing. It
encompasses all components of the
health system.
2. Only about a minimum package of
services, but is anchored in the right
to health for everyone.
3. about individual health (treatment)
services, but puts the focus on
people, not diseases.