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Regional Overview in HIV by Steve Kraus

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This PPT was presented at National AIDS Conference Malaysia 2014

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Regional Overview in HIV by Steve Kraus

  1. 1. Regional HIV Overview: Asia and the Pacific Steven J. Kraus Director UNAIDS Regional Support Team, Asia and the Pacific
  2. 2. A regional overview of trends in HIV infections and AIDS deaths Source: Prepared by www.aidsdatahub.org based on UNAIDS 2013 Estimates for UNAIDS. (2014). The Gap Report. HIV and AIDS in Asia and the Pacific 1990-2013 People living with HIV 4.8 million Women living with HIV 1.7 million New HIV Infections 350,000 Deaths 250,000 2013 “zoom-in” Children living with HIV 210,000 4,800,000 1,700,000 210,000 350,000 250,000 0 1,000,000 2,000,000 3,000,000 4,000,000 5,000,000 6,000,000 Number People living with HIV (Estimate) Women living with HIV (Estimate) Children living with HIV (Estimate) New HIV infections (Estimate) AIDS-related deaths (Estimate)
  3. 3. 350,000 0 100,000 200,000 300,000 400,000 500,000 2001 2005 2009 2013 NewHIVinfections(Number) New HIV infections New HIV infections have declined significantly since 2001, but remain largely unchanged in past 5 years Estimated new HIV infections in Asia and the Pacific, 2001-2013 Source: Prepared by www.aidsdatahub.org based on UNAIDS 2013 Estimates for UNAIDS. (2014). The Gap Report. 30% decline
  4. 4. 0 5,000 2005 2013 Number Cambodia 0 20,000 2005 2013Number Myanmar 0 100,000 2005 2013 Number Indonesia 0 15,000 2005 2013 Number Pakistan 0 10,000 2005 2013 Number Malaysia 0 5,000 2005 2013 Number Philippines Mixed progress in new HIV infections trends across countries in the region Source: Prepared by www.aidsdatahub.org based on UNAIDS 2013 Estimates for UNAIDS. (2014). The Gap Report; and Philippines HIV Estimations and Projections 2014 (Unpublished document).
  5. 5. Countries that account for >90% PLHIV and new infections and high national HIV prevalence in key populations People living with HIV (2013) New HIV infections (2013) National HIV prevalence > 5 % among MSM National HIV prevalence > 5% among PWID National HIV prevalence > 5% among FSW India* 2,100,000 130,000 Indonesia 640,000 80,000 China* 780,000 48,000 Viet Nam 250,000 14,000 Pakistan 68,000 14,000 Thailand 440,000 8,200 Malaysia 86,000 8,000 Myanmar 190,000 6,700 Philippines 22,000 3,400 Papua New Guinea 32,000 2,200 Cambodia 75,000 1,300 Nepal 39,000 1,300 Source: Prepared by www.aidsdatahub.org based on UNAIDS Estimates 2013; Philippines HIV Estimations and Projections 2014 (Unpublished document); National HIV Sentinel Surveillance Surveys; and Integrated Biological and Behavioural Surveys = Yes * 2011 estimates
  6. 6. Female sex workersMen who have sex with men People who inject drugs Transgender National prevalence masks high prevalence geographical areas *Direct FSW; **Indirect FSW HIV prevalence among key populations in geographical areas Note: Countries with national HIV prevalence less than 5% for MSM and FSW, and less than 10% for PWID are presented here. For TG, any available high prevalence geographical locations are included. Source: Prepared by www.aidsdatahub.org based on HIV sentinel surveillance reports and integrated biological and behavioral surveillance reports 5.8 6.5 13.6 14.8 15 15.7 18.3 21.1 6.6 12 12.1 18.6 19 19 22 22.5 9.3 14.9 18.8 30.8 0 5 10 15 20 25 30 35 40 HIVprevalence(%)
  7. 7. 1.56 million 0 300,000 600,000 900,000 1,200,000 1,500,000 1,800,000 2003 2008 2013 NumberofpeoplereceivingART Treatment in Asia and the Pacific: 1.56 million people living with HIV are now accessing treatment Source: Prepared by www.aidsdatahub.org based on 1)UNAIDS. (2013). Global Report: UNAIDS Report on the Global AIDS Epidemic 2013.; 2) www.aidsinfoonline.org; and 3) UNAIDS.(2014). The Gap Report. People receiving antiretroviral therapy in Asia and the Pacific, 2003-2013 25% increase between 2012 and 2013 13% increase between 2011 and 2012
  8. 8. - 500,000 1,000,000 1,500,000 2,000,000 2,500,000 3,000,000 2003 2007 2011 2015 NumberofpeoplereceivingART Number of people receiving ART by 2013 Number of people receiving ART by 2015 (with current pace) Estimate 2013: 1.56 million More and more people are on treatment, but even at the current pace, only one out of two people living with HIV will have access to treatment by 2015 Estimated 2.4 million PLHIV will receive ART in 2015 at current pace of scale up 25% Source: Prepared by www.aidsdatahub.org based on 1)UNAIDS. (2013). Global Report: UNAIDS Report on the Global AIDS Epidemic 2013.; 2) www.aidsinfoonline.org; and 3) UNAIDS.(2014). The Gap Report. 2013
  9. 9. 0 200,000 400,000 2001 2005 2009 2013 AIDS-relateddeaths(Number) AIDS-related deaths [Estimate] 1.56 million 0 1,560,000 2005 2013 PeopleonARTTreatment saves lives: AIDS-related deaths are declining in Asia and the Pacific ~9 folds increase since 2005 26% decline since 2005 AIDS-related deaths, Asia and the Pacific, 2001-2013 Source: Prepared by www.aidsdatahub.org based on UNAIDS 2013 Estimates for UNAIDS. (2014). The Gap Report. People receiving ART
  10. 10. Ambitious, but achievable, new targets
  11. 11. By 2020… 90% of all people living with HIV will know their HIV status 90% of all people diagnosed with HIV will receive sustained antiretroviral therapy. 90% of all people receiving antiretroviral therapy will have durable suppression.
  12. 12. The objective “Maximize the effectiveness of existing tools to virtually eliminate progression to AIDS, premature death and HIV transmission, and thereby transform the HIV pandemic into a low level sporadic endemic.”
  13. 13. The result three-fold increase over current estimates 72%of all people living with HIV will be virally suppressed 3
  14. 14. Key challenges 1. Societal 2. Diversity of facility costs 3. Gaps in the treatment cascade 4. Delivery challenges 5. Financing 6. Addressing the epidemic in adolescents and children
  15. 15. Financing Normative/ Technical Advocacy/ Political R&D Partnering for success
  16. 16. Key achievements - Malaysia  Prevention of vertical transmission of HIV – Option B+ provided for all HIV infected mothers including both documented and undocumented migrants since 2011 – overall 86% (62%->95%) PMTCT coverage in 2013  Treatment - Scaling up ART coverage (over 7000 people initiated ART in the past year) including the availability of ART for prisoners and closed settings  Community based HIV testing – Partnering with NGOs and CBOs, community based HIV testing is initiated in MSM community in Penang and Kuala Lumpur  Harm reduction programmes - Significant success in Needles and Syringes Exchange Programme (NSEP), and the Opiate Substitution Therapy (OST) programme expanded to 18 prisons by 2013
  17. 17. 100% 96% 88% 85% 53% 42% 40% 36% 32% 31% 18% 10% 7% 1% 16% 10% 9% 5% 1% 0% 25% 50% 75% 100% Fiji (2013) Malaysia (2013) China (2012) Thailand (2011) Sri Lanka (2010) Indonesia (2012) Philippines (2013) Pakistan (2013) Viet Nam (2012) Mongolia (2011) Papua New Guinea (2012) Bangladesh (2013) India (2011-12) Cambodia (2012) Myanmar (2011) Lao PDR (2011) Afghanistan (2013) Nepal (2009) Timor-Leste (2009) Upper middle income Lower middle income Low income Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org, India Global AIDS Response Progress Report 2012, and Kumar, U. A., „Azad Launches Rs 14,295 Crore Phase IV of NACP‟, The New Indian Express, 13 February, 2014). HIV expenditure from domestic sources, Asia and the Pacific, latest available year, 2009-2013 63% Committed for NACP IV
  18. 18. Malaysia AIDS spending snapshot Source: Prepared by www.aidsdatahub.org based on www.aisdinfoonline.org 12% 70% 15% 0.2% 3% Malaysia AIDS spending by major spending categories, 2012 Prevention Care and treatment Programme management and admin Enabling environment Others 5 M 3 M 3 M 0.01 M 2 M 2 M 1 M 1 M 0 1 2 3 4 5 6 7 8 Total prevention spending Key populations prevention spending PWID prevention spending Sex workers prevention spending MSM prevention spending US$Millions Malaysia prevention spending, 2012 Domestic International PWID 18.9% FSW 4.2% MSM 12.6% HIV prevalence
  19. 19. Post 2015 Agenda
  20. 20. Key processes feeding into the post -2015 development agenda Source: IPPF. (2014). Post-2015 made simple – Shaping the future of sexual and reproductive health rights
  21. 21. Positioning AIDS in the post-2015 development agenda  AIDS in the post-2015 development agenda  Political commitment for ending AIDS  Progress towards ending the AIDS epidemic will spur progress on a range of development, gender equality and human rights challenges  AIDS under the Sustainable Development Goals (SDG) for health  Situating “ending AIDS” as critical to advancing global health in the post-2015 development agenda  Ensure that the health goal continues to include targets on ending the AIDS epidemic as a public health threat by 2030
  22. 22. Positioning AIDS in the post-2015 development agenda  Human rights  Ending AIDS: A beneficiary of and catalyst for human rights  Support elimination of discriminatory laws, policies and practices  Key populations in the AIDS response  Leaving no one behind is critical to ending AIDS by 2030  Promote strategic investment in HIV programming for those most affected by HIV, including key populations  Gender, sexual and reproductive health, and rights  Ending AIDS can be a catalyst for gender-transformative action which puts people at the centre of development  Call for gender equality and the full realization of women’s rights
  23. 23. THANK YOU www.aidsdatahub.org

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