BANGKOK (Thomson Foundation) - The Asia-Pacific region will not meet the goal of ending the HIV epidemic in 15 years unless it changes laws and attitudes hostile to people living with HIV, the head of the United Nations agency on AIDS said on Wednesday.
Governments need to spend more on programmes targeting key groups, improve access to lifesaving drugs and overhaul punitive laws that stop people seeking help, Michel Sidibe, executive director of UNAIDS, told the Thomson Reuters Foundation.
"I'm fully convinced that if you don't address these issues ... it's impossible to end HIV/AIDS," said Sidibe, speaking on the opening day of an Asia Pacific inter-governmental meeting on HIV and AIDS in Bangkok.
UNAIDS announced a five-year, fast-track approach in November that it said could effectively end the worldwide health threat posed by the human immunodeficiency virus (HIV) by 2030.
HIV, the virus that causes AIDS, is spread via blood, semen and breast milk. There is no cure, but AIDS can be kept at bay for many years by taking cocktails of antiretroviral drugs (ARV).
The Asia-Pacific region, where almost 5 million people are living with HIV, has the potential to achieve the 2030 goal, Sidibe said.
New HIV infections in the region have fallen by 25 percent since 2001, AIDS-related deaths have dropped by 27 percent since 2005 and 1.56 million people now receive lifesaving ARV drugs.
However, the persistent underfunding of certain programmes, the low rate of takeup of ARV drugs and policy barriers threaten these gains, he said.
Less than 8 percent of HIV prevention programmes in the region are focused on "key populations" - men who have sex with men, sex workers and people who inject drugs - and that is where the epidemic is concentrated, Sidibe said.
Governments tend to see these groups as marginal and lacking political capital and ignore their needs, he said.
Yet looking after them would benefit the whole of society, as this would prevent the epidemic from spreading to the general population via partners of drug users, sex workers and gay men.
"We need to show that it's not just about those groups. That if it is not contained, it could spread."
"The Asian (HIV) epidemic is today more concentrated than at any other moment in history," Sidibe said.
The Asia-Pacific region will "never control the epidemic" as long as 92 percent of funding for HIV prevention programmes target the general population, he added.
He also noted that only 33 percent of people living with HIV in the region are receiving treatment, even though India, an Asian nation, is one of the largest producers of generic ARV drugs.
"This should be the first region that could have universal access to treatment, given that it is an innovation and technological as well as economic hub," he said.
Sidibe also said the legal environment in the region is often hostile to people living with HIV and has discouraged them from seeking help.
According to UNAIDS, all 38 countries in the region have laws that make it hard to tackle HIV, ranging from criminalisation of sex work and same-sex relations to compulsory detention centres for drug users.
"I'm convinced that we will make a lot of progress in the next 15 years in terms of innovation," Sidibe said.
"What will stop us from getting there are elements not necessarily linked to innovation because AIDS is more complex. It's about sexuality, behaviour, relationships and emotions."