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Innovation needed to stop HIV/AIDS in Asia

The UN says the Asia Pacific is at a pivotal juncture in curbing the AIDS epidemic, with progress in reducing new infection rates stalled, amid barriers of discrimination, stigmatization and a lack of political will.

The Joint United Nations Program on HIV/AIDS says some 4.9 million people are living with the virus that leads to AIDS across the Asia Pacific, with attention focussed on India, China and Indonesia.

Rates of new HIV infections in the region have fallen by more than 25 percent since 2001, but progress has stalled, says UNAIDS in the Asia and Pacific director, Steve Kraus.

UNAIDS has launched a new campaign aimed at achieving zero new HIV infections, zero AIDS-related deaths, and zero discrimination.

Since 2008, the region's rate of new HIV infections a year has remained unchanged at 350,000 infections. "We have not seen a decline in the last five years," Kraus said.

He says policy programmes are falling short and failing in making inroads towards these goals.

"We know that in this region if we keep doing what we're doing we're not going to get to 'zero' - we have to innovate," Kraus said at the recent 11th International Congress on AIDS in Asia and the Pacific (ICAAP11).

In the Asia Pacific region, 12 countries account for more than 90 percent of people living with HIV and of new HIV infections in the region led by India (2.1 million people), China (780,000) and Indonesia (610,000).

A demonstration of the proper use of a condom is conducted at a community health center in Malabon City, east of Manila, Philippines, 21 November 2010 (Photo: EPA/ROLEX DELA PENA +++(c) dpa - Bildfunk+++)

HIV infections have risen in Indonesia, Pakistan and the Philippines

More infection in Indonesia, Pakistan, Philippines

Progress has been made in curbing the virus' spread. Since 2001, the number of new infections has fallen by 26 percent. Among countries reporting a reduction in new infection rates by over 50 percent include India (down 57 percent among adults), Myanmar (72 percent fall), Nepal (87 percent), Papua New Guinea (79 percent), and Thailand (63 percent).

But major concerns remain as new HIV infections have risen 2.6 times in Indonesia; Pakistan is facing an eightfold increase, and new infections in the Philippines have more than doubled, the UN warns.

The number of people accessing anti-retroviral drugs to keep the virus in check across the region has increased to 1.25 million but well short of adequate coverage. The increased treatment has, however, led to an 18 percent reduction in AIDS-related deaths since 2005 to 2012.

New infection rates among children have also declined by 28 percent since 2001. But the UN report says regional coverage of HIV services to prevent new HIV infections in children remains low at 19 percent.

Young men at increasing risk

Activists and scientists' fears over increasing HIV infections are among people who inject drugs, men who have sex with men - especially adolescents - and transgender communities.

Across the region between 10 million and 27 million men are at risk at infection, the UN says.

Stefan Baral, an epidemiologist at the US-based John Hopkins University says the increasing incidence of HIV rates among young men highlights a failure in education and awareness programs.

"That really tells us that this epidemic is not going anywhere when we're seeing the youngest men that are the highest acquisition risk," Baral told conference delegates. "It also tells us that by the time we start exploring risks at the age of 18 we've already missed the acquisition risk for a lot of these men. It really tells us about the need to do more work with adolescents."

The World Health Organization (WHO) says globally more than two million adolescents between the ages of 10 and 19 are living with HIV, representing a 33 percent increase since 2001.

Transgender communities

Transgender communities are also another risk group requiring greater support, says Laxmi Narayan Tripathi, co-founder of the Asia-Pacific Transgender Network. Tripathi told DW high rates of HIV infections among transgender people means they "require special recognition, a special program."

"Political (support) and commitment on things is very essential. The commitment from UN agencies so they invest and look into the issues of transgender - this minority which is visible but yet treated as invisible," she said.

South Asia governments of India and Bangladesh have taken steps to recognise the rights of transgender people and improve their welfare, Tripathi added.

Governments lack political will

But stigmatization, discrimination and legal sanctions remain barriers to progress, say civil society groups.

A Pakistani transvestite man walks in a street near a mosque in Rawalpindi, on the outskirts of the capital Islamabad on October 22, 2009 (Photo: NICOLAS ASFOURI/AFP/Getty Images)

Transgender people "require special recognition, a special program"

Malu Marin, regional coordinator for non-government organization (NGO) Seven Sisters - a network of seven groups linked with HIVAIDs and sex workers across Asia Pacific, says discrimination and an absence of political will is undermining efforts to reduce HIV rates.

"We have made gains in changing risky behaviours that increase vulnerabilities to HIV infection, but we've not made gains in changing the behaviour of policy makers, political leaders and state actors," Marin said. "We're getting to zero change because of zero access to funding, zero legal reforms and zero political will," she added.

Decriminalization of same sex relationships, sex work and people program to assist who inject drugs are viewed as barriers in reducing HIV infection rates.

"The only thing we are still fighting on is to decriminalize laws that are not helpful to marginalized communities that are being affected," Papua New Guinea-based rights activist for sex workers, Alfred Banes, told DW.

"It is because of those bad laws, reducing or stopping the rights to access, the quality services and other available services is worse. So most of the organizations in the country now we are fighting for those laws to be decriminalized," he said.

Across the Pacific activists and governments have also reached out to church organizations, which still resist calls for law and social reform to deal with the AIDS pandemic.

But UNAIDS' Kraus was strident in challenges lying ahead.

"Our region is filled with laws that continue to criminalize same sex behaviour, 37 out of 38 countries criminalize sex work, we have countries that continue to restrict the free movements of people based on their HIV status," Kraus said.

"We need to challenge the status quo because laws, policies and practices, too, are often the barriers, access to treatment is not available and prevention programmes have not scaled up."