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Second Asia-Pacific Ministerial Meeting on HIV/AIDS
11 July 2004
Bangkok

HIV/AIDS SITUATION AND RESPONSE
IN ASIA AND THE PACIFIC
 BY
MR. KIM HAK-SU
UNDER-SECRETARY-GENERAL OF THE UNITED NATIONS
AND THE EXECUTIVE SECRETARY OF THE ECONOMIC AND SOCIAL
COMMISSION FOR ASIA AND THE PACIFIC

 

Your Excellency, Prime Minister Thaksin,
Mr. Secretary-General,
Excellencies,
Colleagues,
Ladies and Gentlemen,

On behalf of the United Nations Economic and Social Commission for Asia and the Pacific, it is my pleasure to address you all on this very important occasion of the Second Asia-Pacific Ministerial Meeting on HIV/AIDS, hosted by the Government of Thailand.

We are gathered here at a crucial juncture in a race against time.  The AIDS epidemic is a development crisis that is hitting our region.   

This region is home to two-thirds of the world's population.  It is dangerous to assume that the low prevalence rates often cited for countries and areas of this region mean that we are free from the peril of an African tragedy.

In fact, with the region's huge population base, low percentages translate into staggering numbers.  Each minute, one person dies of AIDS in this region.

The commitment of Thai Prime Ministers in the HIV/AIDS response has been exemplary.  Thailand's 90 per cent decline in new HIV infections over the past 12 years is a result of consistent support from its top leadership, and the active participation of communities and the private sector.

Prime Minister Thaksin's active support of the XV International AIDS Conference, his mobilization of leaders in the region, and his meetings with civil society, underscore continuous Thai leadership commitment to HIV/AIDS.

Leaders in this region are increasingly recognizing that HIV/AIDS is a development challenge.   Last year, the 62-government membership of UNESCAP focused their annual Commission session on multiministerial and multisectoral collaboration to address the social and economic development context in which the virus flourishes.  In doing so, the Commission adopted its second HIV/AIDS resolution in three years.

Your own leadership, and that of your Heads of Government and Heads of State, are critical to enhancing investment in HIV/AIDS and stimulating diverse ministries and sectors to collaborate in an emergency response to the crisis. 

Last year, 1,200 Indian ministers, parliamentarians and mayors from all parts of the country gathered to discuss actions that they could take to turn the tide of HIV/AIDS.

Madam Sonia Gandhi's representation of the Government of India at UNGASS 2001 is a striking example of how a then opposition leader and an incumbent government could work together on HIV issues.

China too has achieved significant progress.  This year, China established a new HIV/AIDS working committee, led by a deputy prime minister, and involving all key ministers and provincial governors.

Despite such encouraging steps, political indifference to HIV/AIDS still exists.  It hinders efforts to mobilize sufficient public funding and to foster collaboration among health, education, labour, transport, trade, finance and planning ministries. 

In this region, there is no head of government that leads a national AIDS programme on a day-to-day basis in the same way that they respond to national and local emergencies.

Not many countries in the region have a genuine multiministerial programme, with each ministry having its own budget for HIV/AIDS.

The resource gap is a major challenge facing the Asian and Pacific region.  Last year, only less than 20 per cent of the total financial resources needed for comprehensive responses were raised from all public sector sources combined, including donor and government sources.

A new UNAIDS-ADB study, which Dr. Peter Piot launched this week, indicates that if 4 per cent of this region's health expenditure or 0.2 per cent of the gross national income of countries of the region could be spent on HIV/AIDS, then:

Without such an investment in HIV/AIDS, the region could incur an annual loss of 17 billion US dollars from 2010 onwards.  It is poor households that would bear the brunt of the costs.

HIV/AIDS hits hardest the poor who cannot afford to be sick.  Even those who are not poor to begin with would spiral downwards into poverty.  The epidemic is worsening the vicious cycle of poverty and ill health.

Increasing poverty would slow down achievement of the Millennium Development Goals, even in Thailand.

Communities are in the forefront of the fight against the scourge of HIV/AIDS.  Political leadership and government support are essential for enabling communities to reach their full potential in HIV prevention, care and support.

In much of this region, the HIV epidemic remains largely concentrated in injecting drug users, men who have sex with men, sex workers and their clients.  Shrouded in stigma and discrimination, with no access to information, health care and social support, these groups are most vulnerable.

In some areas of China, 80 per cent of injecting drug users are HIV positive.  In some parts of India, more than half of the sex workers are living with HIV.

Silence and discrimination breed HIV.  Political and government leaders are in the best position to stop discrimination and strengthen law enforcement for protection of the most vulnerable.  Cambodia, Papua New Guinea and the Philippines have enacted specific legislation to protect the rights of people living with HIV/AIDS.

In this region, progress has been made to improve access to ARV drugs.  In the past two years, Thailand has increased five-fold the number of AIDS patients who receive ARV treatment.

The challenge that Thailand faces is to develop a mechanism to reach HIV-positive people in the community who do not come to hospitals, particularly the poor.  UNESCAP's "Partners for Health Project" in Thailand responds to the need for a sustainable means of supporting ARV access, by mobilizing public-private-community partnership.

Recently, China has made a policy decision on free HIV testing for everyone and free ARV treatment for the poor.

Malaysia has issued a compulsory license to allow the import of generic ARV drugs produced in India.

The Pacific Island States are collaborating to develop their ARV procurement strategies.

 

Ladies and Gentlemen,

Are health systems ready to provide the poor with the services that they need at affordable prices?  Do we have sufficient human resources to meet the challenges of the exploding epidemic?

Lack of trained health personnel and poor attitudes towards HIV-positive people have become major barriers to scaling up AIDS treatment programmes.  For example, China has fewer than 200 doctors who have special skills in treating AIDS opportunistic infections, and nearly 1 million people living with HIV. 

 

Ladies and Gentlemen,

Since October 2001 when the Government of Australia hosted the First Asia-Pacific Ministerial Meeting on HIV/AIDS, new action is in progress.  However, the virus is outpacing our action.

We need concerted action. And we need effective action. As the world's largest region, collective Asian and Pacific action can make a difference in resolving the global crisis.

Resolute leadership action and sustained commitment have to focus on five key areas. These are:

As your regional secretariat, UNESCAP stands ready to provide you with long-term institutional support for your efforts to expand multisectoral responses, in the context of our three priorities on reducing poverty, managing globalization and addressing emerging social issues.  We shall of course do so in continued close collaboration with UNAIDS and the cosponsor agencies.

Let's join hands to defeat the virus that today seems so formidable.

Thank you.