HIV and saving lives in Asia, Pacific

If countries in Asia and the Pacific provided early anti-retroviral treatment for those with HIV, says a medical professor from India and the son of a rural Methodist pastor, “Lives could be saved.”

That was the plea from N. M. Samuel, M.D., who served as president of the eleventh International Congress on AIDS in Asia and the Pacificand opened the Nov. 18-22 event in Bangkok.

Early treatment, he pointed out, also acts as prevention since persons on medication are 96 percent less likely to transmit HIV. “Why is it so hard to accept what already has been shown to work?” Samuel asked.

The theme of the Congress was focused on reaching the Triple Zero goal set forth by UNAIDS: “zero AIDS-related deaths, zero new HIV infections, and zero discrimination.”

While the goal remains elusive, the possibility of stopping transmission from mother-to-child during pregnancy and childbirth is scientifically possible.

Rarely is a child born HIV-positive in the United States because of medications and advance treatment. Globally, however, about 1,000 children are born daily with the virus.

“We have the resources, skills, and expertise to prevent parent-to-child HIV transmission, but the question remains whether we have the political and religious will to do it,” said Joe Thomas, executive director of Partners in Population and Development, Bangladesh. “Do we really care enough?”

HIV rates in Asia-Pacific

Despite scientific advances and dreams of an AIDS-free generation, rates of AIDS-related deaths and new HIV infections in Asia and the Pacific are stabilizing but not decreasing. Emerging epidemics are becoming evident in several countries as increases spike in Indonesia, Pakistan, and the Philippines.

Just before World AIDS Day on Dec. 1,UNAIDS released a report on “HIV in Asia and the Pacific”noting that “Despite progress, such as a 26 percent reduction in new HIV infections since 2001, the epidemic still outpaces the response and half of people eligible for antiretroviral treatment are not accessing it. “

The region must “actively engage in policy reform” warns Michel Sidibé, UNAIDS executive director, “to stamp out stigma and uphold human rights.”

More than 3,500 delegates at the congress learned that 4.9 million in the region (64 percent male; 36 percent female) are living with HIV, but only 1.25 million are receiving life-saving anti-retroviral medicines. In 2012, 350,000 new HIV infections were reported and 270,000 died from AIDS.

‘Behind every statistic is a human face’

“We must not forget,” said Festo Kavishe, deputy UNICEF regional director for East Asia and the Pacific, “that behind every statistic is a human face.”

One of those faces belongs to Murugan, a 9-year-old boy in rural India who is being raised in a child-headed household after both of his parents died of AIDS. Samuel noted that children like Murugan can now be born HIV free, but a lack of funding prohibits many mothers from getting tested and treated.

Thanks, however, to a free clinic established by theUnited Methodist Global AIDS Fundand administered by Samuel, Murugan and his siblings are healthy because they are getting medicine, nutrition, and opportunities for education. However, in a nearby hill country clinic, he said, 895 pregnant women have gone for treatment in the past six months, but lack of funding prohibited HIV testing.

“Every child should be born free of HIV, but when neither church nor society provides funds, what can we do?” Samuel asked.

Linda Bales Todd, co-chair of the Global AIDS Fund, indicated that monetary support from the denomination for AIDS ministries has dropped to near zero, but hopes an end-of-the year Christmas appeal will yield enough funding to at least support programs, like those in India, that stop mother-to-child HIV transmission.

“’Just Save One: Baby,’ is not just a slogan,” Todd said, “it is a lifeline of hope and health.”

From indifference to involvement

An interfaith pre-conference in Bangkok brought together leaders from Buddhist, Christian, Muslim and Hindu faith communities, exploring how faith communities can contribute to creating an AIDS-free world.

Lamenting the “widespread indifference of religious communities,” retired Methodist Bishop Yap Kim Hao, 83, of Singapore challenged individuals of all ages to “reach out to people afflicted with HIV/AIDS and listen to their cries and respond to their sorrows.”

Waiting for somebody else to act is unacceptable, he declared in a keynote address. “It is our religious obligation,” said Hao. “We have the responsibility to enlighten our religious people and mobilize their support to reach UNAIDS Triple Zero: zero deaths, zero new infections, and zero discrimination.”

Hao described how he discovered that prisoners with HIV in Singapore were dying because they did not receive free anti-retroviral drugs.

“This is not just a question of charity, but of justice,” he said, noting that people sent to prison for minor crimes were being “handed a death sentence as well.” Prophetically protesting to government officials, he succeeded in getting the government to change its policies and provide life-saving medication.

Possible or impossible?

A recurrent question posed at both conferences was whether the UNAIDS dream of “Getting to Zero” was possible or impossible. Scientific advances make more anti-retroviral medicines available but funding limitations do not make them accessible to the poor of the world.

Stories of stigma and discrimination toward persons living with HIV were common. Religious groups and governments often are unwilling to reach out to vulnerable HIV key populations of injecting drug users, prisoners, sex workers and men who have sex with men, thus prohibiting education, prevention, care and treatment.

Widespread tolerance of violence against women prompts the World Health Organization to deem domestic violence “a global health issue” fueling HIV and AIDS.

At the end was an unanswered query raised by a woman living with HIV from Indonesia: “Will we have zero infections, deaths, and stigma, or zero funding, treatment, and care?”

*Messer, executive director of the Center for the Church and Global AIDS, attended the eleventhInternational Congress on AIDS in Asia and the Pacific in Bangkok.

News media contact: Linda Bloom, New York, (646) 369-3759 or[email protected].

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