By Feizal Samath
COLOMBO, Apr 9 2007 (IPS)

Tired of waiting for governments to deliver on promises, activists, experts and people living with HIV/AIDS in Asia and the Pacific will push for stronger community leadership in the battle against the disease at a regional summit to be held in this city in August.

”This is coming out strongly from presentations to be made at the August summit,” says Kah-Sin Cho, regional programme advisor at the UNAIDS Asia and the Pacific office.

“Community leadership is coming out strongly in these abstracts. They are not depending on the government to do what is needed, whether it is empowering people, communities or people living with HIV/AIDS (PLWHAs),” he said in an interview in Colombo, stressing that civil society “wants to take their future into their own hands.”

More than 3,000 delegates from over 60 countries in Asia and the Pacific are expected to attend the 8th International Congress on AIDS in Asia and the Pacific (ICAAP) in Colombo from Aug. 19-23. It is one of the biggest international gatherings to meet in Sri Lanka and the organisers are hoping the security situation in the country will not deter participation.

The four-day meeting where critical issues on HIV/AIDS relating to the region would be discussed will bring together politicians, government officials, medical experts, academics, PLWHAs, community workers and the media.

Regional experts, who were in Colombo last week for discussions on how best to organise the meeting, said among issues coming up for discussion are stigma and discrimination, access to treatment for PLWHAs, ensuring political leaders keep their promises, ‘harm reduction activities’, scaling up services for the affected and community leadership.

Shiba Phurailatpam, regional coordinator of the Asia Pacific Network of People Living with HIV/AIDS (APN+), says although several governments in the region are providing antiretroviral (ARV) drugs, the coverage is seriously deficient. “For example the Indian programme reaches only 40,000 out of one million who need the drugs. Also those who develop resistance to the first line of treatment don’t have access to the second line of treatment which is not provided,” he said.

Phurailatpam said in Vietnam, 4,000 people are covered out of more than 10,000 PLWHAs. In addition there are other issues where HIV positive people, gay men and drug users face discrimination within the healthcare sector itself. He said stigma and discrimination were among the key challenges of the HIV/AIDS discourse with one UNAIDS report saying only one in seven PLWHAs gets the drugs needed. “There are huge gaps in which governments have failed to deliver and these issues will come out strongly at the meeting,” he said, adding that many people from marginalised groups are to attend the meeting.

APN+ is a network of organisations in 28 countries of HIV positive people fighting against stigma and discrimination, advocating treatment and developing capacities to help those affected.

According to UNAIDS, latest estimates show some 8.3 million people were living with HIV in Asia in 2005. AIDS claimed some 520 000 lives in 2005. In China, the number of people living with HIV is 650, 000 while 31,000 have died from AIDS in 2005. The number is much higher in India, the second largest population after China, where over five million people are affected.

Sri Lanka, having a much lower population of 20 million, is considered a low prevalence country with 5,000 cases and 153 deaths by the end of 2006. But UNAIDS’ Kah, while crediting Sri Lanka with hosting this meeting despite the disease not being as rampant as in other Asian countries, says the country cannot afford to be complacent.

“Even though it’s a low-risk country, that doesn’t mean risk behaviours are not there. Do you want the risk behaviour to turn into an epidemic? This is the problem,” he said.

Geoff Manthey, also a regional advisor with UNAIDS, said there has been a lot of movement forward since the last ICAAP meeting in Kobe, Japan in 1995. He said the Asia Pacific Leadership Forum has been working closely with leaders in the region and developing many initiatives and that many of the presentations will reflect work with marginalised communities, migrant populations, construction workers and truckers.

Kan says one of the challenges is how to make governments accountable and ensure high level declarations and commitments are followed up at country level. “It’s easy to come up with a declaration but following up locally and ensuring it happens is the difficulty,” he said.

Asian parliamentarians through the Parliamentarians for Global Action forum are planning to convene a few sessions here which officials say would be an ideal opportunity for them to interact with grassroots level actors. “Sometimes this interaction is not even available in their home turf,” a local organiser said.

Groups involved in ‘harm reduction activities’ are hoping to convince governments to accept this strategy as a means of minimising new infections through the use of clean needles.

Pascal Tanguay from the Asian Harm Reduction Network, Thailand, says harm reduction is a short-term pragmatic solution which has been very effective in ensuring drug users do not use dirty needles. “It provides them access to health services and helps in the longer term to wean them away from drugs with other rehabilitation programmes.”

Governments frown on this type of strategy saying it only encourages drug users as harm reduction groups do not ask drug users to stay off drugs.

But Tanguay argues that while the ultimate goal of this strategy is to get people off drugs, ‘’we say if you want to use drugs that’s fine but use it as safely as possible so you don’t contract HIV.”

Harm reduction activities are combined with rehabilitation programmes and skills training for recovering drug users.

UNAIDS’ Sri Lanka coordinator David Bridger believes the need to scale up services to ensure all PLWHAs get treatment would also be a focal point at the meeting.

Excerpt: