Ending AIDS in 2030: Do not leave Asia-Pacific Behind

Ending AIDS in 2030: Do not leave Asia-Pacific behind

6 June 2016: Statement from a coalition of Asia-Pacific regional networks (including APNSW) to state representatives and other participants at the 2016 High Level Meeting on Ending AIDS.

Statement is also available in pdf format. (2.4MB)

Do not Leave Asia Pacific Behind

Asia and the Pacific is home to the second highest number of people living with HIV after sub-Saharan Africa. Our culturally, politically and economically diverse region has an epidemic that is predominantly concentrated among key populations – men who have sex with men, sex workers, transgender people and people who use drugs – but also impacts heavily on women and girls, migrants, young people and adolescents, people in prisons, indigenous peoples, orphans, vulnerable children, and ageing populations.

In 2011, two UN-ESCAP Resolutions [1] called for regional action to achieve universal access to HIV prevention, treatment, care and support. Underlying these are specific calls for political leadership to amend or remove laws, policies and practices that fuel stigma and discrimination; ensure sufficient investment to sustain the response; address all forms of gender-based violence; and promote access to affordable medicines, diagnostics and vaccines. Resolution 67/9 also named key populations of people who use drugs, sex workers, men who have sex with men and transgender people. In 2013, governments in the region again committed to addressing policy and legal barriers for key affected populations, and furthermore to eliminating discrimination on the basis of sexual orientation and gender identity and scaling up efforts to achieve Universal Access. [2]

In the five years since the last UN High Level Meeting on HIV/AIDS and the UN-ESCAP Resolutions, Asia and the Pacific has seen an overall reduction in new infections. However, concentrated epidemics among key populations in major cities continue to rise, with new infections rising by 3% between 2010 and 2014. [3] Thirty cities in the region account for almost a quarter of all people living with HIV. While more people living with HIV have access to life-saving anti-retroviral drugs in the last five years, treatment access remains at 34% in the region, lower than the global average of 41%.

Repressive laws, policies and practices that criminalize people who use drugs, sex workers, men who have sex with men and transgender people remain in place. These laws fuel violence, stigma and discrimination, increase exposure to human rights abuses and further heighten vulnerabilities. Discriminatory laws and policies also hinder access to services for adolescents, young people, women and migrants. Without an enabling environment, we cannot achieve effective service delivery nor reach the 90-90-90 treatment targets.

National investments in the HIV response have increased in Asia and the Pacific in the last five years. This illustrates the commitment of some governments in the region to fulfilling their citizens’ right to health and ensuring country ownership of the response. While expenditure is invested heavily in health service delivery and provision of treatment, newer classes of ART drugs and treatment options that have minimal side effects and ensure high quality of life of PLHIV are still not available. Co-infection with hepatitis C is also of increasing concern.

Middle-income countries are being excluded from price discounts and voluntary licenses by multinational pharmaceutical companies. Generic producing countries like India are under significant pressure from developed countries over their use of TRIPS flexibilities. We are very concerned with the Trans-Pacific Partnership Agreement, which contains pro-IP provisions that threaten access to generic medicines. And currently, Japan and Republic of Korea are demanding similar provisions for the Regional Comprehensive Economic Partnership Agreement, which covers 16 countries in our region.

Treatment is a crucial component of the response, but funding for prevention programmes, especially for key populations, remains the lowest priority in domestic financing. With the global shifts in financing of health and HIV programmes, we are alarmed that countries who are on the verge of transitioning to middle income economies will have less or zero access to external HIV financing especially for prevention – jeopardizing the initial gains in the HIV response, especially the work and contribution of communities and civil society.

Community organizations and networks of key populations are at the forefront of the HIV response in Asia and the Pacific. However, the political space for us to engage is shrinking due to stricter regulations, and ideological opposition, which undermines our capacity to engage meaningfully. Thus, we decry and protest the exclusion of Asia-Pacific Transgender Network (APTN) to participate in this High Level Meeting.

As communities and civil society from the Asia-Pacific region, we ask Member States at this UN High Level Meeting on HIV/AIDS to:

  • Retain the naming of key populations, including transgender people, consistently throughout all relevant sections in the 2016 Political Declaration, especially in paragraphs that outline strategies and responses.
  • Commit to a roadmap towards decriminalization of key populations and removing age restrictions and parental and marital consent requirements for adolescents and young people.
  • Ensure universal access to comprehensive harm reduction, sexual and reproductive health and rights, HIV information services and comprehensive sexuality education for all.
  • Ensure implementation of prevention and care strategy for women and girls.
  • Commit to removing policies on HIV-related travel restrictions and deportation.
  • Establish a robust and systematic assessment of how countries fulfill its human rights obligations, including the right to health, especially for key populations and women and girls.
  • Commit to establishing funding mechanisms for civil society and critical enablers.
  • Develop sustainable mechanisms to ensure the availability, affordability and accessibility of treatment and diagnostics for HIV, TB, Hep-C and other co-infections in ALL low and middle-income countries.
  • Utilize all TRIPS flexibilities to prohibit evergreening and other patent rights abuses that curtail access to medicines, diagnostics and vaccines.  LDCs should use the TRIPS transition to 2021 and pharmaceuticals transition to 2033 and suspend IP barriers on generic medicines.
  • Remove TRIPS-plus provisions that negatively impact production of generic medicines; and remove all TRIPS-plus demands from the Regional Comprehensive Economic Partnership Agreement.
  • Support and promote all efforts at local production of pharmaceuticals.
  • Provide an enabling environment and policy space for community and civil society to engage meaningfully in all aspects of the AIDS response, beyond just mere project implementers or beneficiaries.

Ending AIDS as a public health threat will not happen if this meeting leaves Asia and the Pacific behind. Ending AIDS in Asia and the Pacific will only happen if key populations and vulnerable communities are meaningfully engaged in all aspects of the response. Ending AIDS is only achievable, if governments address the political, social and structural barriers to Universal Access: including law and policy reform, access to justice and social protection, stigma reduction and addressing gender-based violence and inequalities. Ending AIDS is possible if adequate funding is front-loaded to respond to the stark realities on the ground. Only with strong leadership and political will, can our governments achieve the goal of ending AIDS by 2030.

This statement is endorsed by over 100 organisations and individuals including:

  • Hon. Michael Kirby, Member of the UNAIDS/Lancet Global Commission on Defeating AIDS, Australia
  • J.V.R. Prasada Rao, UN Secretary General Special Envoy for AIDS, Asia & the Pacific
  • Coalition of Asia-Pacific Regional Networks on HIV/AIDS (7 Sisters)
  • Asia Pacific Alliance for Sexual and Reproductive Health and Rights (APA)
  • Youth Voices Count
  • Youth LEAD
  • APCOM
  • APCASO
  • International HIV/AIDS Alliance
  • Asian Network of People who Use Drugs (ANPUD)
  • International Community of Women living with HIV in Asia and pacific (ICWAP)
  • Asia Pacific Network of Sex Workers (APNSW)
  • International Drug Policy Consortium
  • Asia-Pacific Transgender Network (APTN)
  • Asia-Pacific Network of People Living with HIV/AIDS (APN+)

For a full list of endorsements see the PDF verison of the statement.

References:

[1] Economic and Social Commission of Asia-Pacific Resolutions 67/9 and 66/10

[2] Asian and Pacific Ministerial Declaration on Population and Development, 2013 (Para 20, 84 and 119)

[3] On the Fast Track to End AIDS (UNAIDS 2016-2021 Strategy), UNAIDS, 2015