Fifty-fifth session of the WHO Regional Committee for the Western Pacific
13-17 September 2004, Shanghai, China
Dr Shigeru Omi, World Health Organization Regional Director for the Western Pacific, has warned of the danger of HIV "bridging" into the general population from infected individuals with high-risk behaviour unless countries and areas in the Region act now to avoid a major HIV/AIDS epidemic.
WHO earlier cautioned that HIV/AIDS epidemics would likely continue to spread in countries in the Region unless prevention strategies were actively promoted and expanded in those with high-risk behaviour: injecting drug users, sex workers and men who have sex with men.
Addressing the 2004 Regional Committee for the Western Pacific, Dr Omi said, "The epidemic is still increasing in many countries. We are still not catching up with the epidemic despite success stories against HIV/AIDS epidemic in some countries in Asia, such as Cambodia and Thailand."
The Regional Committee, WHO's governing body in the Region, is meeting in Shanghai, China from 13 to 17 September to review WHO's work in the Region and to discuss future health directions. About 100 representatives, including several ministers of health from Member States in the Region, are attending the meeting.
"Most countries in the Region have low HIV prevalence but increasing HIV infections in sex workers and injecting drug users (IDUs)¯ coupled with high prevalence of sexually transmitted infections and high-risk sexual behaviour¯ implies a great potential of HIV spread to the general populations," Dr Omi warned.
He called on Member States to target evidence-based interventions in areas where HIV transmission is taking place and increase the coverage of these interventions. "Prevention strategies need to be actively promoted," Dr Omi said. "The ideal time for action is now to avoid a major epidemic."
At least 1.5 million people in the Region are living with HIV/AIDS. Surveillance data indicate that HIV infections in sex workers and injecting drug users are increasing in several countries. There is also evidence that the number of injecting drug users is increasing, and that they are engaging in risky sexual behaviour.
As HIV cases increase, so do AIDS cases, with patients requiring support from health systems. WHO warned that Member States need to take immediate action before health systems are pushed to the brink of collapse, and the epidemic undermines the economic, social and political gains of many countries in the Region.
Dr Omi reported to the Regional Committee of the continuing international support for HIV/AIDS in the Region. From the Global Fund to Fight Aids, Tuberculosis and Malaria, total support for HIV/AIDS in the Region has reached US$ 297 million.
The "3 x 5" Initiative is also being readied in the Region, particularly in countries with priority needs: Cambodia, China, Papua New Guinea and Viet Nam. The Initiative seeks to provide antiretroviral treatment to 3 million people living with HIV/AIDS in developing countries by the end of 2005.
The Global Fund is the key partner of countries and of WHO in the implementation of the "3 x 5" Initiative. On a global scale, as of July 2004, 6 million people with AIDS were in need of antiretroviral therapy, but only 440 000 had access to such treatment. In the Western Pacific Region, only 15 000, less than 10% of the estimated 170 000 HIV/AIDS patients in need, were receiving antiretroviral therapy.
Social stigma surrounding the disease remains a major stumbling block to stopping its spread. Said Dr Omi: "Drug use and sex work are often regarded as social evils. Such stigmas inhibit effective HIV prevention and care, and as long as they remain, the epidemic will continue to grow and push the crisis further. Social stigma also limits the effectiveness of public health responses."
Meanwhile, the Regional Committee called on Member States to take the following action:
- further strengthen surveillance activities;
- scale up effective interventions with measurable targets such as needle and syringe exchange programmes and drug treatment for the prevention of HIV in injecting drug users, and the 100% condom use programme for the primary prevention of sexually transmitted infections, including HIV/AIDS;
- promote the "3 x 5" Initiative by improving access to HIV/AIDS treatment;
- improve coordination of efforts to prevent and control HIV/AIDS at country level; and
- promote advocacy to develop political support for an effective response to HIV/AIDS.
- China accounts for about 840 000 HIV infections - nearly two-thirds of the Region's estimated total.
- The highest HIV prevalence rates are found in Cambodia and Papua New Guinea.
- In parts of China, rates of HIV prevalence in injecting drug users range from 20% in Guangdong to 89% in Xinjiang.
- In Viet Nam, there are HIV prevalence rates of more than 20% among injecting drug users in most provinces, and HIV prevalence rates in sex workers have been recorded at 8% in Hai Phong and 15% in Hanoi.
- In Papua New Guinea, there is an HIV prevalence rate of 17% among sex workers in certain areas.
- Increasing HIV epidemics have been noted particularly in China, Malaysia, Papua New Guinea and Viet Nam.