World AIDS Day 2017 promotes the “Right to Health”

The World AIDS Day campaign promote the theme “Right to Health” and the challenges that the 36.7 million people worldwide living with HIV face in realising that rights, especially for those who are vulnerable and affected by the epidemic.

The rights to health is also interrelated with a range of other rights, including rights to clean water, sanitation, decent housing, and access to health services, food, clean environment and safe working conditions.

Dr Juliet Fleischl, WHO Representative to Lao PDR said “To achieve the Universal Health Coverage and Sustainable Development Goals, we need to make sure that “Everyone Counts” and to leave no one behind. WHO is advocating for access to safe, effective, quality and affordable HIV services, medicines, diagnostics and other health commodities for the people who need them. There is also a need to integrate HIV services with other health services, such as those related to tuberculosis, hepatitis, sexually transmitted diseases and maternal and child health”

The number of HIV infection in the country has been slowly declining, with less than 1,000 new infections reported in 2016. However, the trend continues to show an increase of new infection among young women aged 15 to 24 years. Some of these included spouses of clients of sex workers and migrants who are the most affected by HIV.

Globally, good progress has been made to advocate for prevention measures among female sex workers. In 2016, an estimated 55% of female sex workers have received HIV testing compared to only 18% of reachable men who have sex with men.

The HIV epidemic has been concentrated, with pockets of increasing prevalence particularly among men who have sex with men and transgender populations. Among transgender persons who are engaged in sex work, the HIV prevalence was 7% as compared to 1.6% among those who did not report selling sex.

In Lao PDR, there are about 11,500 people now living with HIV. Of these, an estimated 64% know their HIV status and 41% of people living with HIV are receiving Antiretroviral Therapy (ART), which is lower than the regional target of around 50-55% and the global target 90-90-90. However, we see significant steps taken this year in meeting the treatment targets towards ending AIDS by 2030.

The “TREAT ALL” policy has been implemented nationwide to improve the first 90 target since 2016. People living with HIV are given treatment earlier according to the TREAT ALL policy. However, lost to follow-up of people on ART remain a challenge as less than 50% are retained in care to reach the third 90 for viral load suppression.

At the same time, HIV experts warned that it is still too early for development partners and the donor community to phase out support to HIV/AIDS-related matters. Lao PDR is surrounded by the 4 main contributors to HIV infection in the Asia-Pacific region, namely Thailand, Viet Nam, China and Myanmar who contribute 95% of new infections.

An estimated US$5 million needs to be invested annually in key populations, including treatment, if the country wants to achieve the national targets by 2020. So far, approximately US$ 2 million is committed with almost 100% of the HIV budget originates from external sources. To ensure sustainability of the HIV/AIDS program, more domestic funding is needed.

To commemorate World AIDS Day, UNAIDS, WHO, UNFPA and UN Women is collaborating with the French Red Cross, Lao Red Cross, International NGOs like PSI and Lao Non-Profit Associations to conduct a series of activities with the aim of raising awareness with media campaign, a fun fair and a free night concert. The events will help raise public awareness on “Know Your HIV Status” and HIV prevention.

Dr Fleischl and WHO Assistant Director-General (ADG) for Family, Women, Children and Adolescents, Dr Princess Nothemba Simelela promoting World AIDS Day 2017