Getting to “ZERO” in ASEAN: Responses, Gaps, Challenges and Ways Forward

Good morning distinguished delegates, ladies and gentlemen.

It gives me great pleasure today in Brunei Darussalam’s capacity as Chair of the ASEAN Task Force on AIDS to represent the 10 Member States of ASEAN which also include Cambodia, Indonesia, Lao PDR, Malaysia, Myanmar, Philippines, Singapore, Thailand and Viet Nam. ASEAN is home to about 600 million people of diverse ethnicities, cultures, customs, religions, languages, modes of government and levels of development.

The ASEAN Mechanism to address HIV and AIDS is the ASEAN Task Force On AIDS, or ATFOA, formed in 1993. Since then, ATFOA has provided the focus for a coordinated regional response to HIV. It has completed three work programs, and is now launching the fourth Work Program.

ATFOA takes pride in having developed the first ASEAN Regional Report on HIV, which we hope to launch formally in this year’s ASEAN Summit. The report states that over 1.5 million people are estimated to be living with HIV in ASEAN. The epidemic varies throughout the region with some countries in latent, increasing, maturing and declining epidemics. Prevalence rates overall are decreasing, but two ASEAN countries have experienced an increase of over 25% in new cases since 2001.

As in the rest of Asia, the main drivers of the epidemic in ASEAN are unprotected sex with multiple partners and needle sharing in injecting drug use. 75% of all HIV infections in ASEAN are reported among the key affected populations of sex workers, men who have sex with men, transgenders, and people who inject drugs. Other vulnerable populations include intimate partners of these groups and at-risk youths, institutionalized persons, the military and mobile populations.

ASEAN countries have shown global leadership in certain aspects of the response to HIV. We were happy to hear in the presentation yesterday that two ASEAN countries, Thailand and Malaysia, were cited as “Global Superstars” in PMTCT. In addition, Brunei Darussalam and Singapore have also reached 100% coverage of PMTCT. Indonesia, Malaysia, Myanmar and Viet Nam have made many strides in addressing injecting drug use with programmes which include needle and syringe exchange and Opioid Substitution Therapy.

Cambodia and Thailand pioneered 100% condom use programme in sex work with many countries following suit. Lao PDR has introduced laws and legislation that protect people living with HIV as well as at-risk groups. The Philippines initiated institutionalization of pre-departure orientation and access to treatment and health care services for migrant workers.

In addition, Cambodia, Thailand and Myanmar have made noteworthy progress in reversing their epidemics. In AIDS expenditure, 4 ASEAN countries have achieved a high level of domestic funding of above 90%.

In the political arena, ASEAN leaders have made commitments to respond to the HIV epidemic. The first ASEAN Declaration on HIV and AIDS was made during the 7th ASEAN Summit in Brunei Darussalam in 2001. This Declaration was renewed by the Leaders during the 12th ASEAN Summit in Cebu, Philippines in 2007, further strengthening our commitment to universal access. ASEAN leaders have also signed the Declaration on the Protection of the Rights of Migrant Workers in the same year.

In the past five years, initiatives included supporting member states in reaching key affected populations through hosting and funding Regional level meetings and consultations. These included Consultations on At Risk Youth and Greater Involvement and Empowerment of PLHIV.

ATFOA also supported activities that promote enabling environments such as:
• High Level Multi Stakeholder Meeting on HIV Prevention Treatment and Care among Migrants
• the Workshop on HIV Education in the Workplace, and
• a Regional Consultation on Developing Frameworks for HIV prevention among MSM in Asia and the Pacific.

Many countries in ASEAN have already reached their targets in treatment coverage. Nevertheless, most of member states continue to depend on international assistance. For this reason, ATFOA supports the fast-tracking of accreditation for licensing in ASEAN Member States to produce affordable generic ARV drugs.

An important remaining challenge is developing an enabling Policy Environment for HIV program response. Conflicting laws and policies still exist, particularly for HIV prevention among people who inject drugs, sex workers and men who have sex with men.

What is the future for ASEAN?

ASEAN recently signed its Charter, which makes it a legal entity, to fully support the ASEAN Community Building by 2015. One of the key pillars in this community building is the ASEAN Socio-Cultural Blueprint, in which HIV is one of the listed priorities.

An opportunity for ATFOA is collaborating with non-health ASEAN sectoral bodies such as the Senior Labour Officials Meeting, Senior Officials on Youth, and Senior Officials on Drug Matters. In addition, there are opportunities for ASEAN to collaborate with other inter-governmental organizations. For example, in the past few ATFOA meetings, SAARC has been invited to attend in order to seek avenues for collaboration. Similarly, invitations have also been extended to key regional civil society organizations. We also seek closer ties with multi-lateral, bilateral and other international organizations, presently we have active engagement with UN Family, such as UNAIDS and UNDP, as well as other donor agencies. These dialogues and partnerships need to be pursued more strategically, with energy, vigor and passion. By doing this we can move closer in achieving the vision of the Interrelated ZEROs.

ASEAN has now developed the fourth ASEAN Work Program on HIV and AIDS, which will soon be endorsed by the Health Ministers of the Member States. AWP IV will run from 2011 to 2015. Its strategic objectives are to advocate for ASEAN’s collective agenda at international and regional platforms, promote continued information sharing primarily amongst Member States and leverage affordable access to HIV commodities.

The Government of Indonesia, as the Organizers of the next ASEAN Summit and the present Chair of ASEAN — has proposed to commemorate the 10th year anniversary of the first ASEAN declaration on AIDS by renewing the Commitment to HIV/AIDS.

In conclusion, although some countries in ASEAN have already reached their universal access targets, we still require further collaboration and support financially as well as technically. More so, in the provision of affordable access to ARVs.

Our vision is an ASEAN Community that is people centered, socially responsible, inclusive and harmonious, with enduring solidarity and unity. We aim to forge a common identity and build a community of caring societies, where the well-being, livelihood and welfare of all people are enhanced.

Thank you and Good Morning.