Political leaders in Asia and the Pacific have a precious window of opportunity to save millions of people from HIV infection. But to succeed, they will need to drastically increase spending on AIDS and scale up prevention, care and treatment programmes, according to a report by the Asia Pacific Leadership Forum (APLF) on HIV/AIDS and Development.
The APLF, a leadership initiative agreed in 2001 at the first Asia Pacific Ministerial Meeting on HIV/AIDS by 33 countries in the region, is funded by the governments of Australia, Japan, New Zealand, the United Kingdom, the United States and the European Union. The APLF’s aim is to keep HIV at the top of regional and national agendas in Asia and the Pacific, to promote effective leadership and to intensify commitment at all levels.
In the Asia Pacific region, the large majority of citizens remain uninfected. However, low prevalence figures mask pockets of severe, localized epidemics. Around 1 million people became infected with HIV in 2003 alone, bringing the number in the region living with the virus to more than 7 million. India, with 5.1 million people infected, is second only to South Africa as the country with the greatest number of people living with HIV.
The report maintains that an unprecedented opportunity exists for leaders to act now to protect their citizens from AIDS and, ultimately, saves lives. This is more than just and opportunity – it is a grave responsibility and the single-most important challenge for the region’s leaders in the 21st century.
According to the report, there has never been a situation necessitating more courageous and forthright leadership than today’s HIV epidemic in the Asia Pacific region. Leaders need to break the silence that fuels stigma and discrimination by speaking up and taking action on sensitive issues. “In the face of HIV/AIDS epidemic, good governance and responsible political leadership mean talking publicly about sex,” said Chandrebabu Naidu, former Chief Minister of India’s Andhra Pradesh State.
“In a society where there are religious, social, cost and other constraints, it’s even more vital to have political leadership,” said Anand Panyarachun, former Prime Minister of Thailand and chairman of the APLF steering committee.
Some governments in the region, such as China, Indonesia and India, are starting to treat AIDS with greater urgency. For example, the former Prime Minister of India, Atal Behari Vajpayee, declared the disease, “the single most formidable challenge to public health, human rights and development in the new century.”
In China, top-level leaders have made a renewed commitment to AIDS. According to Vice Health Minister, Dr Wang Longde, before the year 2000 the country “focused more on economic development and neglected social development. It is an important lesson we learned from last year’s SARS outbreak.” He contends, however, that the formidable barriers still exist in China, adding: “Leaders of different levels need to realize the importance of HIV/AIDS, especially leaders of high prevalence provinces”
The publication also highlights the need for other streams of leadership – business leaders, community leaders, religious leaders and women leaders – to play a critical role in mobilizing action against HIV. Governments must also play their part in encouraging civil society, nongovernmental organizations, community groups and people living with HIV to be part of the response. Within government itself, all sectors - not just health departments – need to view AIDS as their problem, recognizing that failure to combat the virus will result in loss of economic productivity and a general deterioration in all sectors of society.
The report points out that leaders can make highly influential decisions that ensure access to quality information, given that lack of awareness creates risk. They can also encourage prevention strategies such as condom use, promote needle exchange programmes and make available access to care, support and treatment for those affected.
The longer political leaders wait to implement a comprehensive response, the greater the cost in terms of lives and suffering and the greater the long term financial burden to national budgets. There is no time to lose.