Usaid Tide: Tackling The Hiv Crisis In Asia And Africa Amid Funding Challenges
Asia
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According to the Publication-Released in 2024, Asian countries have been known to be the 3rd largest epidemic countries with HIV infections, after Eastern and Southern Africa. Afghanistan, Bangladesh, Fiji, The Lao People's Democratic Republic, Papua New Guinea, and the Philippines; are countries that are highly affected by the HIV pandemic. In the listed countries, the number of new HIV infections increased by 32% among gay (men-to-men sex) partners and by 85% among non-client sex partners of people from key populations in 2024. In 2023, a new record was revealed that 6.7 million people living with HIV were residing in Asia and the Pacific. The Region accounts for a quarter of annual new HIV infections globally (23%). In Asia, there are 120,000 children aged 0-14 years living with HIV, making up 9% of the total number of children living with HIV globally. Indonesia comprises 26% of the regional total of new HIV infections among children, followed by India 23% and Papua New Guinea 8%. Over the past decade, funding for HIV programs has been decreasing. UNAIDS notes that in the Asia-Pacific region, support for HIV programs by funding has decreased by 2.6 % since 2021 – 2022. During the same period, the contribution of domestic resources has risen by 47% increasing the share of domestic resources from 58% of total HIV funding in 2011 to 82% in 2023. HIV prevention has been crucial in the region. Recent data reported to Global AIDS Monitoring shows inadequate investments in programming key populations and their sex partners in the region. Empowered communities are essential for the region's HIV response, but community-led responses remain underfunded. Social contracting, whereby the government partners with and procures services from community-led organizations, continues to be a potentially powerful but underused option for reaching people from key populations. Continued donor funding will also be critical for the sustainability of community-led response in Asian countries. Key populations play important roles in outreach and mobilization among their community members who are at risk of HIV. In Thailand, the Tangerine Community Health Clinic works closely with TG (telegram) social media influencers through online platforms to increase community literacy and awareness to generate demand for HIV and related services and to reduce internalized stigma among Tangerine communities, which was established in November 2015 at the Thai Red Cross AIDS Research Centre. The United States Department of the Treasury accounted for $667 million pledged to the financing mechanism of the Pandemic fund to support pandemic prevention preparedness and response in 2024. USAID from the American people-supported model of community-led services has been well recognized in Thailand and internationally resulting from its significant contribution to more than 50% of the national HIV service uptake in Thailand. It has become a model recommended by The United States President’s Emergency Plan for AIDS Relief (PEPFAR) for adoption in other countries in Asia. Through the PEPFAR Incentive fund activities to assist Thailand towards becoming self-reliant in HIV response. USAID made considerable progress in gaining increased government investments in USAID-supported community-based organizations from $167,000 in 2016 to almost $ 2 million in 2019. Through, PEPFAR, the US has committed more than $110 billion to HIV response globally. In Laos, USAID has supported the integration of oral-fluid HIV screening into peer-led outreach for guidelines for HIV self-testing. USAID funding has thus played a significant role in the Asia-Pacific region. The sudden stoppage in USAID funding by the US government is a wake-up call for organizations and governments in the Asia-Pacific region and globally to step up in HIV response. Avenues for funding need to be addressed to avoid reliance on external funding such as the USAID Uncertainty in the USAID funding presents the need for policy revaluations on HIV response in Asia and Africa which are hardest hit by HIV infections. With decreased funding in the Asian region, the rate of HIV infection will increase, derailing the plans by UNAIDS to achieve the global target of ending AIDS as a public health threat by 2030. The same scenario is likely to happen in the African continent as it relies heavily on external funding for HIV response and other health activities The government in Asian countries should carry out activities such as research to evaluate new prevention methods like vaccines, microbicides, and long-acting formulations of pre-exposure Prophylaxis or PrEP and to improve the efficient and effective delivery of HIV prevention, care, and treatment.
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