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Redefining AIDS in Asia - Crafting an effective response

An independent Commission on AIDS in Asia was established in June 2006 with support from UNAIDS to review the HIV situation in Asia from a wide socioeconomic perspective reaching beyond the public health context. The commission was Chaired by Dr. Chakravarthi Rangarajan, who is the Chairman of the Economic Advisory Council to the Prime Minister of India. Over an 18-month period, through its review and consultations with a broad range of stakeholders, the Commission has produced a set of findings and recommendations.

aids response

According to the Commission report, to address concentrated epidemics, requires leadership to overcome the social drivers behind the epidemic. These include structural and social factors, such as criminalization and marginalization of certain groups, human rights violations and discrimination. Failing to address these constitutes a major barrier to an effective national response. Many of the recommendations of the commission have far reaching implications. For instance the commission recommends the need for civil society adopting the NGO code of conduct and an AIDS Watch is being created in each countries by the civil society.

Broader themes for discussion

The following broader themes will be presented for discussion. Sub themes under the broader themes will be developed in consultation with a selected group of "resource persons".

1) Redefining the epidemic, and why Asia HIV epidemic is unique. The Report argues that the "standard classification of `low-level', `concentrated' or `generalized' based on the HIV prevalence in pregnant women does not capture the actual nature and dynamics of Asia's epidemics." The Commission on AIDS in Asia instead proposes four epidemic scenarios for Asia : latent, expanding, mature, and declining and links a proposed package of prevention interventions with the most impact for each scenario. How can one take this finding forward in your country and how might one advocate for how government should invest their resources?

2) Decriminalization. How best can we review, remove or relax legislation which harass sex workers, drug users, MSM and the service providers who assist them? What do you think of the suggestion from page are some lessons learnt from the region?

3) Accountability. How can we promote accountability by government, donors/international community and the NGOs/community organizations? Suggest practical AIDS watch mechanisms which can ensure follow-up to internationally or regionally agreed frameworks for scaling up access to prevention and treatment?

4) Increasing domestic funding. The Report stated that "as available resources for funding HIV programmes have increased, the percentage of total HIV expenditure funded out of national budgets has decreased in the 14 surveyed countries - from 60 percent in 1996 to 40 percent in 2004. How does one make the case for increasing domestic resources for AIDS in the Asia region?

5) Country and regional follow up. Discuss follow up country and regional level needed to take forward the recommendations of the Commission on AIDS in Asia . Country advocates could share their plans and describe support needed.

Ideally, each theme will be open for discussion for two weeks. However, considering the time limitation, one my choose to comment on any or all of these issues. The moderator may use his discretion to post the message according to each theme.