Regional Session on AsiaPacific

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• Regional Session on Asia-Pacific  
• The Status of the epidemic in
• Asia and the Pacific
• August 4, 2008
• Aikichi Iwamoto, M.D.
• Governing Council, Asia and the Pacific Islands
• Professor, Infectious Diseases
• University of Tokyo

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HIV prevalence in Asia and the Pacific,
2007Adults and children

• People living with HIV 5.0 M 4.1 6.2 M
• Newly infected in 2007 380,000 200,000
  650,000
• AIDS-related death 380,000 270,000 490,000

2008 AIDS Epidemic Update, July 29, 2008
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Adult HIV Prevalence () in Asia and the Pacific

• 1 - 5 Thailand, PNG,
• 0.5-lt1.0 Cambodia, Myanmar, Viet Nam,
  Malaysia,
• Nepal,
• 0.1-lt0.5 India, Indonesia, Iran,
• Australia, Lao PDR,
• Pakistan, Singapore
• lt0.1 Japan, China,
• Philippines, Korea, Bangladesh, etc.

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Early waves of epidemic in Mid-to-late 1980s
Thailand Cambodia (Myanmar)
A success story
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Sustained and growing epidemic behind the success
Thailand, 1989-2005
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Lessons from foregoers

• Tsunami waves may come successively.
• Complacency and political apathy are not
  allowed.
• Continuous need to fight against stigma and
  discrimination.

HIV waves in Thailand 1984-2007

Dr. Chureeratana Bowonwatanuwong
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Rapidly growing epidemic
Viet Nam
Indonesia
PNG
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Injecting drug users 4,850,000

• Many outbreaks in the region
• - 1980s Sydney, Bangkok, Manipur, Yangon
• - early 1990s Yunnan
• - late 1990s Nepal, Hai Phong, Jakarta
• - early 2000s Taiwan,
• etc.

Male IDUs buying unprotected sex
MAP report 2005
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Women living with HIV

• The proportion of women has increased
• from 26 (2001) to 29 (2007) in Asia.

Children (lt15 y/o) 2007
Living with HIV/AIDS 150,000 Newly infected
24,000 Death due to AIDS 18,000
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Scaling up of antiretroviral therapy

• - The great majority of countries are in urgent
  need of access to
• and scaling up of ART.
• Better salvaging regimen should be available.
• Thailand has scaled up substantially but has to
  use d4T which
• is not used routinely used in the north.

Regimen 1. d4T 3TC NVP 2.
d4T 3TC EFV 3. d4T 3TC
IDV
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Diverse and complex HIV epidemic in Asia and the
Pacific

• History of HIV epidemic
• Route of transmission / Most affected population
• Concentrated area in each country /rural or
  urban
• etc.

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Dense population
60 of world population in Asia and the Pacific
4 / 6.6 billion
Two countries over 1 billion China 1.3
billion India 1.1 billion
Current epi 0.05 0.36
24 million 48 million
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Prevention
India
2006 2.5 M UNAIDS 2007
2005 5.7 M (gt5.5 M in SA) UNAIDS 2006
Expanded and improved surveillance system
The proportion of people living with HIV in India
is lower than previously estimated, but the
epidemic continues to affect substantial numbers
of people. AIDS epidemic update 2007 (March
2008/WHO, UNAIDS)
Strong will Strong commitment
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Many thanks to contributors

• Saphonn Vonthanak, Cambodia
• Chureeratana Bowonwatanuwong, Thailand
• Yi-Ming Arthur Chen, Taiwan
• Masahiro Kihara, Japan
• Kah Sin Cho, UNAIDS
• Pascal Tanguay, Asian Harm Reduction Network
• Ron MacInnis, IAS Secretariat
• Bernard Amahaya Kadasia, IAS Secretariat
• AVERT http//www.avert.org/
• UNAIDS http//www.unaids.org
• WHO http//www.who.int/en/
• Etc.