Rising HIV cases in PH buck global decline

MANILA, Philippines (UPDATED) – New incidents of HIV infections across 25 low- and middle-income countries dropped by more than 50% in a decade (2001 to 2011), according to the 2012 Global Report of the Joint United Nations Programme on HIV/AIDS, or UNAIDS.

But findings in the Philippines went against the trend and painted a grimmer picture. The report, which was released on Tuesday, November 20, revealed that the AIDS epidemic in the country is on the rise, with new HIV infections increasing by more than 25% in 2011.

Most global indicators showed progress toward achieving global targets.

Across the 186 countries that participated in the survey, the results reported record access to HIV treatment, a record drop in AIDS-related deaths, and a significant increase in domestic HIV investments.

The report also showed that in 2011, for the first time, domestic investments in HIV response surpassed global funding. The global gap in resources needed by 2015 has now dropped to about 30%.

Domestic funding grew from US$ 3.9 billion in 2005 to almost US$8.6 billion in 2011. Some 81 countries increased domestic investments for the AIDS response by more than 50% between 2006 and 2011.

“We’re moving from despair to hope,” UNAIDS Executive Director Michel Sidibe said during the launch of the report streamed online.

The results come as countries approach a 1,000-day deadline to achieve the Millennium Development Goals and the 2015 targets of the UN Political Declaration on HIV/AIDS.

Philippine results

Globally, the AIDS response is on the upswing.

But the Philippine story is something else.

UNAIDS’ 2012 report showed a 25% increase in new HIV incidents in the country.

This is consistent with reports that came out in June, which noted a continuing rise in the number of HIV/AIDS cases in the country, and reports that came out in July, which found that the number of new cases in the first half of 2012 already surpassed the number of HIV incidents in 2010.

The rising number of HIV cases in the Philippines has been blamed partly on the lack of access to tools that prevent infection, such as condoms and educational programs. According to the National Demographic Health Survey of 2008, condom use in the Philippines stands at a low 2.8%.

The proliferation of social media networks and online dating sites in the Philippines have also made casual sexual encounters extremely accessible among the MSM (men who have sex with men) community, according to a previous report.

In the latest UNAIDS report, the Philippines was also among the countries which reported either no decrease or less than 25% decrease in HIV-related deaths.

Reported coverage of HIV prevention programs showed varied results. HIV prevention programs among sex workers were at 50-74% while those among men who have sex with men were at less than 25%. The levels of HIV testing among men who have sex with men were also lower than 25%.

As of August 2012, the projected number of people living with HIV from the age of 15 to 49 stands at 21,837, Department of Health (DOH) Assistant Secretary Eric Tayag said in a presentation before the Philippine Legislators’ Committee on Population and Development Foundation Inc in the House of Representatives also on Wednesday.

But the total number of reported cases only stands at 10,514, a 587% increase since 1984, when the first case of HIV was reported.

Alarming trend

Although HIV incidence in the country is less than one percent of the 92.34 million population, Tayag noted that HIV cases in the country are increasing.

In 2012, at least 9 new cases of HIV or AIDS are reported everyday, compared to only 1 new case every three days in 2000.

If the trend continues, DOH projects up to 37,000 new cases of HIV in 2015, the supposed deadline to reverse HIV incidents set by UNAIDS.

UNAIDS Philippines country coordinator Teresita Bagasao, who was also present at the forum, said the AIDS epidemic in the country has two primary faces: men who have sex with men, and to a lesser extent, people who inject drugs.

The stigma behind HIV, as well as homosexual intercourse, condom use, and using injections, have prevented those who might be affected to come out and be treated, Bagasa said.

“If we lift the stigma, lift the discrimination, people will come forward and participate in finding solutions to the problem,” she said.

The rising number of HIV cases in the Philippines has been blamed partly on the lack of access to tools that prevent infection, such as condoms and educational programs. According to the National Demographic Health Survey of 2008, condom use in the Philippines stands at a low 2.8%.

The proliferation of social media networks and online dating sites in the Philippines have also made casual sexual encounters extremely accessible among the MSM (men who have sex with men) community, according to a previous report.

While UNAIDS found that domestic funding for HIV response around the world has overtaken global funding, there is still a funding gap of between P200 million to P300 million in the Philippines.

Tayag said national budgetary allocations for HIV response stands at P120 million, while the money coming from the global fund is only geared towards treatment, not prevention.

The lack of funding for services, coupled with the stigma attached to HIV, has contributed to the AIDS epidemic, said Albay Rep Edcel Lagman.

HIV prevention programs in the Philippines vary among different groups, according to the UNAIDS report. HIV prevention programs among sex workers were at 50-74% while those among men who have sex with men were at less than 25%. The levels of HIV testing among men who have sex with men were also lower than 25%.

“Increased risky behaviors plus low prevention coverage tips the balance,” Tayag said.

Impressive decline

At a glance, the 2012 UNAIDS Global Report showed that in 2011, there were fewer new HIV infections, fewer AIDS-related deaths, fewer children with AIDS, an increase in the number of people accessing lifesaving treatment, as well as a rise in domestic funding for HIV response.

Yet, there are still 34 million people afflicted with AIDS and only about 50% are aware of their HIV status.

But new infections around the world have dropped 20% to 2.5 million in a decade. Globally, there were more than 700,000 fewer new HIV infections in the world in 2011 than in 2001, the UNAIDS report revealed.

In some of the countries which have the highest HIV prevalence in the world, rates of new HIV infections have fallen significantly: by 73% in Malawi, 71% in Botswana, 68% in Namibia, 58% in Zambia, 50% in Zimbabwe and 41% in South Africa and Swaziland.

Sub-Saharan Africa has also cut AIDS-related deaths by one third since 2005 and increased the number of people on antiretroviral treatment by 59% since 2009.

When it comes to access to HIV treatment, a majority or 54% of people with HIV in low to middle income countries now have access to such services.

Homophobic laws

But the treatment gap still continues to be significant. Although there was a 60% increase in the number of people with access to antiretroviral therapy, 6.8 million out of the 14.8 million who need treatment still have to gain access to such services.

Sidibe said that access to treatment must coincide with improved social justice in HIV-prevalent countries.

“If you have homophobic laws, laws that imprisons people who use drugs, sex workers, they will go underground and they will not have access to services. We are trying to work strategically so people can have access to justice,” Sidibe said.

Kenya, for example, has established HIV equity tribunals, which allows people to report HIV-related forms of discrimination.

“It’s the first one in Africa which is giving possibility to HIV people who feel they have discriminated or criminilized could go to that tribunal,” he said.

2015 Global Targets

The UN Political Declaration on HIV/AIDS set the following targets for 2015:

1.Reduce sexual transmission by 50%.
2.Reduce HIV transmission among people who inject drugs by 50%.
3.Eliminate new infections among children and substantially reduce the number of mothers dying from AIDS-related causes.
4.Provide antiretroviral therapy to 15 million people.
5.Reduce the number of people living with HIV who die from tuberculosis by 50%.
6.Close the global AIDS resource gap and reach annual global investment of US$ 22 billion to US$ 24 billion in low- and middle-income countries.
7.Eliminate gender inequalities and gender-based abuse and violence and increase the capacity of women and girls to protect themselves from HIV.
8.Eliminate stigma and discrimination against people living with and affected by HIV by promoting laws and policies that ensure the full realization of all human rights and fundamental freedoms.
9.Eliminate restrictions for people living with HIV on entry, stay and residence.
10.Eliminate parallel systems for HIV-related services to strengthen the integration of the AIDS response in global health and development efforts. –Angela Casauay, http://www.rappler.com/nation/16494-rising-hiv-cases-in-ph-buck-global-decline