UN Agencies Call for Greater Integration of Health Services to Halt the Spread of HIV

SUBANG, Malaysia — With an estimated 930,000 new HIV infections in Asia and the Pacific in 2005, UN agencies have called for urgent efforts to prevent the escalating spread of the virus and reduce mortality by better integrating HIV prevention, treatment and care into maternal and newborn health services.

Calls for strengthening integration of these vital health services came at the opening of the first Asia-Pacific Joint Forum, a conference of health professionals, government officials, people living with HIV, and civil society groups from 22 countries in the region.

With 60 per cent of the world’s population living in the region, many in countries with a high proportion of people between the ages of 15 and 25, the need to scale up HIV prevention, treatment and care efforts and provide better reproductive health services is urgent. Due to inadequate maternal and child health services, many countries also report high maternal and infant mortality, especially during newborns’ first month of life.

As part of the Millennium Development Goals, governments have agreed to reduce maternal mortality, tackle infant and child mortality, and prevent the further spread of HIV and AIDS. In October 2006, the United Nations General Assembly endorsed a new target for universal access to reproductive health by 2015.

Yet in many countries, public health budgets remain low, access to health services, especially in rural areas, remains inadequate, and pervasive gender inequality and discrimination continue to hamper efforts to roll out HIV prevention, treatment and care, and to scale up access to maternal and child health services.

The World Health Organization noted that in many countries, efforts to scale up prevention of parent-to-child transmission and roll out access to HIV treatment are underway. However, these efforts can only succeed if primary health care systems are strengthened, especially by improving outreach and referral services to those who are most in need.

Although patterns of HIV infection vary greatly between and within countries in the region, infections are spreading rapidly among people with high-risk behaviours, who are often poor and marginalized. Women are increasingly vulnerable. Between 2001 and 2004, the estimated number of HIV-positive women in the region increased by 16 per cent to over 2 million. This is a much faster increase than the worldwide average, which is about 8 per cent. In many cases young women become infected through exploitative, coercive or violent sex.

“Linking HIV-prevention efforts with reproductive health care can strengthen and improve access to both,” said Dr. Chaiyos Kunanusont, regional HIV/AIDS Adviser for UNFPA, the United Nations Population Fund. “Millions of women who don’t know their HIV status have an unmet need for effective contraception. Integrated services would enable them to protect themselves and also reduce HIV transmission to their children.”

The number of new infections among children and young people is also growing. In 2005, an estimated 411,000 children were living with HIV in Asia and the Pacific, with 82,000 infected that year alone. About 90 per cent of these were children infected as a result of mother-to-child transmission.

“Many countries in Asia and the Pacific already have national guidelines in place for the prevention of parent-to-child transmission. Many countries have trained health workers and are introducing treatment,” said Richard Bridle, UNICEF Deputy Regional Director for Asia and the Pacific. “The challenge remains how we better link these efforts to prevent disease and improve nutrition to provide a holistic package of services for mothers and their children.”

At the conference, which was jointly organized by WHO, UNICEF, UNFPA and the Joint United Nations Programme on HIV/AIDS (UNAIDS), delegates are expected to agree on a framework for stronger links between maternal and child health, family planning, sexual health and counselling and testing for HIV and sexually transmitted infections. They are also promoting a four-pronged strategy for the prevention of primary HIV infection in mothers and young children.

The first prong focuses on preventing parents-to-be from infection with HIV. Women are especially vulnerable to infection when pregnant and breastfeeding. The second prong seeks to assist HIV-positive women and couples who want to avoid pregnancy. The third prong aims to ensure that pregnant, HIV-positive women are offered interventions to lower the risk that HIV will pass to the baby. The fourth prong ensures that HIV-positive mothers and their families have access to the care, support and treatment they need.

The meeting will also provide an opportunity for countries to share experiences and lessons learned. Already, their shared experiences indicate that many of the services and initiatives needed to lessen the impact of the HIV epidemic will also help promote the reproductive health of young people and reduce maternal and newborn deaths.

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Contact Information:

Dr. Ru-yan Pang, WHO Regional Adviser in Reproductive Health, tel. + (63 2) 9876, pangr@wpro.who.int

Wing-Sie Cheng, Regional HIV/AIDS Advisor for East Asia and the Pacific, tel. + 6017 260 9096, wscheng@unicef.org

Dr. Myo Zin Nyunt, UNICEF South Asia Regional Officer PPTC/ Pediatric Treatment, tel. + 6017 2608742, mnyunt@unicef.org

George Ionita, UNICEF East Asia and Pacific Regional Officer, tel. + 60172609096, gionata@unicef.org

William A. Ryan, Regional Information Adviser for Asia and the Pacific, UNFPA, tel. + 66 2 288 2446, mobile + 66 89 897 6984, ryanw@unfpa.org