Fiji success in containing AIDS noted on World AIDS day

Transcript

Today is World AIDS Day and the UNAIDS deputy executive director, Jan Beagle, is in Fiji to mark that country's successful efforts to contain the exponential growth of HIV over the past decade.

Fiji has 2000 people with HIV and 100 new cases each year but Ms Beagle says the country is on track to end the AIDS epidemic as a public health threat by 2030.

Other parts of the Pacific are still struggling against HIV so Don Wiseman asked Ms Beagle why Fiji has been so successful.

A woman walks past an AIDS billboard in PNG Photo: AFP

JAN BEAGLE: It's I think really a combination of factors. It's because they've had engaged political leadership over quite an extended period of time and very strong cross sector partnerships. So partnerships with communities, with a lot of different sectors, with the health sector, with the education sector, with the private sector, faith-based organisations, young people, people living with HIV. So bringing together a broad coalition of public private partners and that's very important and we see that in many countries, that you need to have that combination of leadership but community involvement to have success. And then they've also made a lot of moves to have an enabling environment. Because one of the issues with HIV is that you have groups in society that may be marginalised who may be at higher risk of HIV such as sex workers or transgender people or men who have sex with men, migrants and others, and often these people are not having easy access to services because they are criminalised or marginalized in some ways. So the fact Fiji was one of the first countries in the region to decriminalise homosexuality for example, the fact that they have legislation that prohibits discrimination against people living with HIV, that they removed HIV-related travel restrictions. All of that has been very important in terms of making sure that populations at risk can have access to services. Another area they've done very well, they've focussed a lot on preventing transmission of the virus from mother to child so they've got testing of pregnant women up to nearly 100 percent and that means pregnant women with HIV are then able to prevent the transmission to the child. So I think they are very close to having what we are looking for, and AIDS free generation in Fiji.

DON WISEMAN: Well that's good news, isn't it. But PNG, a completely different story. They've been battling this epidemic for such a long time now. I get the impression the numbers are down a little.

JB: No, they're down quite a lot. I mean there has been a decline of more than 50 percent in new infections since 2000, so that's quite good.

DW: But still 2000 each year.

JB: It's a lot, it's a lot. And there were about 1000 HIV deaths in 2014 but that's more than 50 percent drop since 2005. So that's quite a big change. They've got around 18,000 people on treatment, that of course means they still have that many others since they've got 37,000 people living with HIV - that's only half of people on treatment. But still, it does mean some progress. However I think the challenges are really among the key populations. Studies have shown that in Port Moresby that prevalence among transgender sex workers as 24 percent and female sex workers 19 percent. So that's really, really high.

DW: So it has had significant resources thrown at it but it needs more.

JB: What we are saying at UNAIDS, across the board, is that there is no point putting resources in in indiscriminate ways. You know we just realized a new report for world AIDS day and what we are saying is you need to focus on those geographic areas and those population groups where the data shows you have the greatest risk. And that means in PNG they should be focussing on those key populations and on certain geographic areas such as the Highlands and others where they have high levels of incidents. But there are many other issues. I mean the level of stigma and discrimination in PNG as in many countries is still very, very high. You've still got criminalisation of homosexuality, of sex work. So you've got an environment where people aren't going to easily access services.