AIDS in Asia amid competing priorities: a review of national responses to HIV.

Introduction: The paper reviews progress in addressing the HIV epidemic and questions whether at the midway mark to the conclusion of the Millennium Development Goal set for 2015, the goal number 6 of halting and reversing the HIV epidemic will be reached.

Methods: Fourteen 2008 United Nations General Assembly Special Session on HIV/AIDS country progress reports and 18 country reports on Universal Access 2009 were analyzed. Data on national HIV strategic plans was also provided by 18 countries that participated in the regional training on costed national strategic plans 15-16 September, in Bangkok in 2008.

Results: Four countries with substantial populations in Asia are on track to achieve Millennium Development Goal 6. Elsewhere, elements of a potentially effective response are being introduced, but the degree of urgency and scale needed to curb the epidemics are not yet evident. Most national programmes still lack key planning components for the operation and financing of the response. Only 13 national strategic plans explicitly address the three key populations at higher risk for HIV. One third of the countries that have designed plans for effective interventions have not costed them.

Discussion: Early successes in controlling HIV epidemics in Asia may not be sustainable in the future. There is an urgent need to make prevention scale-up as robust as treatment scale-up and to focus programmes on high impact prevention, which directly contributes to reduction of new HIV infection. A necessary objective is to convince policy makers that the emergency posed by HIV continues.