1. The Status of the epidemic in
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

2. HIV prevalence in Asia and the Pacific, 2007 Adults and children
People living with HIV 5.0 M [4.1 – 6.2 M]
Newly infected in ,000 [200,000 – 650,000]
AIDS-related death 380,000 [270,000 – 490,000]
2008 AIDS Epidemic Update, July 29, 2008

3. Adult HIV Prevalence (%) in Asia and the Pacific
1 - 5 %: Thailand, PNG, 0.5-<1.0%: Cambodia, Myanmar, Viet Nam, Malaysia, Nepal, 0.1-<0.5%: India, Indonesia, Iran, Australia, Lao PDR, Pakistan, Singapore <0.1 %: Japan, China, Philippines, Korea, Bangladesh, etc.

4. Early waves of epidemic in Mid-to-late 1980s
Political commitment ( budget)
Massive campaign
100% condom policy
Thailand
Cambodia
(Myanmar)
A success story
Thailand
Cambodia

5. Sustained and growing epidemic behind the success
Thailand,

6. Lessons from foregoers
Tsunami waves may come successively.
Complacency and political apathy are not allowed.
Continuous need to fight against stigma and discrimination.
IDU
Female SW
Male House wife
Child
MSM
Migrant
Elderly and the youth
HIV waves in Thailand
Dr. Chureeratana　Bowonwatanuwong

7. Rapidly growing epidemic
Indonesia
PNG
Viet Nam

8. 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

9. Women living with HIV Children (<15 y/o): 2007
The proportion of women has increased
from 26% (2001) to 29% (2007) in Asia.
Asia
Children (<15 y/o): 2007
Living with HIV/AIDS: 150,000
Newly infected: ,000
Death due to AIDS: 18,000

10. Scaling up of antiretroviral therapy
AIDS death:
2001
2007
S & SE Asia 170, ,000
East Asia 12, ,000
Oceania < ,200
- 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.
NAPHA
GPOvir
Regimen 1. d4T + 3TC + NVP
2. d4T + 3TC + EFV
3. d4T + 3TC + IDV

11. 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.
1-50
51-100
>20000

12. 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% 1% 2% If
= 24 million
= 48 million

13. Prevention India 2005 5.7 M 2006 2.5 M (>5.5 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
Prevention

14. 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
UNAIDS
WHO
Etc.