1. Regional overview slides
UNAIDS Asia and the Pacific

2. 90 000 4.2 million ZERO Asia and the Pacific Fast-Track Targets
By 2020
Fewer than
90 000
new infections
More than
4.2 million
on treatment
Purpose: Zooming in from global targets to regional Fast-Track targets
Key message: These are the regional  targets that we need to reach by It is important to note that we, as the Asia Pacific region, can collectively reach the target only when the individual countries has reached the country level Fast-Track targets by 2020
Talking points: These numbers again translate into 75% reduction of new HIV infections from 2010, 81% of all PLHIV on treatment and zero discrimination.
It is important to note that there is a narrow window of opportunity between now and 2020 if we are to achieve the ambitious Fast- Track targets by 2020
ZERO
discrimination
Source: UNAIDS. (2016). Fast-Track Commitments to End AIDS by 2030

3. HIV response has achieved notable success in declining new infections globally and regionally: a model and roadmap for other health threats
Global
16% decline
between 2010 and 2016
Fast-Track Target 2020:
new HIV infections
new HIV infections in 2016
New HIV infections
Asia and the Pacific
13% decline
between 2010 and 2016
Fast-Track Target 2020:
90 000
new HIV infections
new HIV infections in 2016
New HIV infections
Purpose:  to demonstrate that HIV response has achieved success - in terms of decline in new HIV infections - globally and regionally
Key message: HIV response has notable success globally and regionally, However success has been achieved at different levels in different regions. The reasons standing behind the success can be shared as lessons for response of other diseases
Talking points: Both globally and regionally the new infections are declining but the pace of decline is not fast enough to reach the Fast-Track target. Especially during the past 6 years the decline in new HIV infections has stalled. There were only 13% reduction in new infections between 2010 and 2016 in the region (comparing to 35% decline between 2000 and 2010)
New HIV infections
2020 Fast-Track target*
*The 2020 target is equivalent to a 75% reduction since 2010.
Source: Prepared by based on UNAIDS 2017 HIV Estimates

4. A significant variation in new HIV infections trends in Asia and the Pacific countries
Percent change in new HIV infections between 2010 and 2016
Distribution of new HIV infections by country, 2016
new HIV infections in
Asia and the Pacific in 2016
(10,500, 4%)
Purpose:  to show the variations in trend of new HIV infections among countries in Asia and the Pacific and proportion shared by each country
Key message: To achieve the Fast-Track target of less than new HIV infections in 2020, Asia and the Pacific region has to maximize the response in countries where the epidemic is expanding and, at the same time, intensify the response in countries where the infection has already declined - to prevent the resurgence of the epidemic.  
Talking points: Many countries has made progress in their HIV response - but there is a significant variation - some countries have successfully turn their epidemics around while, however, the others have still facing challenges. Steep reduction of 50% in annual new infections occurred in Thailand, but the Philippines saw a 141% increase between 2010 and Success made by some countries can be overwritten by others who fail to make progress.
China
India
Indonesia
Myanmar
Pakistan
Philippines
Thailand
Vietnam
Source: Prepared by based on UNAIDS 2017 HIV Estimates

5. Expanding share of new HIV infections among men who have sex with men
Share of new HIV infections by population,
7% in 2000
26% in 2016
MSM
MSW TG
PWID
FSW
Clients
Purpose: To show the trend and share of new HIV infections by population in the past 16 years
Key message: There is a significant increase in MSM new infections as share of total new HIV infections in the region (based on data from 11 countries as stated in the slide)
Talking points: In 2016, 1 in 4 new infections are among MSM…..worrisome and continuous increase from less than 1 in 10 new infections in This is the aggregate number for 11 countries and MSM as share of total new infections varies by countries - from over 90% in Philippines to less than 10% in Bangladesh. But one thing is consistent across all countries …there is no sign of decline in share of new infections among MSM….at best is plateauing.
Additional info: Though published estimates for China and India is not available – reported HIV cases from China indicates rising trend of homosexual transmission. Scientific studies also show high HIV incidence among young MSM in urban cities (Guiyang -18.9%, Beijing -10.6%, Shanghai-5.6%, Kunming – 5.3%, Chongqing -4.9%)
In India – incidence studies also show higher HIV incidence among MSM in Southern areas such as Hyderabad (2.2%)
Note: This slide has animations
Partners of key populations (females)
Partners of key populations (males)
Based on data from 11 countries: Bangladesh, Cambodia, Indonesia, Lao PDR, Malaysia, Myanmar, Nepal, Pakistan, Philippines, Thailand, Viet Nam
Source: Prepared by based on AIDS Epidemic Modelling submitted for the HIV estimates 2017

6. Overview of new HIV infections among young people (15-24) in Asia and the Pacific
Proportion of young people (15-24) in total new HIV infections, 2016
Percent change in new HIV infections among young people, 2010 and 2016
Philippines
136%
increase
Myanmar
25%
decrease
Indonesia
24%
decrease
Thailand
49%
decrease
Lao PDR
40%
decrease
India
17%
decrease
Cambodia
60%
decrease
Regional average
17%
decrease
Papua New Guinea
11%
increase
Afghanistan
68%
increase
Purpose: To show the trend and proportion of new HIV infections among young people in Asia Pacific countries.
Key message: A significant proportion of young people are getting infected with HIV, and increasing HIV infection trends are also observed in some countries.
Talking points: In Asia and the Pacific region, 1 in 3 new HIV infections are among young people aged 15 to 24. In many countries, proportion is much higher than regional average - for example, more than half of new HIV infections are among young people in Philippines, Myanmar and Indonesia. In India, Lao PDR and Thailand, young people account for about 40% to 50% of new infections. It is worrisome that in some countries such as Pakistan, Philippines, PNG and Afghanistan, the new HIV infections trends are increasing among young people in the past 6 years. In Philippines, the increase in new HIV infections among young people (15-24 yr) was as high as 136% since 2010.
Nepal
54%
decrease
Pakistan
25%
increase
Bangladesh 1%
decrease
Viet Nam
43%
decrease
Malaysia
42%
decrease
Australia 1%
increase
Source: Prepared by based on UNAIDS 2017 HIV Estimates

7. Key populations prevention gap
Asia and
the Pacific
Key populations prevention gap
Female sex
workers
Men who have sex with men
People who inject drugs
11.4 M
4.2 M
4.1 M
Key populations size
90%
GAP
90%
GAP
90%
GAP
Condom use at last sex
90%
GAP
90%
GAP
90%
GAP
HIV testing coverage
200 needles and syringes
GAP
Needles and syringes
Purpose:  To show the snapshot of key populations prevention gap in Asia and the Pacific
Key message: New infections are concentrated among key populations in Asia and the Pacific and yet key populations’ access to prevention services are far from optimal. Unless key populations are reached with scale and quality prevention and treatment services, AIDS will not be over in Asia and the Pacific
Talking points: From basic prevention tool such as condom to recent innovations such as PrEP, coverage is still lagging behind to reach Fast-Tack prevention targets. HIV testing is also entry point for prevention, treatment and care continuum but only about half of key populations in the region know their HIV status. Progress towards treatment target among key populations is a critical need that is to be measured and monitored, but representative data is still lacking to understand gaps and leakages across treatment cascade among key populations.
Additional info:
1)Treatment data is still lacking for KP because : a) at service delivery sites - KP prefer not to disclose their associated behaviours due to stigma and discrimination at health care facilities ; b) from KP surveys– countries have started to collect KP treatment status through IBBS but it is still nascent stage and representative data is not yet available.
2) TG is not included in the slide because availability of TG data is still limited to come up with regional median/average. Regional median on HIV testing coverage among TG ( based on 8 available countries- Bangladesh, Cambodia, India, Malaysia, Nepal, Pakistan, Philippines, Thailand) is 41%
3) PrEP pilot for MSM (8 countries)– Australia, China, India, Malaysia, New Zealand, Philippines, Thailand, Viet Nam
PrEP pilot for FSW (3 countries) – China, India, Thailand
PrEP pilot for PWID (2 countries) – China and Thailand
Limited data
On treatment 8
countries have PrEP projects for MSM
PrEP
countries have PrEP projects for FSW 3 2
countries have PrEP projects for PWID
Prepared by based on Global AIDS Monitoring 2017

8. HIV testing coverage among key populations
HIV testing is the entry point for prevention and treatment but about half of key populations do not know their HIV status
HIV testing coverage among key populations
Purpose: To show the regional median of HIV testing coverage among key populations
Key message: Though HIV testing is the entry point for treatment and care, less than half of key populations in the region tested for HIV in the last year
Talking points: This is just to quickly show the regional median of HIV testing among key populations. One dot represent one country and there is a diverse HIV testing coverage across countries in the region. With our commitments towards treatment targets, achieving first 90 (knowing the status) is very crucial and yet barely half of key populations in the region know their status.
Source: Prepared by based on Global AIDS Monitoring (GAM) Reporting 2017

9. Progress towards the 90–90–90 targets: global versus Asia and the Pacific, 2016
70%
[51 – 84%]
77%
[57 – >89%]
82%
[60 – >89%]
Asia and the Pacific
71%
[47 – >89%]
66%
[44 – >89%]
83%
[55 – >89%]
Purpose:  to show the achievement that has been made across the treatment cascade ( target)
Key message: For Asia and the Pacific, the Fast-Track target is achievable. Thanks to people centered public health approach, the region has made a substantial progress towards the target but the progress made has to be maintained   
Talking points: By the end of 2016, about 71% of the 5.1 million people living with HIV in the region were aware of their HIV status. Of those who knew their status, 66% were accessing antiretroviral therapy; among those on treatment, 83% were virally suppressed.
2.4 million people living with HIV in Asia and the Pacific were on treatment at the end of 2016 (47% of all PLHIV are on treatment). Progress varied between countries. Australia, Singapore and Thailand have treatment coverage 80% or more, while in Pakistan, Afghanistan, Indonesia and Bangladesh less than 20% of people living with HIV were receiving life saving treatment.
Although there is a significant achievement reported in terms of viral suppression in the region (i.e. 83%), it is important to note that the viral load testing coverage among people receiving treatment are still very low in the region - only about 52% of PLHIV who are on treatment (in 18 reported countries) had tested for viral load in the past 12 months. Many people on treatment are not receiving this very critical disease-monitoring service. Indonesia reported only 0.2% of people on ART were tested for viral load in There is an urgent need to scale up viral load testing in the region.
of people living with HIV who know their status are on treatment
of people living with HIV know their status
of people on treatment are virally suppressed
Source: Prepared by based on UNAIDS special analysis, 2017

10. PLHIV know their status Tested for viral load **
Asia and the Pacific
Towards Fast-Track
treatment targets
66%
5.1 M
Countries with CD4 threshold policy for treatment initiation
countries have national policy on routine viral load
monitoring for antiretroviral therapy
Estimated
PLHIV
PLHIV know their status
People on ART *
Tested for viral load **
Suppressed viral load
Treatment cascade, 2016
treat all regardless of CD4
CD4 ≤ 500 24
CD4 ≤ 500 but treat all key populations regardless of CD4
CD4 ≤ 350 but treat all key populations regardless of CD4 25 2 5 15 6 9
2016
2017
71%
83%
*As of June 2017, estimated 2.5 million people were receiving ART in Asia and the Pacific region
** China and India do not report viral load testing data in 2017 GAM reporting and Indonesia reported only 0.2% of people on ART tested for viral load in Estimated 52% of PLHIV who are on treatment in 18 reported countries had tested for viral load in the past 12 months.
Purpose:  to show the achievement that has been made across the treatment cascade ( target)
Key message: For Asia and the Pacific, the Fast-Track target is achievable. Thanks to the leadership and commitments made by all stakeholders including community and civil society organizations, the region has made a substantial progress towards the target but the progress made has to be maintained.   
Talking points: By the end of 2016, about 71% of the 5.1 million people living with HIV in the region were aware of their HIV status. Of those who knew their status, 66% were accessing antiretroviral therapy; among those on treatment, 83% were virally suppressed.
2.4 million people living with HIV in Asia and the Pacific were on treatment at the end of 2016 (47% of all PLHIV are on treatment). Progress varied between countries. Australia, Singapore and Cambodia have treatment coverage 80% or more, while in Pakistan, Afghanistan, Indonesia and Bangladesh less than 20% of people living with HIV were receiving life saving treatment.
Although there is a significant achievement reported in terms of viral suppression in the region (i.e. 83%), it is important to note that the viral load testing coverage among people receiving treatment are still very low in the region - only about 52% of PLHIV who are on treatment (in 18 reported countries) had tested for viral load in the past 12 months. Many people on treatment are not receiving this very critical disease-monitoring service. Indonesia reported only 0.2% of people on ART were tested for viral load in There is an urgent need to scale up viral load testing in the region.
Additional Info:
CD4 Threshold for treatment initiation
2016 Reporting: Treat all regardless of CD countries (Afghanistan, Australia, Cambodia, China, Japan, Lao PDR, Maldives, Marshall Islands, Micronesia (Federated States of), Republic of Korea, Samoa, Singapore, Solomon Islands, Thailand, and Vanuatu)
2017 Reporting: Treat all regardless of CD countries (Afghanistan, Australia, Cambodia, China, Fiji, India, Japan, Kiribati, Lao PDR, Malaysia, Maldives, Marshall Islands, Micronesia (Federated States of), Myanmar, Nepal, Papua New Guinea, Republic of Korea, Samoa, Singapore, Solomon Islands, Sri Lanka, Thailand, Tonga, Vanuatu, Viet Nam)
2016 Reporting: CD4 ≤ 500 but treat all key populations regardless of CD4 – 6 countries (Mongolia, Myanmar, PNG, Sri Lanka, Tonga, and Viet Nam)
2017 Reporting: CD4 ≤ 500 but treat all key populations regardless of CD4 – 1 countries (Mongolia)
2016 Reporting: CD4 ≤ 500 – 9 countries (Bangladesh, Bhutan, Fiji, India, Malaysia, Nepal, New Zealand, Pakistan, and Philippines)
2017 Reporting: CD4 ≤ 500 – 5 countries (Bangladesh, Bhutan, New Zealand, Pakistan, and Philippines)
2016 Reporting:CD4 ≤ 350 but treat all key populations regardless of CD4 – 2 countries (Indonesia, and Kiribati)
2017 Reporting:CD4 ≤ 350 but treat all key populations regardless of CD4 – 1 countries (Indonesia). Based on info from Taoufik, it has moved up to CD4<500 but treat all for KP
No info – 6 countries (Brunei, DPRK, Nauru, Palau, Timor Leste, and Tuvalu)
Viral Load testing
2016 Reporting: Routine viral load for monitoring antiretroviral therapy – 22 countries (Afghanistan, Australia, Bangladesh, Cambodia, China, Fiji, Indonesia, Lao, Malaysia, Maldives, Marshall Islands, Mongolia, Nepal, Pakistan, PNG, Philippines, Samoa, Singapore, Sri Lanka, Thailand, Tonga, and Viet Nam)
2017 Reporting: Routine viral load for monitoring antiretroviral therapy – 24 countries (Afghanistan, Australia, Bangladesh, Cambodia, China, Indonesia, Lao PDR, Malaysia, Maldives, Marshall Islands, Micronesia (Federated States of), Mongolia, Nepal, New Zealand, Pakistan, Papua New Guinea, Philippines, Samoa, Solomon Islands, Sri Lanka, Thailand, Tonga, Vanuatu, Viet Nam) – (Singapore reported no policy for viral load testing this year; Viet Nam do not report NCPI this year)
2016 Reporting: Data on coverage of viral-load testing facilities – 5 countries (Bangladesh, Pakistan, Philippines, Thailand, and Viet Nam
Prepared by based on Global AIDS Monitoring 2017 Reporting and UNAIDS 2017 HIV Estimates

11. Double disease burden of TB-HIV in Asia and the Pacific
Globally, Asia and the Pacific accounts for
2/3
of estimated new TB cases
3/5
of multidrug-resistant/ rifampicin-resistant TB
1/5
Purpose:  To show TB burden as well as TB-HIV burden in Asia and the Pacific region as proportion of global burden
Key message: Concerted and integrated efforts are needed to prevent and address both TB and TB-HIV burden in the region  
Talking points: 2 out of 3 TB infections globally are in Asia and the Pacific and 60% of MDR-TB burden is in this region. Globally, Asia and the Pacific is the home for 13% of PLHIV but 20% of TB-HIV co-infections are in this region. Systematic collaboration between TB-HIV programmes will save lives and improve the quality of life of people living with and affected by HIV.
of estimated TB-HIV co-infections
1/2
of estimated TB mortality
Source: Prepared by based on WHO. (2017). Global TB Report 2017

12. Treatment success rate
TB- HIV response overview in Asia and the Pacific
treatment target and gaps
2nd 90
3rd 90
1st 90
37%
90%
31%
81%
n/a
73%
People with TB-HIV co-infections receiving anti-retroviral therapy
People with TB-HIV co-infections know their HIV status
People with TB-HIV co-infections who are virally suppressed
TB treatment outcome: Higher rate of deaths and lower rate of treatment success among HIV-positive TB cases
Treatment success rate
100%
Death rate
100%
Purpose:  To show the treatment cascade of people with TB-HIV co-infections along with the treatment success rate and death rate comparison between new TB cases vs. HIV-positive TB cases
Key message: The progress of treatment targets in our region is at However, it is about 50% lower (37-31-n/a) for people with TB co- infections, people with higher risk of mortality without treatment of both infections.
Talking points: From the perspective of HIV care and treatment, 63% of people with TB-HIV co-infections DO NOT know their status, and close to 70% of people with TB-HIV co-infections are NOT receiving anti-retroviral therapy.
In terms of TB, treatment success rate among people with TB-HIV co- infections is much lower than new TB patients in general (75% vs 83%) with much higher death rate (14% vs 3%). This underscores the need for programme strengthening of both TB and HIV programmes to save people living with HIV from the preventable TB-related deaths.
New and relapse TB cases
HIV-positive TB cases
Source: Prepared by based on UNAIDS 2017 HIV Estimates; and WHO. (2017). Global TB Report 2017

13. Support countries to put in place guarantees against discrimination in law, policies, and regulations
Legal barriers to the HIV response remain in 38 UN Member States in Asia and the Pacific
Purpose: To show the snapshot of legal environment pertaining to key populations and PLHIV (challenge)
Key message: Criminalization and punitive laws pose as barriers to access prevention, treatment and other health-related services and it also has impacts on basic human rights and quality of life of people who are living with and affected by HIV.
Talking points: Criminalization is neither a solution nor tool to prevent the spread of HIV infections. Neither does it prevent or deter risk behaviours of key populations. In fact, it even fuels the epidemic by making the services less accessible to key populations and PLHIV and it is in a way promoting the chance of engaging in risk behaviours. For example, raids on sex workers or brothel closures could not prevent or control sex work, but just making the sex workers unreachable through prevention services.
Additional info: Malaysia - criminalize sex work; criminalize same sex relations; confine PWID in compulsory detention center ( in some aspect yes-by NADA National Anti drug agency); impose death penalty for drug related offence; impose HIV-related travel restriction on entry, stay or residence
Countries that criminalize sex work -  37 countries in Asia Pacific except New Zealand (Note:Criminalization of sex work means- criminalization of  either (i) sex work in private; (ii) soliciting; and (iii) brothels)
Countries that criminalize same-sex relations - All south Asian countries ( Afghanistan, Bangladesh, Bhutan, India, Maldives, Pakistan, Sri Lanka) except Nepal; South-East Asia countries - (Brunei, Malaysia, Myanmar, Singapore); Pacific (Kiribati, PNG, Samoa, Solomon Islands, Tonga, Tuvalu)
Countries that detain PWID in compulsory detention centres:South Asian countries - Sri Lanka only; East Asia - China; South-East Asia countries - (Brunei, Cambodia, Indonesia, Lao, Malaysia, Myanmar, Singapore, Thailand, Viet Nam)
Countries that impose death penalty for drug-related offences- South Asian countries - (Bangladesh, India, Pakistan, Sri Lanka); East Asia - (China, PR Korea, Republic of Korea;  South-East Asia countries - (Brunei, Indonesia, Lao, Malaysia, Myanmar, Singapore, Thailand, Viet Nam)
Countries that impose some form of HIV-related travel restriction - East Asia - DPR Korea only;  South-East Asia countries - (Brunei, Malaysia, Singapore); Pacific - (Federated States of Micronesia, New Zealand, PNG, Samoa, Solomon Islands, Tonga)
Source: Prepared by based on UNAIDS, Punitive Laws Hindering the HIV Response in Asia and the Pacific (as of June 2016)
Asia and the Pacific

14. Resource Availability and Fast-Track Resource Needs in Asia and the Pacific
Purpose:  To show resource availability and Fast-Track resource needs in Asia and the Pacific
Key message: Countries in Asia and the Pacific continue to increase their share of investment in the AIDS response but there is still a significant resource gap for the Fast-Track resource needs.
Talking points: About 3.6 billion was spent for AIDS responses in 2016, a 26% increase from Spending from domestic sources has increased from 1.8 billion in 2010 to 2.7 billion in However there is over 2 billion falls short of 6 billion resource needs for the Fast-Track responses.
Prepared by based on UNAIDS estimates on HIV resource availability, 2017

15. THANK YOU www.aidsdatahub.org