The UK and US agreed at UN General Assembly High Level Meeting on AIDS in June 2006 that comprehensive HIV prevention is essential, including expanded access to male and female condoms. For the past 10 years DFID has been the fourth largest condom provider, providing over a billion condoms since 2001. USAID was the largest individual donor for contraceptives and condoms in 2004, contributing 35 per cent. of total donor support. But in Africa there are still only enough condoms to provide eight for each man each year. The UK will continue to play its part, and work closely with the US to ensure an appropriate and effective response to AIDS, including on the provision of condoms.
The Government of India’s National AIDS Programme (NACP) began in 1992, and the second phase of the programme (NACP 2) will run until March 2007. Key achievements under NACP2 include the establishment of 1,033 focused prevention interventions among vulnerable groups, 875 voluntary counselling and testing centres and 679 sexually transmitted disease clinics at the district level.
Currently, only half of the populations at greatest risk of infection (sex workers, men having sex with men and injecting drugs users) are currently covered by prevention interventions. Anti-Retroviral Therapy (ART) was introduced by the programme in 2004 but the roll out has been slow and serious issues of access, adherence, and capacity remain. By May 2006, only 32,000 people were covered by the free treatment programme.
Yet, there is emerging evidence that the strategy of concentrating on focused interventions among those at highest risk is having an impact in states in the south.A recent analysis of HIV data from 216 antenatal clinics and 132 sexually transmitted infection clinics for 2000-04 suggest that HIV prevalence among women aged 15-24 years in southern states declined from1.7 per cent. in 2000 to 1.1 per cent. in 2004. HIV infection levels also fell among men aged 20-29 years who attended sexually transmitted infection clinics in the south.
In Thailand, Government policy is to provide Anti-Retroviral Therapy (ART) to all those in need as part of the national Health Insurance scheme. This has contributed to Thailand’s successful high treatment coverage rates. There has been concern that Thailand has failed to maintain initial HIV prevention successes. There are now worrying increases in infection prevalence rates in young people, married women and men who have sex with men. The Government recently announced that they would increase investment in this area with the aim of reducing new infections by 50 per cent. by 2010, but has not yet presented plans for this. Continued high levels of stigma and discrimination remain a major barrier to an effective response.
The Government of China is making a concerted effort to tackle HIV and AIDS, including more than doubling its spending since 2003.
In August DFID agreed to provide £30 million over four and a half years to help the Government of China’s national HIV and AIDS programme contain the number of people living with HIV and AIDS to1.5 million by 2010. This is part of a £92 million programme that is also supported by the Global Fund to fight AIDS, TB and Malaria. Following the approval of the programme DFID officials have been continuing to hold discussions with the Government of China about its implementation.