Goal 6: Combat HIV/AIDS, Malaria, and Other Diseases

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1 113 The large majority of HIV sufferers live in just six countries. Adult HIV victims in the region are mainly men. In Lao People s Democratic Republic (Lao PDR), over 90% of those living with HIV have access to antiretroviral drugs. In most other countries, less than 30% of those who need them currently have access to antiretroviral drugs. Most economies have been very successful in reducing the prevalence of tuberculosis, but prevalence rates are rising in seven n economies although the rates are still quite low. Introduction Goal 6 has three targets: 6.A: Have halted by 2015 and begun to reverse the spread of HIV/AIDS. This is targeted at the age group but for most economies, comparable data on HIV prevalence are available only for those aged years. Time series are currently too short to assess if this target will be met. MILLENNIUM DEVELOPMENT GOALS 6.B: Achieve, by 2010, universal access to treatment for HIV/AIDS for all those who need it. This is a new target introduced in the revised MDG framework. 6.C: Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases. Key Trends HIV is mainly a man s disease in Asia. Figure 6.1 shows the total number of persons over 15 years living with HIV and the breakdown by gender. Most of the HIV victims in the region are living in just six countries the People s Republic of China (PRC), India, Indonesia, Myanmar, Thailand, and Viet Nam. Adult HIV victims in Asia are primarily men. The averages for all countries are 65% for men and 35% for women, but percentages about 40% for women are reported by India, Thailand, Myanmar, Papua New Guinea, and Sri Lanka. Antiretroviral drugs need to be more accessible. Figure 6.2 shows the percentage of those living with advanced HIV infection that have access to antiretroviral drugs. MDG target 6.B is for all those who need it to have access to these drugs. Only Lao People's Democratic Republic (Lao PDR) is near to meeting this target, although as Figure 6.1 shows, Lao PDR has a relatively small HIV population about 5,000. Among the six economies where most of Asia s HIV sufferers live, Thailand does best by providing treatment to about 60% but in PRC, Indonesia, Myanmar, and Viet Nam, less than 30% of HIV sufferers are receiving antiretroviral drugs. For almost all countries, the 2007 percentages are higher than for 2006 and Cambodia, Malaysia, and Thailand reported particularly large gains in Figure 6.1 Adults Living with HIV, 2007 Breakdown by Gender (percent) Number ( 000) India 2,300 China, People's Rep. of Thailand Viet Nam Indonesia Myanmar Pakistan Malaysia Cambodia Nepal Papua New Guinea Australia Uzbekistan Korea, Rep. of Bangladesh Kazakhstan Tajikistan Japan Philippines Azerbaijan Lao PDR Kyrgyz Republic Singapore Sri Lanka Men Women Source: Derived from Regional Table 1.22.

2 114 Figure 6.2 Percentage of the Population with Advanced HIV Infection with Access to Antiretroviral Drugs, 2006 and 2007 Lao PDR Cambodia Thailand Papua New Guinea Malaysia Philippines Viet Nam Uzbekistan Kazakhstan China, People's Rep. of Myanmar Indonesia Sri Lanka Armenia Nepal Bangladesh Tajikistan Pakistan Source: Table The prevalence of tuberculosis has been greatly reduced. Figure 6.3 shows the prevalence of tuberculosis per 100,000 inhabitants for 44 economies. Prevalence refers to the total number of persons with the disease, many of whom may have been suffering from tuberculosis for several years. Tuberculosis is one of the major diseases targeted by MDG target 6.C. In 36 economies, tuberculosis prevalence rates were lower in 2007 compared with those in Particularly large reductions were achieved by five Pacific economies (Kiribati, Marshall Islands, Solomon Islands, Timor-Leste, and Tuvalu) and by Bhutan, India, Nepal, and Philippines. However, seven economies in Central and West Asia namely, Armenia, Azerbaijan, Georgia, Kazakhstan, Kyrgyz Republic, Tajikistan, and Uzbekistan reported increased prevalence, although the increases were generally small. The rise in prevalence of tuberculosis may reflect some deterioration in health services following the collapse of the former Soviet Union. Figure 6.3 Prevalence of Tuberculosis, 1990 and 2007 (per 100,000 people) Cambodia Philippines Papua New Guinea Kiribati Bangladesh Timor-Leste Bhutan Tajikistan Lao PDR India Marshall Islands Indonesia Nepal Afghanistan Mongolia Pakistan Viet Nam Tuvalu China, People's Rep. of Thailand Solomon Islands Myanmar Uzbekistan Kazakhstan Kyrgyz Republic Korea, Rep. of Malaysia Vanuatu Micronesia, Fed. States of Azerbaijan Georgia Armenia Sri Lanka Turkmenistan Palau Brunei Darussalam Hong Kong, China Maldives Nauru Cook Islands Fiji Islands Tonga Singapore Samoa Source: Table ,000 1, Data Issues and Comparability Data on prevalence of HIV/AIDS generally come from various sources covering particular subgroups of the population. Infection rates may be under-reported in several countries because of the stigma attached to the disease. Also, persons with HIV/AIDS are particularly susceptible to various opportunistic diseases, and they may instead be reported as infected by only the opportunistic disease. Data to compute the proportion of population with advanced HIV infection with access to antiretroviral drugs are derived from various sources such as ministries of health, bilateral partners, foundations, and nongovernment organizations, and statistical modeling methods. However, the indicator does not distinguish between the different types of treatments available. Data on the prevalence of tuberculosis are typically derived from demographic and health surveys as administrative records may be incomplete. These are not generally repeated annually and may only cover particular target groups. They often have to be extrapolated to adjoining years and to the whole population.

3 115 Table 6.1 Target 6.A: Have halted by 2015 and begun to reverse the spread of HIV/AIDS 6.1 HIV Prevalence (percent of population years) 6.3 Proportion of Population Aged Years with Comprehensive Correct Knowledge of HIV/AIDS (percent) Female Male Afghanistan Armenia (2005) 15 (2005) Azerbaijan < (2006) 5 (2006) Georgia < (2005) Kazakhstan (2006) Kyrgyz Republic < (2006) Pakistan (2006) Tajikistan (2005) Turkmenistan 5 (2006) Uzbekistan < (2006) 7 (2002) China, People s Rep. of Hong Kong, China Korea, Rep. of <0.1 <0.1 Mongolia < (2005) Taipei,China MILLENNIUM DEVELOPMENT GOALS Bangladesh <0.1 < (2006) Bhutan < India (2006) 36 (2006) Maldives <0.1 <0.1 Nepal (2006) 44 (2006) Sri Lanka <0.1 <0.1 Brunei Darussalam a Cambodia (2005) 45 (2005) Indonesia (2003) 0 (2003) Lao PDR < Malaysia Myanmar Philippines <0.1 < (2003) 18 (2003) Singapore Thailand (2006) Viet Nam (2006) 50 (2005) Cook Islands Fiji Islands Kiribati Marshall Islands 27 (2007) 39 (2007) Micronesia, Fed. States of Nauru Palau Papua New Guinea Samoa Solomon Islands Timor-Leste Tonga Tuvalu Vanuatu Australia Japan <0.1 <0.1 New Zealand a Brunei Darussalam is a regional member of ADB, but it is not classified as a developing member country. Source: Millennium Indicators Database Online (UNSD 2009).

4 116 Table 6.2 Target 6.B: Achieve, by 2010, universal access to treatment for HIV/AIDS for all those who need it 6.5 Proportion of Population with Advanced HIV Infection with Access to Antiretroviral Drugs (percent) Afghanistan Armenia 8 12 Azerbaijan 14 Georgia Kazakhstan Kyrgyz Republic 14 Pakistan 1 3 Tajikistan 4 6 Turkmenistan Uzbekistan China, People s Rep. of Hong Kong, China Korea, Rep. of Mongolia Taipei,China Bangladesh 3 7 Bhutan India Maldives Nepal 3 7 Sri Lanka Brunei Darussalam a Cambodia Indonesia Lao PDR Malaysia Myanmar 7 15 Philippines Singapore Thailand Viet Nam Cook Islands Fiji Islands Kiribati Marshall Islands Micronesia, Fed. States of Nauru Palau Papua New Guinea Samoa Solomon Islands Timor-Leste Tonga Tuvalu Vanuatu Australia Japan New Zealand a Brunei Darussalam is a regional member of ADB, but it is not classified as a developing member country. Source: Millennium Indicators Database Online (UNSD 2009).

5 117 Table 6.3 Target 6.C: Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases 6.9 Incidence of Tuberculosis 6.9 Prevalence of Tuberculosis (per 100,000 people) (per 100,000 people) Afghanistan Armenia Azerbaijan Georgia Kazakhstan Kyrgyz Republic Pakistan Tajikistan Turkmenistan Uzbekistan China, People s Rep. of Hong Kong, China Korea, Rep. of Mongolia Taipei,China 0 MILLENNIUM DEVELOPMENT GOALS Bangladesh Bhutan India Maldives Nepal Sri Lanka Brunei Darussalam a Cambodia Indonesia Lao PDR Malaysia Myanmar Philippines Singapore Thailand Viet Nam Cook Islands 6 (1991) (1991) 31 Fiji Islands Kiribati Marshall Islands Micronesia, Fed. States of Nauru Palau Papua New Guinea Samoa Solomon Islands Timor-Leste Tonga Tuvalu Vanuatu Australia Japan New Zealand continued.

6 118 Table 6.3 Target 6.C: Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases (continued) 6.9 Death Rates Associated 6.10 Proportion of Tuberculosis with Tuberculosis Cases under DOTS (percent) (per 100,000 people) Detected Cured Afghanistan (1997) (1997) 84 Armenia Azerbaijan (1996) 60 Georgia Kazakhstan (1998) (1998) 72 Kyrgyz Republic (1996) (1996) 82 Pakistan Tajikistan (2002) (2002) 84 Turkmenistan (2000) (2000) 84 Uzbekistan (1998) (1998) 81 China, People s Rep. of Hong Kong, China (1999) (1998) 78 Korea, Rep. of Mongolia (1996) 88 Taipei,China 10 4 (2006) Bangladesh Bhutan India Maldives Nepal (1996) (1996) 89 Sri Lanka Brunei Darussalam a (1999) (1998) 84 Cambodia Indonesia Lao PDR (1996) Malaysia Myanmar (1996) Philippines (1996) 88 Singapore Thailand (1996) (1996) 77 Viet Nam Cook Islands 2 (1991) (2005) (2005) Fiji Islands Kiribati (1997) (1998) 90 Marshall Islands (1998) (1998) 75 Micronesia, Fed. States of Nauru (2000) (1999) 100 Palau Papua New Guinea (1997) (1997) 73 Samoa (2006) (2005) Solomon Islands (1996) Timor-Leste (2002) (2002) 79 Tonga Tuvalu (2005) (2004) 75 Vanuatu (1999) (1999) 91 Australia (1998) (1997) 80 (2005) Japan (2000) (1999) 60 (2005) New Zealand (2000) (2000) 60 (2005) DOTS = Directly Observed Treatment Short Course. a Brunei Darussalam is a regional member of ADB, but it is not classified as a developing member country. Sources: Millennium Indicators Database Online (UNSD 2009); for Taipei,China: economy sources.