Message from Hon’ble Sowai Lyonpo Hon’ble Minister of Health
‘Prevent, Test & Treat All’ – Fast-Tracking response to End AIDS!
Having experience of over three decades since the evolution of HIV/AIDS epidemic in the world, tremendous progress against AIDS have inspired a global commitment to end the epidemic by 2030. The United Nations General Assembly agreed in June 2016 that ending AIDS by 2030 requires a Fast–Track response to reach three milestones by 2020:
■ Reduce new HIV infections to fewer than 500 000 globally by 2020.
■ Reduce AIDS-related deaths to fewer than 500 000 globally by 2020.
■ Eliminate HIV-related stigma and discrimination by 2020.
Today there are almost 36.7 million people living with HIV/AIDS with 2.1 million new infection in 2015 alone. Globally we are witnessing declining trend in AIDS related deaths due to improved treatment coverage and easy accessibility to safe and affordable medications, the total AIDS related deaths recorded in 2015 was 1.1 million. Globally there are 1.8 million children (<15 years of age) currently living with HIV/AIDS and in 2015 almost 150,000 children were newly infected with HIV/AIDS. Almost 50 percent of the global HIV/AIDS cases are reported from Eastern and Southern African Region (19 million), followed by Western and Central African Region (6.5 million), and Asia & Pacific Region (5.1 million). In 2014 there were 3.5 million people living with HIV/AIDS in South East Asia Region, out of which 230,000 are new infections reported in 2014 alone, translating into 640 people getting infected every day. HIV continues to exact its toll, with an estimated 230 000 AIDS-related deaths every year and currently there are 1.2 million people accessing Anti-Retroviral Treatment in the region. Five high-priority countries in the Region account for 99% of the HIV burden. These are India, Indonesia, Myanmar, Nepal and Thailand. Given the considerable progress achieved both at the global and regional level, Ending the AIDS epidemic and leaving no one behind in the response will profoundly affect the entire lifespan of millions of people around the world, for generations to come. The post AIDS world will be very different from the one we know today—and it is one we can create. It will be a world in which every child is born HIV-free to healthy parents, and any child living with HIV receives the treatment, protection, care and support to survive and thrive into adulthood and old age. The world has committed to end the AIDS epidemic by 2030 as part of the Sustainable Development Goals. This ambitious yet wholly attainable objective represents an unparalleled opportunity to change the course of history for ever—something our generation must do for the generations to come. More than decade ago, the first known cases of HIV/AIDS sparked a concern in Bhutan - ushering in a time defined by how little we knew about it and in which those affected by it faced were completely left with no clue. We have made extraordinary progress in the fight against HIV since that time, but much work remains to be done. On World AIDS Day, we remember those who we have lost to HIV/AIDS, celebrate the triumphs earned through the efforts of scores of advocates and providers, pledge our support for those at risk for or living with HIV, and rededicate our talents and efforts to achieving our goal of an AIDS-free generation. Today, there are 515 people detected with HIV virus out of which 396 are currently living with the virus in the country with equal proportion of male to female ratio. Among the total reported cases, almost 7 percent of the cases are attributable to vertical transmission from their infected parents. As always Heterosexual continues to remain the predominant mode of HIV transmission and promotion of safe sex still remains the greatest challenge given the unsafe sexual practice. Even though, Bhutan continues to maintain the prevalence rate <0.1%, HIV/AIDS still remains one of the priority public health problem, given the increasing mobility of our people, porous border with our neighboring countries, low demand for condom use and high sexual promiscuity nature. As we observe this special day, I on behalf of the Ministry of Health and the Royal Government of Bhutan would like to submit our sincere thanks and gratitude to His Majesty the Kings for their guidance in reshaping the policies and programmes for the prevention and control of HIV/AIDS in the country. Further, we also would like to submit our humblest appreciation to Her Majesty the Gyalyum Sangay Choden Wangchuck for her unwavering commitment and support to the cause, Her Majesty Gyalyum has been the true pioneer for the entire success that we have achieved over last one decade in our response to HIV/AIDS. As a key highlight of the day, Bhutan is proud to announce that Anti-Retro viral treatments will be made available for all the people diagnosed with HIV irrespective of their body immunity count (CD4 count), and this policy shift is expected to bring a positive change in our fight against this disease. As a signatory member to the UN convention in endorsing the Sustainable Development Goals (SDG), Bhutan will also be pledging to ‘fast track’ our response to end AIDS by 2030, while mitigating the ill effects of social stigma and discrimination associated with the disease. While treatment scale-up can be one of the most thought awaited achievements for us, we would also urge the individuals infected with HIV to closely observe their compliance to medication. Early initiation of ARV medication and good compliance will immensely improve the health outcome of the infected individuals and will reduce the transmission from source through suppressed viral load, however there are also equal risk of drug resistance. Now the onus is with every individual to address the issues concerning the spread of the virus, thereby we urge everyone not to be ignorant to the growing menace of HIV/AIDS, though in relatively small scale. With the widening detection gap (42%), we are concerned that there are ongoing transmission of HIV virus in our society, as people are unaware of their HIV status. This year the theme for the event is ‘Prevent, Test & Treat all’ is very timely with the launch of our new policy to treat all the people living with HIV/AIDS in the country. The Ministry of Health will strive hard to prevent the spread of HIV while expanding HIV testing services to a community level through targeted intervention programmes. Linkage to care after diagnosis and retention on care will remain our primary focus and this will be achieved through a stronger collaboration and partnership with the civil society organizations like Lhak-sam (Network of People Living with HIV/AIDS in Bhutan). In Bhutan, the national theme for the day would be ‘to bridge the detection gap’, as we see that we still have high detection gap despite the integration of HIV prevention services in to core primary health care package. Therefore, one of our key strategy would be to scale-up HIV diagnostic services and introduce community led HIV testing services to reach out to the most-at-risk and vulnerable population groups. Today, as we observe World AIDS Day, I on behalf of the Ministry of Health and the Royal Government of Bhutan would urge every citizen of our country to be responsible to partner the government in realizing our goal of creating AIDS free society and contribute positively to our nation building. I also would like to take this opportunity to acknowledge the supports that get from our developmental partners, national stakeholders, NGOs/CBOs and individuals to our fight against HIV/AIDS. Together we can defeat AIDS, we shouldn’t leave any space for complacency.