The Western Pacific Region of WHO has 37 Member States and areas and covers a vast geographical expanse from the far western province of Xinjiang in China to French Polynesia in the Pacific. The HIV epidemic in the Western Pacific Region is as diverse as its Member States.
As of December 2005, an estimated 1.5 million people were living with HIV in the Region, with China, Cambodia, Viet Nam, Malaysia and Papua New Guinea accounting for a vast majority. Within the Region, the incidence and prevalence of HIV is mostly concentrated in selected high-risk population groups, now termed "most at risk populations", such as injecting drug users (IDUs), sex workers and their clients, men who have sex with men (MSM) and mobile and displaced populations. Only Cambodia and Papua New Guinea report generalized epidemics with population prevalence rates exceeding 1%. Elsewhere, the prevalence of HIV is low although the overall regional daily toll from HIV includes an estimated 500 new infections and about 200 deaths.
The Region's population is characterized by considerable mobility across and within borders, a factor that contributes to an increased risk of HIV transmission. In the Pacific, the high prevalence of Sexually Transmitted Infections (STI) is an important factor related to the potential for further epidemic spread of HIV in that area. In recent surveys conducted during 2004-2005 in six sentinel countries of the Pacific (Fiji, Kiribati, Tonga, Samoa, Solomon Islands, and Vanuatu); chlamydia is the most prevalent STI, found in up to 29% of pregnant women in certain areas.
Despite the great need for the implementation of evidence-based strategies with a proven record of reducing HIV and STI transmission, prevention and harm reduction programmes in the Western Pacific Region are still severely limited. It has been estimated that coverage of prevention programmes has only reached 1% of MSM, 5.4% of IDUs and less than 20% female sex workers.
At the beginning of 2004 about 15 000 people, or approximately 8% of those in need, were receiving antiretroviral therapy. By June 2006, that number had grown to nearly 40 000, around 30% of the estimated need (Table 1). Progress has been particularly notable in Cambodia where more than 70% of people living with HIV/AIDS (PHA) in need of treatment are now receiving ART. Progress, albeit more modest, is also reported from China, Viet Nam, Papua New Guinea, the Lao People's Democratic Republic and Malaysia.