The Pacific region, which is home to the smallest, most isolated and least developed countries, covers more than a third of the planet’s surface, but is home to just 0.14% of the world’s population – a similar share of the global burden of HIV. However, in the Pacific region, even a small number of people living with HIV can lead to high incidence and prevalence rates.
Pacific countries are often included in the wider Asia-Pacific regional groupings, where the enormous challenges faced by Asian countries may overlook the difficulties and needs of the smaller Pacific countries.
These regional realities led in October 2007 to the creation of an independent Pacific AIDS Commission to study the current magnitude of the HIV epidemic in the region.
Countries in the Pacific are at different stages of achieving the Millennium Development Goals, but the report indicates that none of them is likely to meet all of the 2015 health targets.
There are officially 29,629 people living with HIV in the Pacific region, with 5,162 new HIV infections reported in 2008.
Papua New Guinea has the largest proportion of cases, growing exponentially from 21% in 1984-1989 to over 99% in 2008. Papua New Guinea has officially reported 28,294 cases, but UNAIDS estimates there are 54,000 people living with HIV. According to experts, by 2012 the national HIV prevalence in Papua New Guinea will be 5.07%, and the total number of HIV-infected people will reach 208,714.
Unprotected sex is the main route of HIV transmission in the region. The number of HIV-positive young people is growing steadily, and young women become infected at an earlier age than young men. In New Caledonia, French Polynesia and Guam, unprotected sex between men and injecting drug use are considered to be the main drivers of the epidemic.
Between 2001 and 2009, funding for HIV programs in the region increased more than fivefold, reaching $ 77 million in 2008. The high cost of implementing HIV programs in the Pacific region is attributed to high cultural and linguistic diversity, limited and expensive transport networks and poor communication infrastructure.
While the Commission commended the leaders of the Pacific region for their timely action in support of the AIDS response, it also noted that knowledge is still limited due to weak surveillance, data collection and analysis systems.
The report noted that the AIDS response in the Pacific region can be more effective if more attention is paid to unprotected sex and other risky behaviors, rather than just populations.
Since strong family and religious ties are central to the life of the Pacific region, any success in the response to the epidemic will only be possible if the HIV response is integrated into these social structures. The report also recommends greater involvement of people living with HIV in policy-making and program implementation, as this will only strengthen the response.
AIDS in the Pacific should not be seen as a burden that diverts resources to address other priorities. AIDS creates an opportunity to develop and address inequality, injustice in our societies.