Feature story

‘Thinking politically’: strategies for effective responses to HIV in Asia and the Pacific

28 August 2011

Dr Nafis Sadik, United Nations Secretary-General Special Envoy for HIV/AIDS, Dr Kent Buse, Senior Advisor at UNAIDS and Dr Werasit Sittitrai, Thai Red Cross on the panel of “Thinking Politically.”
Credit: UNAIDS/Kim

Activists, academics and HIV programme implementers met in Busan, South Korea at the 10th International Congress on AIDS in Asia and the Pacific (ICAAP 10) to explore and debate the political complexities of HIV responses. The event, entitled ‘Political Sciences and the Politics of HIV in Asia and the Pacific,’ shed light on the often highly contested nature of responses to the epidemic.

This satellite was part of a global initiative spearheaded by UNAIDS and the International AIDS Society, ‘Thinking Politically about HIV.’ The initiative seeks to strengthen the capacity of people engaged in the response to understand and influence politics in a more systematic way in order to foster an enabling environment for effective AIDS responses.

Panellists shared experiences of effective political analysis which have been used to identify strategic opportunities to move the agenda on HIV in a positive direction in countries across the region.

“When I began my work in reproductive health, I found enormous suspicion and ignorance, even among highly educated people. A great deal of that negativity has disappeared,” said Dr Nafis Sadik, United Nations Secretary-General Special Envoy for HIV/AIDS. “Political leaders came to understand that they had more to gain than to lose by responding to the enormous latent demand for reproductive health services, especially among women — and the same holds true for HIV.”

Political leaders came to understand that they had more to gain than to lose by responding to the enormous latent demand for reproductive health services, especially among women — and the same holds true for HIV

Dr Nafis Sadik, United Nations Secretary-General Special Envoy for HIV/AIDS

A number of countries in the Asia-Pacific region have shown impressive political responses over the last ten years. Thailand is one of the heralded ‘success stories’ in the 1990s resulting in dramatic declines if new HIV infections from 143,000 new infections in 1991 to 29,000 in 2000. Speaking at the session, Dr Werasit Sittitrai of the Thai Red Cross explained how that these results were achieved through a transformation of the political landscape, driven by evidence-based advocacy and civil society pressure. “One of the most successful strategies was advocating the potential economic consequences of inaction to political leaders,” he said.

While the region has much to progress to celebrate, the HIV response is at a crossroads. Programmes are buffeted by donor fatigue and many countries retain laws and policies that effectively prevent people living with HIV and key populations at higher risk from access to life saving services. In this context, a better appreciation of the politics of the challenges is critical to continued success — particularly by the next generation of leadership.

One of the most successful strategies was advocating the potential economic consequences of inaction to political leaders

Dr Werasit Sittitrai, Thai Red Cross

According to Dr Kent Buse, chair of the session and Senior Advisor at UNAIDS, “the AIDS response is particularly political because some of the behaviours that put people at risk of HIV — sex, sex work, and drug use — are taboo in many societies. People living with and affected by HIV have therefore continuously challenged the values and ideologies of leaders and the international community.”

Additional speakers at the event included Professor Dennis Altman, of La Trobe University, co-chair of the Advisory Group for Thinking Politically and Dr David Stephens of RTI International.

Discussion at the session will feed into broader debates and events for the 2012 International AIDS Conference (Washington DC, United States). A special issue of Contemporary Politics, featuring case studies on successful political responses to HIV in a number of countries, is being prepared for publication ahead of the 2012 Conference.