Context: "HIV&AIDS constitutes a global emergency and one of the most formidable challenges to human life and dignity; (it) undermines social and economic development throughout the world and affects all levels of society."(UNGASS) In June 2001, at the UN general assembly special session on HIV&AIDS (UNGASS), governments of 189 countries committed to jointly respond to the pandemic, following a set of targets to be reached by 2005 and 2010. In 2003, the WHO and UNAIDS initiated an ambitious initiative called “3 by 5” that aimed at providing antiretroviral therapy (ART) to three million people living with HIV&AIDS in low and middle income countries by the end of 2005. In July 2005, at the G8 summit in Gleneagles, rich countries made a commitment to scale up HIV prevention, treatment and care to reach universal access to treatment by 2010. Later in 2005, at the World Summit, all world leaders adopted the commitment to develop and implement a package for HIV prevention, care and treatment with the aim of coming as close as possible to the goal of universal access to treatment by 2010 for all those who need it.

Reality at the ground:
Beside these commitments expressed in different occasions the bitter reality is that entire Asia is facing an unprecedented challenge of HIV&AIDS, with possibly huge economic and social consequences. Despite of series of claims andok commitments of the governments, donors and civil society in seriously pursuing the epidemic, large number of people in the region continue to face crisis of existence. People are dying from AIDS related deaths because they have no access to food, care and support and medicine. Those who are struggling to escape the jaws of death are compelled to put up with stigma, discrimination and inhuman treatments; a mockery of democracy.

The debilitating human rights condition, increasing democratic deficit, unabated conflicts, and increasing religious fundamentalism in most of the countries in Asia, pose great challenges to address the causes and consequences of HIV&AIDS. To add, increasing inequalities, mass exodus and exacerbating violence, particularly against women make the issue of HIV&AIDS more complex.

Poor families with HIV&AIDS cases in different parts of Nepal, India, Pakistan, Cambodia, Vietnam, Thailand and in China have already started to face serious economic crisis at the household level, women and children are under the hardest hit. Families have started to sell their land and properties for treatments. Children are compelled to drop out from their schools. Poor and the most marginalized families are going through serious challenges of existence. Poor families such as in Cambodia are forced to live in hunger. Food Insecurity has been another serious emerging threat.

On the other hand, due to weak public health care system in many countries of Asia; the poor and the most marginalized sections are excluded in accessing basic health care services. Similarly, due to the lack of comprehensive care and treatment services PLHAS are excluded in accessing available services. Common issues such as lack of transportation cost to reach to the treatment center and lack of nutrition have posed serious challenges. Many poor families in Asian countries with HIV&AIDS cases are in need of emergency support.

Unfortunately most of HIV&AIDS related policies which are largely concentrated in improving human behaviors have grossly neglected the structural causes and consequences of the epidemic. They have failed to see HIV&AIDS from a development framework.

In the mean time neither the existing HIV policies nor the broader development policies correspond to the realities that the households are facing. The fund allocation patterns of the governments still reflect the fact that governments are still reluctant in prioritizing the epidemic in terms of fund allocation. Another bitter fact is that most of the ongoing HIV&AIDS programs in the region are donor funded which largely constraints the liberty of national institutions as well as this trend continues to put them under fear psychosis. On the other hand, the constant failure of the Donors in meeting their funding commitments has grossly neglected the human rights aspects of hundred thousands of lives in Asia. The way the epidemic is challenging the overall socio-economic and political structures, that if timely interventions are not implemented on the ground Asia might face serious financial crisis and in turn a massive development crisis.

In these critical contexts, it will be almost impossible to achieve MDG in the region, if there are no timely interventions on the ground.

Gender insensitive policies!
Both government and donors have failed to ensure gender aspects in their HIV &AIDS related planning, implementation and evaluation processes. Women’s rights aspects have not yet gained political significance in overall HIV &AIDS policies. Treatment services are yet to be women friendly. On top of it, patriarchy in different forms has created potential vulnerabilities for women. Increasing incidences of domestic violence and increasing trends of girls trafficking in Asia have further worsened the conditions of women and girls. Women and girls are forced to face multiple crises; unfortunately policy priorities have failed to address these realities.

Who is getting benefit?
Today, while AIDS remedial efforts continue to mature and become more sophisticated, the target population in resource-poor countries remains outside its sphere of influence. There is a danger that the AIDS bureaucracy, public and private, worldwide, may become more important than the needs of the target population. The lack of a significant, sustained impact on the target population may lead to the celebration of modest program successes for a pandemic that kills more than 2 million people every year. In the mean time, the constant failure to curb the impacts of the epidemic and its steady escalation calls into question whether there is a systematic flaw to respond to the epidemic, and whether the problems are with our systems, and their governance mechanism which keep from delivering effective results. The bitter fact is that though there is enough resource floating around; it is not reaching the real communities.

Asian Civil society to take actions
Asian civil society has a long history of struggles for rights, justice and democracy. They have successfully fought against colonialism as in India and against autocratic regimes such as in Nepal. Political interest being the driving force, issues which do not carry considerable political weight fail to arouse much interest to Asian civil societies. The fact is that HIV&AIDS has not been an important human rights, development and political issue for Asian civil society.

Unless civil society groups including trade unions, business sector, and faith based networks, academia, student unions, parliamentarians and political parties combine efforts to fight the pandemic, the battle can't be won comprehensively. This is the time to see initiatives going beyond the time bound projects, and gearing ourselves towards social movements.

Opportunity
“Universal Access” is the global commitment to provide HIV prevention, treatment, care and support services to all those in need. Originally the idea was to set up national targets through comprehensive assessments of their epidemics and the obstacles to scaling up national responses, in consultation with civil society, people living with HIV and other country-based partners. However, till date many Asian governments lack such national targets.

Unfortunately Universal Access has not been a serious public debate in Asia. Civil society, media, grassroots are still away from this discourse. World AIDS Days 2007, 2008, 2009, 2010 will give us an opportunity to campaign together to "Keep the Promise of Universal Access", with a range of associated themes and campaign initiatives to keep up momentum. It is time for Asian civil society to act up. We have opportunity to bring local and national issues within the broader framework of Universal Access Campaign so that we can address the issue at the local, national and global levels.

There is unprecedented community and political mobilization around AIDS. Significant resources have been mobilized. The most significant policy and action framework was laid out in the Millennium Development Goals (MDGs). This is now time for us to be proactive and take actions from the grounds where we are standing. We have opportunity to amplify voices and make governments, donors and civil society to be more accountable.

Thus we call...

• Governments to immediately introduce humanitarian relief programs for PLHA in poor families in Asia.
  
  
• To redefine and implement long term development programs that address the structural causes of the epidemic and to allocate enough resource.
  
  
• To strengthen public health care systems with special focus to HIV & AIDS treatment and care.
  
  
• To ensure just and democratic governance in HIV & AIDS related interventions from global to local levels.
  
  
• To ensure political and meaningful participation of PLHA and other communities in decision making processes.
  
  
• To ensure the governance mechanism of CCM through the transparent and democratic processes.
  
  
• To strengthen monitoring and evaluation systems to ensure the effectiveness of the ongoing programs, their transparency and accountability. Promote social audits.
  
  
• Governments and donors to promote development strategies based on the needs and experience of people and local realities. We call for strengthening of national policy making, based on nationally defined needs and priorities that are decided through the political participation of PLHA, vulnerable communities and civil society.
  
  
• Governments to fully recognize the centrality of gender equality and equity in over all HIV & AIDS planning, implementation and monitoring processes. We call for donors and governments to promote women’s rights and end violence against women.
  
  
• Governments for a commitment for the reduction in military spending, and give priority to public health and HIV & AIDS.
  
  
• To end stigma and discrimination and ensure legislative measures to protect the rights of PLHA and other marginalized communities to lead a dignified life.
  
  
• Provide responsible care and quality treatment to persons living with HIV & AIDS.
  
  
• International donors and governments to take immediate action for fair and transparent aid, and to meet the commitments of debt cancellation.
  
  
• For the increase in financial support for the Universal Access Target by 2010. In addition, sustained and predictable funding for the Global Fund to fight AIDS, tuberculosis and malaria must be assured.
  
  
• No TRIPS. Guarantee the free access of HIV & AIDS related medicines including ART for people living with HIV & AIDS. Ensure public health rights take precedence over pharmaceutical patents.
  
  
• Governments to take actions for the reform of the multilateral system of governance and the strengthening and democratization of the United Nations a reform of the World Bank, IMF and other International Financial Institutions, together with the WTO to adhere to these principles.
  
  
• Governments to ensure that engagement with civil society in the process of decision making - nationally, regionally and at the international level - is effectively facilitated.
  
  
• To promote multi-sectoral approach ensuring enough resource, capacity and coordination. As MDG provides a ground to systematically develop links among eight goals, it could be one of the best possible alternatives.
  
  
• Civil society, business sector, political parties, religious leaders, trade unions, student unions and all other networks and individuals to reflect, and realize the urgency of the epidemic and to take immediate actions to mobilize themselves and their respective constituencies to protect the rights of the people and to make a better Asia, a citizen’s Asia. Please circulate for wider solidarity!

  Please express your solidarity:	secretariat.asia@apachanet.org
  Know more about Universal Access:	www.apachanet.org