As members may be aware, in January 2018, the Australian government signed a AU$22.5 million five-year strategic partnership agreement with UNAIDS in the Asia–Pacific region to advance the vision outlined in the UNAIDS Strategy: On the Fast-Track to end AIDS. While initiatives such as this are welcomed and the Department of Foreign Affairs and Trade (DFAT) continues to contribute to the Global Fund to Fight AIDS, TB and Malaria funding overall for HIV and other BBVs has dropped off markedly in recent years, ASHM remains concerned there is still much to do.
DFAT used to provide significant funding directly to HIV services across the region, but this has been reduced significantly in recent years. In Papua New Guinea (PNG), for example DFAT ceased funding HIV prevention services at PNG Catholic Church Health Services (CCHS) and Anglicare clinics in June 2017. These clinics provide more than 40% of the HIV treatment in country and have not been funded by the PNG Government to-date. These services need to be absorbed by the GoPNG budget if they are to continue.
Globally funding for HIV and other health issues has shifted (and largely declined) and while countries that are able to should step up we need to be aware that sudden changes over short time periods are impacting progress being made. It remains very uneven. While those governments are stepping up some are struggling for example in PNG but the The Sexual & Reproductive Health Integration Project (SHRIP) supported by DFAT is an excellent example of locally-led partnership with expertise provided by Australia-based technical assistance (such as ASHM and Burnet Institute).
SHRIP is a collaboration to move away from stand-alone often externally-funded siloed HIV services and integrate health services and improve the delivery of HIV and sexual and reproductive health (SRH) services and outcomes across 18 provinces in PNG. However we need to continue to build on those gains through for example ongoing mentoring, tacking ART resistance and supporting the health system with the tools, training and guidance they identify that they need. And especially in tackling stigma and discrimination in health care settings which is being routinely cited as the number one reason for barriers to prevention, treatment, care and support. ASHM alongside more than 50 societies and associations in the regions across Asia, the Pacific and PNG stands ready to partner, adapt and support the response to local contexts, needs and challenges with state of the art expertise and learning from the Australian Context. Find out more about The Regional Network
ASHM is proud to have supported the clinical workforce in the HIV response in the region for over 15 years and particularly in PNG where for 14 years we have been providing clinical mentoring and accredited HIV prescriber training through the Collaboration for Health in Papua New Guinea: A partnership project since 2003, which delivers clinical and laboratory training and mentorship to nearly 400+ healthcare workers managing HIV in seven PNG provinces with CCHS, Igat Hope and NAPWHA. ASHM has seen vast improvements in ability to test and treat in the areas we have worked in bolstered by well established relationships and knowledge on the ground. Alongside The Sexual and Reproductive Health Integration Program (2017–2019) we also provide direct technical advice to the PNG National Department of Health to develop HIV training packages for clinicians/health workers include community health workers.
The Pacific is a priority geographic region for ASHM with huge challenges in targeting BBV and STI. [Michelle] ASHM in partnership with The Oceania Society for Sexual Health and HIV Medicine (OSSHHM) based in Fiji, has been supported by the Global Fund through UNDP to establish a pool of local (Fiji-based) clinical mentors to provide technical assistance to 11 neighbouring Pacific Island countries and territories (achieved this year). The Pacific Sexual Health Workforce Capacity Building Program further delivered development of training packages and guidance, and provision of technical support to governments.
Research is critical as epidemic and priority populations from an Asian model cannot simply be applied to the Pacific. In 2016, ASHM collaborated with the University of New South Wales aiming to assess and examine the behaviour risk factors and social and structural determinants of HIV risk that drive the epidemic among vulnerable groups, including MSM, transgender people, sex workers and seafarers. Find out more about The Pacific Multicountry Mapping and Behavioural Study. ASHM is currently completing the development of Transgender Health Training for Pacific Health Workers aimed at health care workers in Pacific countries with an Introduction to addressing transgender health needs—with the objective of providing general and better health care to a vulnerable population not receiving adequate HIV/STI services.