Cambodia awarded MDG prize for AIDS response excellence

PHNOM PENH, Sept. 20 (Xinhua) -- Cambodia has been presented with a Millennium Development Goals Award for its national leadership, commitment and progress towards achievement of Goal 6 - Combating HIV, malaria and other diseases, a press release from UN Office in Cambodia said on Monday.

Cambodia has been honored within the 'Government' category of the annual Awards initiative, presented at a high-profile event in New York City, the United States, it said.

Cambodia is recognized for efforts on HIV that have contributed to a decline in HIV prevalence from an estimated 2 percent (among adults aged 15-49) in 1998 to a projected 0.7 percent in 2010.

Cambodia has also achieved the universal access target for treatment, with over 90 percent of adults and children in need receiving antiretroviral therapy (ART), due to the expansion of the Continuum of Care program established in 2003. Survival of PLHIV on ART after 12 months is estimated to be 87.4 percent in total (86.7 percent of adults and 93.9 percent of children).

"The Royal Government of Cambodia's response to HIV and AIDS has successfully scaled up HIV prevention, treatment, care and support for people living with HIV in Cambodia and generated benefits at the individual, community and health center level due to a high level of collaboration among all stakeholders, including UN agencies, civil society and development partners," said Teng Kunthy, Secretary General of the Cambodia National AIDS Authority.

Selecting Cambodia for the Award, the MDG Awards Committee was particularly impressed with the Government's successful scale-up of programs grounded in strong national leadership on HIV/AIDS, the solid National Strategic Plan (NSP) and collaborative partnerships, adhering closely to the 'Three Ones' principles one national coordinating body, one national multi-sectoral strategic plan, one single monitoring and evaluation system, the release said.

Innovative prevention programming in Cambodia over the last 10 years has included the introduction of the 100 percent Condom Use Policy which showed successes in preventing new infections. Progress has also led to impacts on the other health-related MDGs of reducing child mortality and improving maternal health.

Successful scale-up of HIV services has contributed to a nearly 50 percent decrease in HIV prevalence among pregnant women at antenatal clinics, and in 2009 more than 32 percent of HIV- infected pregnant women received treatment to reduce the risk of mother-to-child transmission of HIV, an increase from 11.2 percent in 2007.

The nomination of Cambodia for the MDG Award was a joint initiative by the UN system in Cambodia.

"We congratulate Cambodia on receiving the MDG Award. This experience shows if all the ingredients for success are in place that Millennium Development Goals are achievable strong leadership and commitment from the highest level, a sound policy framework backed up by the adequate level of resources and implementation capacity, and coordination and collaboration among all partners," said Douglas Broderick, United Nations Resident Coordinator in Cambodia. "The lessons learned here can be applied to accelerating the progress of those Goals still facing challenges, to ensure their achievement by 2015," he added.

However, "HIV is still a very real challenge in this country, and stigma and discrimination remain high, which creates a barrier to accessing services for prevention, care, support and treatment, " said Douglas Broderick.

Cambodia wins award from United Nations for cutting HIV/AIDS

Sep 20, 2010
DPA

Phnom Penh - The United Nations said Monday that Cambodia had won an award for the government's successes in dealing with HIV/AIDS.

The Millennium Development Goals (MDG) award follows the drop in the nation's HIV prevalence from an estimated 2 per cent of adults in 1998 to a projected 0.7 per cent this year.

The UN's resident coordinator in Cambodia, Douglas Broderick, attributed success in tackling the disease to strong leadership, sound policies and collaboration between government and its partners.

'The lessons learned here can be applied to accelerating the progress of those goals still facing challenges to ensure their achievement by 2015,' he said referring to other MDGs that remain off-target such as the number of women dying in childbirth.

In the past decade Cambodia introduced its 100-per-cent Condom Use policy, one of a range of measures that has helped to halve HIV prevalence among pregnant women.

Another measure has tripled the number of HIV-positive women who receive drugs to prevent mother-to-child transmission of HIV. In 2007, just 11 per cent received medication. Last year, one-third did.

The UN added that more than 90 per cent of people needing antiretroviral therapy now get the drugs they need.

But UNAIDS country director Tony Lisle warned HIV was not yet beaten, and pointed out that injecting drug users remain a high-risk group.

'HIV is still a very real challenge in this country, and stigma and discrimination remain high, which creates a barrier to accessing services,' Lisle said.

His comments echoed worries expressed by AIDS campaigners who have long condemned provisions in the 2008 anti-trafficking law that outlaw prostitution.

Police have arrested numerous sex workers and driven many underground in the past two years, which has made it harder for health workers to reach them.

Organizations providing health services for sex workers have long expressed concern that their staff risk being arrested for providing sex workers with condoms and sexual health information.

The UN acknowledged that in its statement announcing the award, saying 'changes in the legal and policy environment' had hampered efforts to help those most at risk.

Award for Cambodia's "Rouge" Lady

Dr Nafis Sadik of the UN presents Cambodian first lady Bun Rany an award for her role in combating HIV/AIDS and reducing discrimination against those living with the disease at the Red Cross Headquarters in Phnom Penh on Tuesday. (Photo: Kim Sovannara, The Phnom Penh Post)

“This award is a slap in the face for Cambodians living with HIV and those most at risk, especially sex workers, homeless people and people who use drugs” - Joe Amon, director of health and human rights for Human Rights Watch

Bun Rany to receive UN award for reducing HIV/AIDS stigma and discrimination ... while her husband regime is promoting just the opposite

HIV patient Touch Sokhak, 45, speaks to reporters about the inadequate facilities of his families home at the Tuol Sambo relocation site on Friday. (Photo by: Rick Valenzuela)

Cambodian first lady Bun Rany attends last year’s World AIDS Day celebrations in Phnom Penh. (Photo by: Heng Chivoan)

AIDS award spurs questions

Monday, 16 November 2009
Robbie Corey Boulet
The Phnom Penh Post

“This award is a slap in the face for Cambodians living with HIV and those most at risk, especially sex workers, homeless people and people who use drugs” - Joe Amon, director of health and human rights for Human Rights Watch

A UN special envoy is scheduled to present first lady Bun Rany with an award recognising her role in combating HIV/AIDS and in reducing stigma and discrimination against people living with the disease, a move that has raised some eyebrows among human rights groups, one of which called it “a slap in the face”.

The Asia-Pacific Leadership Forum on HIV/AIDS and Development Award will be presented by Dr Nafis Sadik, the UN secretary general’s special envoy on HIV/AIDS in Asia and the Pacific, during a ceremony Tuesday at the headquarters of the Cambodian Red Cross, which Bun Rany heads.

UNAIDS Country Director Tony Lisle said Sunday that the decision to present the award to Bun Rany had been prompted by her “very, very, very active” role in HIV/AIDS issues.

“Her focus has been very specific,” he said. “It’s been particularly focused on orphans and vulnerable children, the rights of people to access anti-retroviral therapy and also engaging communities at the local level in reducing stigma and discrimination.”

He added: “I know that in cases where children have been excluded from school, she’s intervened and sent very clear messages about the inappropriateness of exclusion on the basis of one’s HIV status,” he said.

The adult HIV prevalence rate stood at 0.9 percent in 2006, far below the 2015 Millennium Development Goal of 1.8 percent, though the baseline used to set that goal was later revised downward.

Award questionable: NGOs

This accomplishment aside, several human rights workers said the government’s record on HIV/AIDS issues was blemished at best.

“This award is a slap in the face for Cambodians living with HIV and those most at risk, especially sex workers, homeless people and people who use drugs,” said Joe Amon, director of health and human rights for Human Rights Watch. “Rather than uncritical praise, UNAIDS should be speaking out about this government’s discrimination, stigmatisation and neglect of Cambodia’s most marginalised communities.”

Amon cited this year’s Borei Keila eviction as an example of poor treatment of HIV/AIDS patients. City Hall forcibly relocated 40 HIV-affected Borei Keila families to the Tuol Sambo relocation site in June and July. Rights groups have regularly criticised conditions at the site, which have included a lack of food and oppressive heat.

Though she was less critical of the decision to give the award, Pung Chhiv Kek, founder of the rights group Licadho, said she hoped it would prompt Bun Rany to take action in preventing Borei Keila-style evictions in the future.

“I would like to take this opportunity to appeal to her that recently, there have been some families that have HIV/AIDS, and the government put them in a special place,” she said. “I hope that she will do something so that these people have the possibility to live with the rest of the population. It’s a kind of discrimination.”

In response to civil society criticism, Lisle said he agreed that Tuol Sambo was “a big mistake”, but he argued that the award was justified.

Tuol Sambo, he said, “does not in any way take away from Cambodia’s excellent track record in reducing stigma and discrimination.”

AIDS Infection Rate Drops in Cambodia

By Rory Byrne, Voice of America
Phnom Penh
04 September 2007

Like many small, poor countries in Asia and Africa, Cambodia faces a challenge from HIV - the virus that causes AIDS. By all measures, Cambodia should be devastated by AIDS. Brothels are commonplace, illegal drugs are widely available and Cambodia's health-care system is so poor the government can only spend about two dollars a person a year. Yet despite these problems, the rate of new infections has dropped steadily. VOA's Rory Byrne has more from Phnom Penh.

Reth is a tuk-tuk taxi driver in Phnom Penh. He was diagnosed as HIV positive in 1997.

He nearly died from an AIDS-related illness about five years ago before free drug therapy became available.

Today, about 80 percent of all HIV-positive people in Cambodia receive free life-saving anti-retroviral drugs. International aid groups largely pay for the medications. U.N. officials say Cambodia spends about $49 million in public and private funds to combat the virus. "Now I make power enough, that I can do a job, anything, it's no problem now," says Reth.

The number of AIDS cases here has fallen in the last decade from 3.2 percent of the population to 0.9 percent today. Credit is given to condom distribution programs and education on how to prevent transmission of the virus.

The United Nations AIDS co-ordinator in Cambodia, Tony Lisle, says the government has done a good job. "I think the main reasons behind this remarkable success is the enormous commitment of government. I think very strong partnerships between government and civil society, NGOs, and other partners to ensure that we had a very, very comprehensive program that addressed the high points of the epidemic, the epicenter of the epidemic, which is basically sex workers and their clients."

Cambodia is poor and is recovering from decades of conflict. Thousands of women see no choice but to become sex workers.

Health workers, like Dr. Sophal Kaing, teach safe-sex practices in brothels. "We prevent HIV from (by) using 100 percent condom use. It means she use the condom to (with) every client, even her sweetheart."

One Cambodian prostitute says, "We have to beg the customer, we have to talk to him. And if he still does not agree to use a condom, I will refuse to have sex with him."

Despite the progress, experts warn there remains a chance the infection rate could still rise, particularly among gay men, injecting drug users and so-called indirect sex-workers -- women working in bars and clubs.

Tony Lisle from UNAIDS adds, "I think the biggest challenge for all the partners who are at the front line of the response is to really ensure that we address indirect sex work (ers) and their clients because behavioral trends are changing, people are moving to sweethearts and indirect sex work so that's what we really need to keep our accelerator on."

Despite these dangers, experts say the lesson from Cambodia is that if the political will is there, the disease can be contained, even in the poorest nations.

UN agencies call for concerted effort to rapidly scale up access to HIV testing and counselling services in Asia and the Pacific

UNICEF Press Centre

PHNOM PENH/CAMBODIA, 4 June 2007– Fewer than 10 per cent of people infected with HIV in HIV in Asia and the Pacific are aware of their status. This is a major obstacle in the campaign to prevent the spread of HIV and to provide AIDS treatment, say United Nations agencies, which today called on governments in Asia and the Pacific to rapidly expand access to HIV testing and counselling.

Representatives from the World Health Organization (WHO), the United Nations Children's Fund (UNICEF) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) will meet 4-6 June in Phnom Penh, Cambodia, with experts and civil society delegates to identify strategies for dramatically increasing the availability of these services.

As of 2006, an estimated 8.5 million people are living with HIV in the Asia Pacific region. In 2006 alone, a million additional people were infected and more than 500 000 people died. With so few people aware of their status, efforts to prevent new infections and treat those who are positive are becoming more difficult.

“Knowing his or her HIV status is a public health and human rights imperative, as it leads to life-extending HIV treatment, care and support services, as well as to evidence-based prevention interventions," said Dr Shigeru Omi, WHO Regional Director for the Western Pacific.

More than 20 years after the first reported case of HIV in the Region, access to testing and counselling is limited. Although voluntary counselling and testing sites have been established in all countries, poor infrastructure and limited human resources hinder the capacity of health services to introduce and deliver the needed testing and counselling.

Persistent stigma and discrimination also prevent many individuals from actively seeking help. Those infected tend to wait till they are too ill, thus jeopardizing the success of treatment. And often, those already at risk of HIV infection, such as partners of injecting drug users or men visiting sex workers, do not perceive themselves at risk of being infected.

In an effort to overcome these obstacles, United Nations agencies are calling for an increase in client- and provider-initiated testing and counselling, as well as a strengthening of prevention, treatment and care services.

The Phnom Penh consultation involves some 70 experts and scientists, representatives of nongovernmental organizations, civil society and affected communities, along with human rights experts from Asia and the Pacific. They will be looking at existing testing and counselling policies and practices, discussing global guidelines, and identifying ways to scale up HIV testing and counselling as part of prevention, treatment, care and support services in the Region.

An important component of this deliberation is the recently released WHO and UNAIDS guidance on provider-initiated HIV testing and counselling services. Provider-initiated HIV testing and counselling (PITC) is an approach in which health care providers specifically recommend an HIV test, when it fits the local epidemiological and social context. This requires that health facilities have the capacity to ensure that patients receive and understand basic information on HIV and have given informed consent prior to the testing. Provision of individual post-test counselling and referral to specialized services are steps that follow the HIV test, ideally done at laboratories linked to quality assurance and control schemes.

“Expanding access to quality HIV testing and counselling will require strengthening of existing infrastructure, quality assurance systems and human resource capacity, as well as monitoring and supervision systems, at all levels of the health system," said Dr Samlee Plianbangchang, WHO Regional Director for South-East Asia.

According to the new guidelines, HIV testing continues to be voluntary and in compliance with the "3 C's" – informed consent, counselling and confidentiality. This requires that laws and policies against discrimination on the basis of HIV status are in place. Where such laws exist, a more concerted effort is needed to ensure they are enforced.

“As we work to scale up testing and counselling suitable to the regional context we must safeguard the rights of those who test positive while securing resources for training in the health care system to further reduce stigma and discrimination,” says Prasada Rao, UNAIDS Asia Pacific Regional Director. “We need a greater commitment to change attitudes about the virus and strengthen political will to make anti-discrimination policies a reality.”

Priority also needs to be given to children, who have faster disease progression than adults and for whom there are specific HIV testing issues around consent and confidentiality. Of the 64 000 children living with HIV in the Region who are estimated to be in need of treatment, only one in five are receiving antiretroviral treatment, and nearly all of these children are in three countries - Cambodia, India and Thailand.

“By increasing access to early diagnosis of HIV in infants and children, we are in a better position to improve the quality of life for children who test positive by providing better care, support and treatment,” said Anupama Rao Singh, Regional Director of UNICEF East Asia and Pacific Regional Office. “However, we need to ensure that when it comes to testing children, we adhere to the Convention on the Rights of the Child, especially that the best interest of the child is respected.”