The Pacific is a unique and vulnerable region that spans a third of the world's surface and accounts for just 0.14% of the world's population. For Pacific countries, even a small number of people living with HIV can translate into high incidence and prevalence rates that can have devastating impacts on individuals, families, communities and economies.
There have been 29, 629 reported cases of people living with HIV in the Pacific, with 5,162 new HIV diagnoses reported in 2008 (UNAIDS, 2009, p.1).
Notably, cases from Papua New Guinea make up an ever-increasing proportion of the total cases detected in the Pacific - from 21% in 1984-1989 to over 99% in 2008. Reported cases in Papua New Guinea total 28,294, but UNAIDS estimates there are 54,000 people living with HIV. Levels of under-reporting in the rest of the Pacific are likely to be similar.
On the basis of the reported numbers of PLHIV the countries of the region fall into three clusters:
- PNG - overwhelming locus of the Pacific epidemic;
- Fiji, French Polynesia, New Caledonia and Guam - with significant numbers of HIV cases;
- other countries, including smaller island states - with fewer known cases (UNAIDS, 2009, p2).
The Pacific region has a potent mix of risks and vulnerabilities to HIV:
- Sexually transmitted infections (STIs) are endemic
- High incidence of gender inequality and gender-based violence
- High incidence of teenage pregnancy
- Highly mobile populations
- Limited or no access to condoms
- Slow or negative economic growth and the consequential lack of employment opportunity
- Male-to-male sex is often hidden and denied
- Traditional social safety networks (extended family and clan networks) are being significantly weakened
A framework for national and regional activities in the Pacific to coordinate a collective response to HIV and AIDS.
Started in 2003 to help strengthen Pacific Island governments, NGOs and communities to develop and implement responses to HIV/AIDS. A five-year project was created in response to the need for teamwork and for improved planning, technical design, management and evaluation of HIV and AIDS responses in the Pacific.
The essential ingredients for moving forward involve strengthening health systems; overcoming stigma and discrimination; strengthening community involvement and resilience; and aligning regional and international support with national priorities and national service delivery.
Turning the tide: an open strategy for a response to AIDS in the Pacific: report of the Commission on AIDS in the Pacific - Suva, Fiji : UNAIDS Pacific Region, 2009.