(file image) Photo: RNZ
As the world marks World AIDS Day on Sunday, the United Nations is warning that infection rates are surging in Fiji and Papua New Guinea.
UNAIDS says that between 2010 and 2023, infections in Fiji increased by 241 percent.
Papua New Guinea has long had notoriously high levels of HIV infection, but in the past year numbers reached a record 6700 cases.
The head of the NGO Business for Health (B4H) Ann Clarke says PNG has "dropped the ball" when it comes to dealing with HIV.
RNZ Pacific spoke with Clarke, who works with local companies to help contain the spread of HIV.
(The transcript has been edited for brevity and clarity.)
Ann Clarke: Don, you and I have been communicating on this topic since back in the early 2000s when access to testing and treatment was nowhere near what it is today in 2024. But unfortunately, the AIDS crisis may have passed, because we can prevent people dying of AIDS, but, in theory, but in Papua New Guinea we had another 6700 new infections last year, which is more than double what we had in the early 2000s.
Don Wiseman: And why?
AC: We have dropped the ball. We have not had mainstream education and continued awareness about sexual and reproductive health for workplaces, for schools, for children and for people in the mainstream. Limited funding means that the targeted approach by our international aid agencies is all focused on key affected populations, people living with HIV, people of diverse sexuality, sex workers, men who have sex with men. This is awesome. They are people most affected by HIV, but in Papua New Guinea, we have a mixed epidemic. We have HIV in the key affected populations, but we also have young women and men and older women and men in the workplace being newly infected in 2024.
DW: Who's to blame?
AC: Well, we always need someone to blame. Well, first of all, I blame myself for not being able to raise enough money to talk constantly on the topic. Second of all, we have to share the responsibility amongst everybody who decides and allocates funding. The government of Papua New Guinea has to assume responsibility for the lifelong health and well being of children in Papua New Guinea. Children in Papua New Guinea deserve to have excellent community health services from time of birth and excellent sexual and reproductive health services and education when they start school. But not all children in PNG get to go to school, so expecting priority to sexual and reproductive health services is a challenge for the PNG government.
DW: When we talk about 6700 new infections in the past year, what's the total number of people living with HIV in PNG?
AC: Okay, so in 2024 we have an estimated 77,000 people living with HIV. Not all of them know their status, but we do know that 48,000 of them are on ART or antiretroviral therapy. But our challenge in 2024 is to achieve what we call viral suppression. And the good news is that we have 28,330 - you know these numbers exactly when you have to provide people with daily treatment - so 28,330 people have achieved viral suppression, which means that they continue to take their treatment, they monitor their viral load, and they cannot transmit HIV to their baby or their sexual partners. So what's that, about a third? Not quite, nearly half. Let's be positive, nearly half of people in living with HIV and PNG have achieved viral suppression because they take ART.
DW: Well, UNAIDS' slogan, or its theme, for this Sunday is 'take the rights' path'. What do they mean by that?
AC: For UNAIDS its focus is about the rights of those marginal and most vulnerable to HIV infection, the right to access treatment and services for people who are sex workers, people from the gay community or transgender people, often they feel - or know their rights are compromised because of the law, and it makes accessing services or even care and support more challenging. For the Business For Health, B4H, project, our focus is on expanding the idea of what rights are associated with HIV. For things like a person living with HIV and their right to work, their rights to confidentiality, their rights to reasonable accommodation. We've taken a big, broad look at that, and said the rights to sexual and reproductive health, education, their rights to be included, the fact that disabled people and disabled workers are more vulnerable to infection of any kind. So lots and lots of our communications over the last month is to get people to consider the broader view of the rights to access good health, and the recognition that being able to access all of those rights will end HIV.
DW: Now your organisation, you work very closely with businesses.
AC: Yes.
DW: How does this impact business, these surging levels of HIV?
AC: The answer to that question is exactly the same as how I would have answered it when I first met you back in the early 2000s and I put yourself in the seat of a CEO or a managing director who a young person and aspiring, your best young manager, and in PNG, it's likely to be a younger woman, who is infected with HIV. An aspiring, powerful young woman comes to tell you that they're HIV positive. If they don't understand their rights to access testing and free services and free drugs, you may lose that person because they are ashamed or embarrassed or think that they're going to die. So the message is still the same. To ensure that everyone in every workplace understands that they are entitled and have the right to access free testing and free treatment, and that they have the right to ask for reasonable accommodation from their managers and supervisors. Otherwise, the workplace is likely to lose altogether, a fantastic young person from their workforce.
DW: And you do seem to get pretty good support from across businesses in PNG.
AC: I'm the master of looking positive. We end 2024 with absolutely zero cash sponsors for our work this year. But we persist and businesses pay to attend our workplace training, which is what sustains the employment of our team.