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Laos HIV response under scrutiny
Campaigners and health officials in Laos have raised the alarm at the national response to HIV and AIDS, and its over-reliance on external funding. Low government engagement has resulted in HIV being poorly integrated into the public health system and 93 percent of the national AIDS budget coming from foreign donors. HIV services have also not been sufficiently decentralised, in a country where 70 percent of the population live in rural mountainous areas. As a result, awareness and knowledge of HIV among the general population is low and it is common for people to come forward for treatment when they have already fallen ill.
Laos has a relatively small HIV epidemic, with an estimated prevalence of 0.3 percent. However, new infections have been on the rise in recent years and prevalence among vulnerable and hidden groups, such as sex workers and men who have sex with men, is much higher and there remain considerable obstacles to reaching these groups. While coverage of antiretroviral (ARV) treatment for people living with HIV (PLHIV) is higher than the average for the region at 54 percent, a significant gap remains. Funding for ARVs comes from the Global Fund to Fight AIDS TB and Malaria but this is time-limited and the related costs and treatment for opportunistic infections are not always included.
The National Committee for the Control of AIDS and UNAIDS have warned that a shift in mindset is needed to improve the effectiveness and sustainability of Laos’ HIV response. The government’s role in this is critical - Omar Syarif, Programme Manager of the Asia Pacific Network of People Living with HIV/AIDS, commented: “it’s very crucial for the government to strategise how they will address the needs of its citizens who have HIV and need treatment.”