Responding to HIV/AIDS

The estimated adult HIV prevalence in Nepal appears to be showing a gradual downhill trend according to the official report of the government, yet the country continues to experience a “concentrated” type of epidemic where in one segment of the society (injecting drug users), the estimated prevalence – the proportion of the population living with HIV – is more than 5 percent. Since the first case of HIV was diagnosed in 1988, 17,058 had been officially reported as of Dec 2010. In a country of around 28 million people, and with the estimate of 63,528 infections in 2009, there is no time for complacency on AIDS. Gains have been significant – but these are now fragile, and faced with funding uncertainties, Nepal needs to look outside the box on how it can ensure its response is sustained and most effective. The current data shows that for every two new infections detected, one is coming in the net for treatment, hence there is no space for “business as usual” in the country’s response on HIV and AIDS.



The Players



Nepal acted early and quickly in responding to the HIV epidemic. And with this action came hundreds if not thousands of key players. For one, the government, through the National Center for AIDS and STD Control (NCASC), has done and continues to do a colossal job of preventing a wide-scale epidemic amidst an equally colossal challenge common to resource-poor countries, that is to be able to effectively seize the opportunity and act ahead of the epidemic. Nepal, moreover, has a vocal and vibrant civil society whose constituents serve both as a strong advocate in ensuring that AIDS is on top of the list of the country’s development priorities and as AIDS service providers as well. Their work on the ground aptly complement the government’s services particularly in providing access to HIV/AIDS prevention, treatment, care and support services to a large segment of the population, including those socially and geographically marginalized groups. There are also very generous external development partners in Nepal that have continuously “walked the talk” and have put their money where their collective commitment is. Indeed, according to the 2010 Report on HIV/AIDS Resource Inflow in Nepal, over 95 percent of funding for the country’s response on HIV and AIDS comes from external support.  



So, does the country need additional players to effectively respond to HIV and AIDS? Will the saying “too many cooks spoil the broth” apply to Nepal’s AIDS kitchen?



Welcome addition



Since 2005, Nepal had actively implemented the Asia Pacific Leadership Forum on HIV/AIDS and Development, more popularly known as “APLF”, which aims to strengthen political and civil society leadership in order to help create an enabling environment for an effective AIDS response. There are over a dozen of active APLF Nepali leaders and one comes from the business sector. For years, there has been careful planning and analysis on why and how the business sector in Nepal should be meaningfully engaged with the country’s response on HIV and AIDS. Last month, at the General Assembly of the Federation of Nepali Chamber of Commerce and Industry, the Business Coalition of AIDS in Nepal (BCAN) was born. It was officially launched by the Right Honorable Prime Minister Jhala Nath Kanal in front of almost 2,000 business leaders and community members from all over Nepal. The newest player is a welcome addition and can have important impact, both socially and economically.



Globally, AIDS has largely struck the working-age group in the prime of their life. According to figures from the International Labor Organization in 2006, the global labor had lost 28 million people to AIDS, almost the same as Nepal’s population today. And the number will, with all certainty, continue to grow without a long-term multisectoral response from the government and civil society including the private sector. As the president of MTV Networks International, William H Roedy, said: “AIDS is the defining moral issue of our time and businesses must play a critical role in the fight against the global spread of the epidemic. The business community is uniquely positioned to use our influence, resources and leadership to challenge stigma, promote prevention and facilitate treatment”.  



Here at home in Nepal, over 80 percent of the estimated HIV infection is seen in the 15-49 age bracket, mainly transmitted through unprotected sex. While multisectoral engagement has been initiated, in reality there are very few sectors, aside from health, that are deeply engaged in the response. Hence, the birth of BCAN is a timely initiative. As an initial step, BCAN aims to put into practice the 2007 National Policy on HIV/AIDS in the Workplace developed by the Ministry of Labor and Transport Management. It links its work to the HIV/AIDS and STD Control Board (HSCB) mandated to, among other endeavors, collaborate with various non-government organizations working on HIV and AIDS in Nepal. I am confident BCAN will prove to be a worthy addition in Nepal’s multi-sectoral response on HIV and AIDS.



Writer is UNAIDS Country Coordinator, Nepal

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