The United Nations Secretary-General’s Special Envoys for AIDS are committed individuals selected by the United Nations Secretary-General to help advance the AIDS agenda at global level and to ensure that AIDS is kept high as a political priority in their respective regions. In a series of interviews with Unaids.org, the Special Envoys for AIDS shared their views on the state of the AIDS epidemic and their own role in the global effort to end the epidemic.
J.V.R.Prasada Rao, a national of India, was appointed United Nations Secretary-General’s Special Envoy for AIDS in Asia and the Pacific effective July 2012.
Mr Rao was the Director of India’s National AIDS Control Organization for five years before serving as India’s Permanent Secretary for Health and Family Welfare. There, he played an instrumental role in implementing a comprehensive and decentralized national AIDS control programme. He then joined UNAIDS in 2004, where he was appointed Regional Director for Asia and Pacific and subsequently Senior Advisor to the Executive Director. He has served as Member Secretary of two independent commissions on AIDS in Asia and the Pacific and is currently a Commissioner of the Global Commission on HIV and the Law.
During his work, Mr Rao consistently advocated for the empowerment of vulnerable communities and people living with HIV as an essential element to achieving an effective AIDS response in Asia and the Pacific.
UNAIDS.org: As one of the United Nations Secretary-General’s Special Envoys for AIDS, what do you consider to be your role in the response to the epidemic?
The United Nations Secretary-General Ban Ki Moon and the UNAIDS Executive Director Michel Sidibé share the vision of getting to zero new HIV infections, zero discrimination and zero AIDS-related deaths. This includes Asia and the Pacific, a region which represents more than half of the world’s population. Although the region has seen progress in the areas of HIV prevention and treatment, we still have a long way to go to get to zero. Thus, my aim is to bring this message to top political leaders across the region.
We must use the critical three-year period before 2015 to reach the Millennium Development Goal on combatting HIV. I would like to share this message with political leaders, parliamentarians, community representatives and donors.
What motivates you in this role?
The biggest motivating factor for working as Special Envoy on AIDS is the historical opportunity we have to reverse the spread of HIV in Asia Pacific and to achieve the Millennium Development Goals.
I have been working on AIDS programmes for the past 15 years, first in the Government of India and later at UNAIDS, and faced enormous challenges - particularly in the early days of the AIDS response. Things have changed a lot since then, but I learned some important lessons which I can now pass on to others to make our collective efforts in responding to the epidemic more efficient.
The number of new HIV infections has stabilized in Asia and decreased in the Pacific in recent years. What has changed in the region?
In the last 10 years, some countries have shown remarkable progress in terms of HIV prevention, which has helped bring down new HIV infections. As a whole, the number of new HIV infections in the region is declining, but I am still not happy with the rate of this decline, and in many countries new HIV infections continue to rise.
Successful countries, such as Thailand, Cambodia, India and Malaysia, have invested wisely in HIV prevention programmes for key populations at higher risk. In the Pacific, countries like Fiji and Samoa have demonstrated that a determined leadership and a strong commitment to the AIDS response can make a big difference. Regional inter-governmental bodies like the Association of Southeast Asian Nations (ASEAN) and the United Nations Economic and Social Commission for Asia and the Pacific (ESCAP) have kept AIDS a priority, and this has contributed greatly to the stabilisation of HIV infections in member countries.
What key issues and challenges remain in the response to AIDS in Asia and the Pacific?
I would like to highlight the threat that comes from political leadership being complacent and claiming victory too early. AIDS is becoming less of a priority in some of the Asian countries that have seen improvement in recent years. We need to work with the leadership in these countries to ensure that the response to AIDS does not lose momentum. We cannot afford a second wave of the epidemic in the region.
The region is lagging behind the global average in the provision of HIV treatment and prevention services to stop new HIV infections among children. Programme managers and political leaders should be aware of this and work to improve access to treatment to vulnerable communities, women and children.
Adverse legal environments continue to be a challenge in many countries in the region. Key populations such as men who have sex with men, sex workers and people who use drugs are still criminalised in most countries. I will encourage political leaders and legislators to reform both the laws themselves and the way they are enforced. Small countries like Fiji and Nepal have demonstrated that when leaders commit, they can alter the environment of stigma and discrimination surrounding AIDS.
Throughout your career you have consistently advocated for the empowerment of vulnerable communities. What is the role of key populations in Asia and the Pacific in the response to AIDS?
People living with HIV and key populations at higher risk such as men who have sex with men, sex workers and people who use drugs play a central role in the response to AIDS. The Asia Commission report and country-specific surveillance data show that countries need to invest in programmes to prevent HIV infections among key populations, yet many countries are still not dedicating appropriate resources. I would like to see constructive activism from leaders and members of key populations in pressuring governments to provide adequate funding for HIV prevention and treatment services for the most vulnerable communities.
At this critical juncture of the AIDS response, the unity and commitment of community leaders is crucial. Some have successfully demonstrated how community-owned HIV programmes for HIV prevention and treatment can be cost-effective and produce positive results. We need to see more of these community-owned HIV programmes implemented in various countries. This is bound to make a difference to the course of the epidemic.