• Your Excellency Dr. Somsak Chunharas, Deputy Minister for Public Health of the Royal Thai Government
• Dr. Ms. Shamshad Akhtar, Executive Secretary of ESCAP
• Dr. Michel Sidibe, Executive Director of UNAIDS
• Mr. Nicholas Rosellini, Deputy Director, UNDP
• Ms. Nukshinaro Ao, Representative of Civil Society
• Honourable Ministers
• Your Excellencies the Ambassadors
• Ladies, gentlemen and friends

May I begin by extending warm greetings from the Government and people of Fiji.

Today marks yet another historic occasion. We come together as regional leaders, champions, policymakers and practitioners from diverse sectors and from countries of the Asia-Pacific region to deliberate on how far we have come and what needs to be done to improve the Asia-Pacific regional response to HIV-AIDS.

I wish to express my gratitude to UN-ESCAP, and to the Executive Secretary, for their leadership in convening this intergovernmental meeting at such an important time when the post-2015 development agenda is being discussed; and for giving us an opportunity to contribute to the ongoing efforts to end AIDS.

ESCAP, through conveneing these meetings in close partnership with other UN entities, provides a unique platform for mutual accountability and assessment of the progress on the commitments that we will make at the global and regional levels.

I also extend my appreciation to UNAIDS for working in close collaboration with ESCAP in the organization of this meeting and for supporting the participation of member states.

My appreciation extends as well to the other UN partners for their valuable contributions.

I wish to thank the Royal Thai Government for its generosity in hosting this meeting. The Royal Thai Government has shown outstanding leadership in delivering HIV services to all groups, including key populations. And I say with much feeling that we have learned much from your vast and varied experiences, and I emphasize that we continue to learn from you.

This important inter-governmental meeting allows us to review the progress that we have made in implementing the roadmap we endorsed when we last met in 2012. The road map provided the impetus for much of the progress we have made since then by initiating the process of national reviews and consultations to address legal and policy barriers to HIV services.

Over the next two days, i look forward to building upon the outcomes of that meeting, and of us working together to arrive at a forward looking strategy to achieve our vision of ending aids in the foreseeable future.

Global Targets

New targets have been set by the global community to put an end to the AIDS epidemic. Amongst them is the ambitious treatment target - 90-90-90. This requires that by 2020:

• 90% of people living with HIV know their HIV status;
• 90% of people diagnosed HIV positive are on sustained antiretroviral therapy (ART); and
• 90% of people on ART have a suppressed viral load.

Other targets include reducing the annual number of new hiv infections by more than 75 per cent to 500,000 by 2020, and achieving zero discrimination.

Underlying these targets is a commitment to zero discrimination and leaving no one behind. This human rights based approach is critical to protecting marginalized populations, eliminating stigma and discrimination, and making the right to health a reality.

Achievements and Successes

The Pacific as a region, and Fiji in particular, have come a long way towards reducing the stigma and discrimination associated with HIV status. For a long time, fear and shame resulted in silence and isolation, a high incidence of opportunistic infections, poor health, and early death.

Today, the stigma and shame have subsided significantly, and a growing number of positive men and women have had the courage and confidence to reveal their status, seek treatment, and in turn improve their health prospects. Today, positive people living with HIV are more secure in the knowledge that they will not be rejected or shunned from life-saving health and social services; that they will be accepted in their communities, workplaces and places of worship. The role of faith-based organizations must be acknowledged for it has been critical to this turn around.

Allow me to mention a few other achievements of my own country and the Pacific region:

• Firstly, Fiji has taken the lead in introducing human rights based legislation. Our HIV decree, policies and guidelines have brought about dramatic changes, including decriminalizing men who have sex with men; requiring voluntary and informed consent for HIV testing including for persons under 18; and lifting travel restrictions on people living with HIV. Palau has also recently decriminalized homosexuality.

 
• Second, we have made serious efforts to prevent HIV amongst our youth as one of our most marginalized and vulnerable groups. This marginalization is sadly reflected in the rising prevalence of suicide as a cause of youth death, and the high rates of teenage pregnancy and STIs as well as sexual violence against young women and children. Our youth peer education programme continues to address some of these challenging issues.

As an HIV advocate, I have derived much personal satisfaction from raising awareness about HIV amongst our young people. So far, I have visited 153 secondary schools around the country. I only have 27 schools to go.

• Lastly, we have taken bold steps to eliminate mother to child transmission by adopting option B-Plus with the new ART guidelines released in 2014 by the World Health Organization. This has been a success for Fiji, improving accessibility and up to date interventions with treatment, care and support.

Alongside our own efforts, the Asia and Pacific region has shown impressive gains. These include:

• The reduction in new HIV infections since 2001;
• The reduction of mother to child transmission;
• The use of existing flexibilities under the trade-related aspects of intellectual property rights agreements (TRIPS); and

• The manufacture and accessibility of high quality, affordable generic drugs which have delivered life-saving treatment for millions of people living with HIV regionally and globally.

Financing the AIDS Response

Countries in the Asia-Pacific region have taken responsibility for financing the AIDS response. Many countries now fund the bulk of the AIDS response from domestic resources. I am pleased that my own country has taken this important step towards ensuring financial sustainability of the aids response.

Government provides a grant for HIV prevention and care, including free anti-retroviral therapy for all.

Despite these strides, large funding gaps still remain. External funding must be continued for the least-developed countries and Pacific Island Countries which cannot mobilise the resources to fund their own responses without compromising other health and development priorities.

At the same time, it is incumbent on us all to manage available funds more efficiently, by directing funds to where the epidemic is concentrated – among the key (most vulnerable) populations, namely men who have sex with men, sex workers, trans-gender people, injectable drugs users, and, in the Pacific, the young people.

Moreover, we should continue to explore home grown opportunities and innovations to integrate HIV and AIDS services into existing and emerging national programmes for example: Universal Health Coverage.

I cannot stress enough that the resources we spend will have a limited impact at best if we do not have the will to ensure that the people most in need of HIV services are able to access them.

Removing Legal and Policy Barriers to Universal Access

This emphasizes the importance of continuing the process we began through escap resolutions 66/10 and 67/9 of identifying and taking steps to remove the legal and policy barriers that impede access to hiv services by key populations. Legal and policy frameworks are critical to addressing stigma and discrimination, and ensuring the rights and dignity of positive people.

As Australia’s Hon. Justice Michael Kirby astutely observed some 20 years ago (and we are again privileged to have him with us at this meeting), that the most effective way of preventing the spread of HIV is to protect the human rights of the persons at risk. These are the vulnerable and marginalized members of our society.

The AIDS paradox as it was called is now widely accepted as the human rights approach to AIDS.

In the Pacific, a more robust human rights-based approach to HIV and sexual and reproductive health and rights is urgently required. This includes the need for anti-discrimination legislation; the decriminalization of homosexuality and sex work which continue to be criminal offences in most countries; and the criminalization of marital rape. In the 21st century, countries must adopt legislation that recognizes sexual orientation and gender identity.

We would also benefit from mandatory teaching of sexuality education in schools and improved access to condoms and HIV/STI prevention information for young people.

HIV and the Broader Development Agenda

As we enter the post 2015 development era, we look forward to the challenge of implementing the new set of sustainable development goals (SDGs) that the global community will formally adopt later this year.

These goals build on the foundation laid by the MDGs including MDG 6 on HIV-AIDS.

The new SDGs represent a comprehensive and integrated set of global priorities for inclusive, equitable and sustainable development. Proposed goal 3.3 aims to end the aids epidemic, along with other communicable diseases, by 2030.

Alongside this, there are goals to:
1. Ensure universal access to sexual and reproductive health care services and “safe, effective, quality, and affordable essential medicines and vaccines for all” (Goal 3.7 and 3.8);
2. Achieve gender equality and the empowerment of women and girls (Goal 5); and
3. Promote social inclusion, eliminate discriminatory laws, policies and practices, and reduce inequality (Goal 10.2 and 10.3).

In this way, the SDGs exemplify the multi-sectoral approach that has been recognized as so crucial to stalling the HIV-AIDS epidemic, removing the stigma and discrimination, and ensuring a more caring and supportive environment for those living with HIV and AIDS.
In the pacific region, the Pacific sexual health and well being shared agenda 2015–2019 does this by integrating sexual and reproductive health services.

One positive outcome in Fiji is that our reproductive health clinics are increasingly referred to as a “one stop shop” where an integrated approach sexual and reproductive health services encompass HIV, STIs and reproductive health.

This integrated approach must not stop at the provision of health services. Pacific countries today face rising levels of poverty, hardship and vulnerability, as well as deepening inequalities and growing youth unemployment.

At least one in four people across our region are now estimated to be living below the average national basic needs poverty line.

HIV flourishes along with other STIs in an environment where there is poverty, inequality and social exclusion. We must therefore tackle these broader development challenges if we are to have a real chance of ending the AIDS epidemic by 2030 (SDG 3.3).

Importantly, there is a need to reduce the vulnerability of women to HIV and STIs by improving their social and economic status including their access to decent work and economic resources, protection from sexual and physical violence, and the right to make their own sexual and reproductive choices.

Leadership and partnership

Allow me to say a last word on leadership and partnerships.

Both are essential if we are to bring an end to HIV and AIDS. We need leadership at all levels and from all sectors of society if we are to achieve our vision. We need to build and strengthen partnerships of all kinds and at all levels.

Last but not the least, we need ownership of the response, as a region, as a country and as individuals.

Member states of the Asia-Pacific region have shown tremendous political will, commitment and innovation in leading the world in the fight against HIV. ESCAP’s resolutions 66/10 and 67/9 are testament to this.

Today, I am proud to stand before you as Fiji’s representative on HIV and AIDS, and as President of my country, along with other political and civil society leaders of the Asia-Pacific region, to reaffirm our commitments to the 2011 political declaration on HIV and AIDS; to MDG 6; to getting to zero; and to reversing the spread of HIV.

The challenge is to ensure that the commitments we make over the next few days do not remain empty rhetoric or a string of words on a conference document. We must walk the talk when we return to our homes.

Only in this way can we hope to secure a future of dignity for everyone and ‘to leave no one behind’.

As the late Nelson Mandela put it so eloquently:

Quote: “I have walked that long road to freedom. I have tried not to falter; I have made missteps along the way. But I have discovered the secret that after climbing a great hill, one only finds that there are many more hills to climb. I have taken a moment here to rest, to steal a view of the glorious vista that surrounds me, to look back on the distance I have come. But I can rest only for a moment, for with freedom comes responsibilities, and I dare not linger, for my long walk is not ended.” Unquote.

So let us take a moment to enjoy our achievements and look back on the distance we have come. But let us not rest on our laurels or linger too long, because we have many more hills to climb.

Thank you for this opportunity to address you.

I have much pleasure in declaring the meeting open.