HIV Epidemic Situation in Nepal

Bigyan Ojha

Global summary of the AIDS epidemic

Number of people living with HIV in 2015

Total

Adults

Women

Children (<15 years)

Total

Adults

Children (<15 years)

Total

Adults

Children (<15 years)

People newly infected

with HIV in 2015

AIDS deaths in 2015

36.7 million [34.0 million – 39.8 million]

31.8 million [30.1 million – 33.7 million]

16.0 million [15.2 million – 16.9 million]

3.2 million [2.9 million – 3.5 million]

2.1 million [1.9 million – 2.4 million]

1.9 million [1.7 million – 2.1 million]

240 000 [210 000 – 280 000]

1.1 million [940 000 – 1.3 million]

1.0 million [1.2 million – 1.5 million]

190 000 [170 000 – 220 000]

Source: UNAIDS Factsheet, November 2016

Global strategy on HIV 2016–2021 towards ending AIDS

• The international community has committed to ending the AIDS epidemic as apublic health threat by 2030 – an ambitious target of the 2030 Agenda forSustainable Development adopted by the United Nations General Assembly inSeptember 2015.

• Interim targets have been established for 2020.

• The strategy describes the health sector contribution towards the achievementof these targets. It outlines both what countries need to do and what WHO willdo.

• VISION : Zero new HIV infections, zero HIV-related deaths and zero HIV-related discrimination in a world where people living with HIV are able to livelong and healthy lives.

• GOAL : End of the AIDS epidemic as a public health threat by 2030.

The global targets for 2020

90% of all people living with HIV will

know their HIV status 90% of all people diagnosed with HIV will

receive sustained antiretroviral

therapy. 90% of all people receiving antiretroviral

therapy will have durable

suppression.

Source: UNAIDS October, 2014

Facts about HIV Epidemic in NepalIn Nepal, the first-ever AIDS case was reported in 1988. Ever since, the nature of the HIV

epidemic in the country has gradually evolved from being a “low-prevalence” to “concentrated” epidemic.

Prevalence is 0.20 % among adult aged 15–49 years.

There are approximately 39,281 people estimated to be living with HIV.

Children (0-14 years): 1,589

Adults (15-49 years): 30,074

Adults (50+ years): 7,733

The key populations are as follows:

People who inject drugs (PWID)

Sex workers and their clients (Male and Female)

Men who have Sex with Men (MSM) and transgender people

Male Labor Migrants and their wives

Prison Inmates

Heterosexual transmission is dominant

Source: HIV Estimates, NCASC, 2015

Cumulative HIV Cases in Nepal, as of July 2016

Facts about HIV Epidemic in Nepal (Contd…)

Source: HIV Estimates, NCASC, 2015

Facts about HIV Epidemic in Nepal (Contd…)

Source: NCASC, July 2016

ART services in Nepal

Source: NCASC, July 2016

Policies and strategies in Nepal

• National AIDS Policy, 1995

• HIV AIDS Strategy 2006 – 2011

• National HIV/AIDS Action Plan 2008 - 2011

• National HIV/AIDS Strategy 2011 - 2016

• National HIV Strategic Plan 2016 - 2021

• National strategy on HIV Drug Resistant Monitoring & surveillance in Nepal 2014-2020

• Nepal HIV Investment Plan 2014 - 2016

• National HIV Research Agenda In Nepal

• Strengthening HIV second generation surveillance in Nepal

• National Advocacy Plan on HIV AIDS

Development Partners

Most of the resources for the national response to HIV in Nepal comefrom external sources (bilateral, multilateral, and INGOs).

Among external development partners following have been the maincontributors;

• GFATM – The Global Fund to Fight AIDS, Tuberculosis and Malaria

• UN agencies

• The Pooled fund partners of Nepal Health Sector Programme –Implementation Plan II (the World Bank, DFID, AusAID, and KFW)are also external sources that are contributing to the national HIVresponse.

• Other partners include Care International, AIDS Health Foundation(AHF) and Family Planning Association Nepal (FPAN), which arealso contributing to the national response to HIV.

Challenges

• Cohesion, integration, availability and quality of HIV-related services;

• Participation of key populations and people living with HIV;

• HIV-response policies for migrants and their spouses;

• Clarity and focus of roles of service providers;

• Integration of community and private services with public-sector services;

• Elimination of vertical transmission services through integration of maternal and child health services, also through private and community services.

• Strategic information, data quality and use.

Recommendations

• Focusing and intensifying good-quality services for key populations in keylocations;

• Adopting zero tolerance to discrimination;

• Ensuring an adequate HIV response, including addressing migration andmobility;

• Eliminating vertical transmission of HIV and keeping mothers alive andwell;

• Recognizing that treatment is also prevention;

• Integrating relevant HIV services into general health services;

• Investing in collection, generation, analysis, translation and use of relevanthigh-quality strategic information, and using modern information andcommunication technology, such as mobile health (m-health) and electronichealth (e-health) technologies.

Thank You !