Communities First: Towards a Sustainable Response to HIV in Asia and the Pacific

A discussion paper prepared by APMG Health, the Australian Federation of AIDS Organisations (AFAO) and the UNAIDS Regional Office for Asia and the Pacific summarising commitments to support a community-led response to HIV.

This is the first in a series of occasional papers produced by the Australian Federation of AIDS Organisations (AFAO) designed to disseminate information and analysis on HIV and key populations in the Asia-Pacific region. The papers build on AFAO’s Consensus Statement on Australia’s International Leadership Role on HIV, jointly endorsed by Australian HIV organisations working internationally and available at

There has been strong progress towards achieving HIV targets in several countries in the region, but the epidemic is outpacing the response in others. Improved antiretoviral therapy (ART) access has reduced the annual number of HIV-related deaths by 24% since 2010, but mortality rates are increasing in several countries. Gay men and other men who have sex with men are experiencing rapidly growing HIV epidemics in several countries, with young men especially at risk.

An increase in availability of heroin and the scarcity of harm reduction services in many countries is fuelling resurgent epidemics among people who inject drugs. Despite legislative reforms and other progress, shrinking civic space and stigma and discrimination against people living with HIV and key populations stand in the way of more rapid progress. At least three-quarters of new HIV infections in the region are among key populations and their sexual partners.

This makes the role of key population-led community organisations in the region critical. Although the proportion of domestic funding for HIV responses in some countries has increased significantly, much of this is allocated to treatment and care and the proportionof domestic funding for key population HIV prevention services and programs remains low.

About the author

Lou McCallum's picture

Lou is a director of APMG and is based in Sydney. He has worked in the response to HIV in a variety of roles since 1983 including management of AIDS home and community programmes and was Executive Director of Australia’s national AIDS NGO. Lou has a background in paediatric nursing, nursing service management and public policy. He worked alongside friends and colleagues in the early part of Sydney’s response to HIV in the gay community, setting up volunteer emotional support and home-care programmes, providing community support in outpatient clinics and providing VCT counselling. Lou began working as an HIV and development consultant in 1998, focusing on technical assistance for national and provincial AIDS policy development, and implementation and strengthening of the civil society response to AIDS. Lou is an experienced adult learning trainer and has prepared and conducted training programs for a wide range of health and community workers. He is also a consumer health advocate and has served two terms as national chairperson of the Consumers’ Health Forum of Australia.