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Final Report Executive Summary The Asia Society’s Third Annual Asian Dialogue on HIV/AIDS in Mumbai emphasized that an effective response at the national and regional level will require strong leadership, collaborative partnerships, and comprehensive programs which carefully balance prevention, care, and treatment. This reinforced and synthesized what the global community already knows about HIV/AIDS. Speakers came from across Asia, including Thailand, Malaysia, China, Iran, and Cambodia to join their counterparts from India. Representing the diverse responses of India’s civil society, participants included members from the Sonagachi Project, the Positive Women’s Network (PWN), Swaasthya, Avahan, and the HumsafarTrust. Each individual and organization brought their unique perspective to the discussion. Senior level representatives including a Senator from Thailand, local and national Ministers, and other Government Officials, joined senior executives from BBC World Service Trust and business leaders from Standard Chartered Bank, ICICI OneSource, and ModiCare. Their voices provided unique insight into the role of corporate and government responsibility. Additionally, international organizations were represented by UNAIDS, Transatlantic Partners Against AIDS, Global Business Coalition on HIV/AIDS, and the UN Development Programme. The consideration of best practices formed an integral part of the discussions during which leaders in the field presented examples of their work, and ways to implement strategies throughout the Asia Pacific region. Success stories ranged from Thailand’s heralded work on condom promotion and YRG Care’s work in India, to creative and progressive projects such as media training in China and needle exchange programs in Iran. There have been a number of breakthroughs across all sectors in Russia including media, business, and civil society as well as important new commitments by the government. The key factor of blood safety was mentioned across the board. Throughout the day, the need to talk openly and honestly about sex and sexual practices was highlighted as a major issue for the region. All speakers stressed the need to dismiss taboos and change perceptions to eliminate stigma attached to HIV/AIDS. Issues present in all regional examples included the importance of respect for human rights, empowerment of women, engagement of family members, open collaboration with media, mobilization of new spokespersons, including celebrities, politicians and members of the positive community. The gathering attracted over 250 participants from across India and from a variety of fields, including medical doctors, members of the policy, business and NGO communities, and experts, academics and scholars in the field. Their involvement and interaction with the panelists was a testament to the increased awareness in India. Introduction As India quickly moves into the 21 st century and assumes a global leadership position across all sectors, including business, arts, politics and security, the impact of HIV/AIDS threatens to reverse its potential growth and prosperity. India now has the world’s largest number of HIV/AIDS infections with 500,000 new infections last year alone. There are ominous signs that the epidemic is continuing to spread. The stakes are very high. An unchecked HIV epidemic could undermine economic gains in the world's largest democracy, and threaten security in the region. In an effort to bring fresh attention to this growing epidemic, and to support India’s response to it, the Asia Society, together with its partners, the Confederation of Indian Industry (CII), Positive Lives, and the Tata Institute of Social Sciences (TISS), hosted the Third Annual Asian Dialogue of HIV/AIDS in Mumbai on April 28, 2006 This project built on the success of Asia Society’s work in Shanghai in June 2005 and included a groundbreaking exhibition of documentary photography, an international symposium with leaders from throughout the region, and a star-studded Gala Dinner with performances, in an effort to strengthen current responses to HIV/AIDS in Asia. The goal of the Annual Asian Dialogue on HIV/AIDS was two-fold. First, the Asia Society utilized its network of leaders in the region to bring together a multi-sectoral gathering of stakeholders from civil society, government, business and the arts to share their experiences on the imapct of HIV/AIDS at the local, national and regional levels. Second, these events provided an opportunity to share best practices, creatively explore how to address joint challenges, and together develop broad strokes for moving forward in developing and instituting a sustainable public policy in the region. Timed to coincide with the symposium, Asia Society and its partners presented a groundbreaking exhibition of documentary photography, in an attempt to highlight the critical role of art in raising awareness and understanding the impact of the epidemic. The photography display, depicting positive images and stories of HIV/AIDS throughout the region, provided an opportunity to reach Mumbai’s growing middle-class and professional, executive and patron communities. The goal was to increase awareness of the human dimension of HIV/AIDS and to break down the high wall of HIV/AIDS-related stigma and discrimination that remains entrenched. This neutral forum allowed activists and leaders to openly exchange ideas in new and creative ways. In this context, there continues to be an urgent need for regional experience sharing on this issue. It was recently reported that India has the highest number of AIDS cases in the world, while the number of new cases is increasing most rapidly in Russia and the former Soviet Union. In contrast, after years of denial, China ’s high level leadership now serves as a model for other Asian nations in the fight against the disease. Despite this, there is no support for, and in some cases active dismissal of, civil society in China. Progressive examples of success can be found in the most unexpected places – such as harm reduction programs in Iran and engagement of the Islamic leadership in Malaysia. These examples were brought to the forefront of discussions, allowing experts, activists, politicians and executives to think critically about the epidemic. This method of experience sharing allowed for learning regional lessons, focusing on the common challenges and forming new partnerships across sectors. Building a Social Agenda for HIV/AIDS : Sharing Asian Experiences The following is a brief synopsis of the major points covered during individual sessions. 1. Shared Experiences: Narratives and Lessons from the Region
2. Investing in Women: Ensuring Rights in the Era of Globalization
3. The Case for Business: Creating a Conscious Dialogue at the Workplace
4. Keynote address by Minister Oscar Fernandes 5. Building Social Movements: The Critical Role of Human Rights and Social Justice
6. Advocacy and Awareness – Using the Resources of Media and Education
7. Next Steps and Forging Future initiatives/collaborations
Key Results and Policy Proposals 1. Sharing Experiences in the Region. Asia has witnessed many innovative and path-breaking experiments in some of the most unlikely places. These include: needle exchange programs in Iran and China, education and awareness raising initiatives and condom promotion programs with religious leaders and clergy in Malaysia and Thailand, the unionization of sex workers in India, addressing the needs of affected and infected children in China and India, and engaging media through direct training as in China or by employing stars from pop culture and athlethes in public service announcements in India. India and Russia’s success in mobilizing parliamentarians has set an important example in Asia. Thus, while the United States and other donor nations may recognize many of these as successful models, there still seems to be a lack of awareness and experience sharing among those in the region working at the local and state levels. It was stressed that responses have the greatest impact when leaders and policy makers convene to share ideas and assess lessons learned. In this forum, participants were urged to work within and among local and regional networks to build an effective framework for collaboration. Speakers agreed that it is vital for stakeholders to collaborate with broader developmental efforts, such as working with G-8 leaders to put HIV on their respective country’s agenda. 2. Challenges in identifying the major centers of the epidemic. It is a challenge to identify single definitions of key drivers and transmission vectors for HIV/AIDS in Asia. As a result of the diversity across and among borders, peoples, governments, religious, and cultures, there is a need to understand not just broad trends, but the localized context in which they exist. Although examples such as intravenous drug use, transactional sex, and trafficking are all behaviors associated with increased risk of infection, better research is needed to understand how they are interlinked with vulnerability to infection. The rich field of social science, and the depth of research institutions in India and the region, can and should be utilized to more fully comprehend the nature of the disease. 3. Stigma and discrimination continue to prevail in India and throughout the region. This presents a fundamental challenge for those living with HIV/AIDS. The marginalization of those infected and affected, which is a human rights violation, tends to hinder direct access to treatment and care. Often, those infected are ostracized by society, denied treatment by health care workers, and refused admission by schools. There is little or no discussion on taboo issues such as homosexuality and MSM, drug use, and the lack of sex education and sexual health care facilitates particularly for women. 4. Education is widely recognized as the most critical tool for confronting issues related to morality, stigma, and social taboos. It is a vital method for development and reform. Peer education was highlighted as a successful model, especially among youth. Most participants agreed that community-based sex education is necessary. Widespread gender inequality exacerbates the spread of HIV/AIDS as women are the most vulnerable, demographically. Oftentimes health educators in India are uncomfortable with teaching or discussing these stigmatized issues, and will often simply skip the chapter in the textbook. This is particularly critical as culturally sensitive issues such as MSM activities and premarital sex are difficult to address through mass media in India, and are most appropriately discussed in a more targeted, peer-group, classroom setting. Conversely, in China TV has been the best way to provide education on HIV/AIDS, mainly due to the fact that eighty percent of households in rural China have access to TV. 5. Need for new and creative partnerships . Collectively engaging business, civil society and government is critical in the fight against HIV/AIDS. In general, public-private partnerships have been productive, but their success is dependant on the executive power of the public sector party of the partnership. As it is important to bring the best resources available into the public sector, there is also a great advantage in having private partners who are able to provide these resources. One example is the Chinese government’s use of text messaging on cell phones as a means of spreading information and promoting awareness. Text messaging could be a useful tool for countries like India and others in the region, where cell phone usage is widespread and increasingly popular, and where telecom costs are dropping with increased privatization. 6. Addressing human sexuality, behavior, desire, pleasure, and recreation : Asia is seeing the growth of increasingly affluent societies concurrently with a shift away from traditional values. This includes greater mobility of the younger population, especially as new industries and sectors evolve. Additionally, the current economic and social environment in India has led to an increase in the number of youth engaging in premarital sex. Despite this trend, sex is still not openly discussed. One speaker suggested that although behavioral changes are important, sexual education and raising awareness are necessary. The role of sexual violence and gender inequality also further facilitates the spread of HIV/AIDS and must be addressed. 7. Powerful role of business. Examples of leadership within the corporate community were shared by several corporate leaders. A particularly successful model was Standard Chartered's HIV/AIDS Ambassadors, a program in which senior executives champion the issue within the corporate sector and beyond. Other representatives spoke about their ability to work with civil society organizations, bringing their core competencies and unique skill sets and resources to programs in the field. It was emphasized that large companies, which have seen the positive impact in both financial terms and employee satisfaction have much to gain from their involvement on this issue. 8. Role of creative arts in raising awareness : Creative arts can play an important role in raising awareness about HIV/AIDS, not only through TV and journalism, but also through film, music, and theater. Most speakers agreed that in the creative arts the production itself is at least as important as the message. For example, weekly TV programs that are well made attract a large number of viewers not because they are about HIV/AIDS, but because they are entertaining and well-made. Baseline surveys or work in India and China suggest that art and the media can help eradicate taboos and modestly change behavior as well as attitudes about HIV/AIDS. The importance of the arts in humanizing HIV/AIDS and those affected by it was a consistent message during this panel. 9. The Role for Women as successful agents of Development : Globally, and particularly in Asia, women must be active participants and play a central role in any development agenda. Gender biases that impact access and treatment as well as societal stigma must be better understood and reduced. There are also legislative opportunities to better empower women, who are often not protected under existing laws. The role of religion in limiting women’s roles, and at the same time enabling them based on the application of religious doctrine was a key factor during the discussion. Challenges included the lack of effective integration of HIV/AIDS into the women’s movement in India, as well as the illegality of homosexuality as a continuing hurdle in preventing open discussion of MSM activity and sexuality in countries such as India and China. Next Steps and Future Partnerships Continuing the Dialogue . The Positive Lives exhibit continues to tour India with the aim of using the photographs and visual stories to raise awareness and target new audiences. The exhibit seeks to dispel the myths and taboos associated with those affected and infected by HIV/AIDS, while portraying the human and emotional aspects of the disease UN High Level meetings : The recent General Assembly special session in May 2006 on HIV/AIDS has provided a crucial evaluation of the various steps taken by countries worldwide in dealing with the pandemic. India now has the largest number of HIV/AIDS infections in the world, making it more critical than ever to forge new partnerships, make better informed decisions, and implement proactive policies. Such an effort must be undertaken across the board and involve all sectors. Moscow /G-8 Summit in St. Petersburg : By looking at health issues, the summit will incorporate high level discussions about infectious diseases including HIV/AIDS. Since HIV/AIDS is a threat to socio-economic and sustainable development in the region, the agenda includes the creation of a possible international center for the development of a vaccine against HIV. It will also examine the shared interests among Russia, China, India and other G-8 members in strengthening and coordinating their individual responses to HIV/AIDS. The Asia Society and the AIDS in Asia Initiative The Asia Society is an international organization dedicated to strengthening relationships and deepening understanding among the peoples of Asia and the United States. Founded in 1956 by John D. Rockefeller III, the Society reaches audiences around the world through its headquarters in New York and regional centers in Houston, Los Angeles, San Francisco, Washington, DC, Hong Kong, Manila, Melbourne, Mumbai and Shanghai. A nonprofit, nonpartisan educational organization, the Society provides a forum for building awareness of the more than thirty countries broadly defined as the Asia-Pacific region - the area from Japan to Iran, and from Central Asia to New Zealand and the Pacific Islands. Through art exhibitions and performances, films, lectures, seminars, conferences, publications and assistance to the media, as well as materials and programs for students and teachers, the Asia Society presents the uniqueness and diversity of Asia. Launched in the Fall of 2003, the Asia Society’s initiative on AIDS in Asia has aimed to mobilize Asian decision makers and their American counterparts to build a collaborative response to Asia’s growing HIV/AIDS crisis. Through successful public educations programs, policy briefings, photography displays and international high-level policy fora, the initiative has activated and united policymakers, business leaders, and opinion leaders to assess the growing impact of the disease in Asia, and facilitate the building of strategic partnerships to combat the epidemic in a comprehensive manner. The Third Annual Dialogue on HIV/AIDS is one of the signature events in attaining the goals of the Initiative. Previously held in Tokyo and Shanghai, it has played a strategic role in bringing together leaders, policy makers and others affected and infected by HIV/AIDS with the aim of formulating goals and sharing experiences. Contact Information Asia Society |
   
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