"Are you counting me?" Addressing the challenge of estimating vulnerable populations in South Asia
Regional workshop seeks to strengthen national reporting on HIV
April 3, Colombo - How does a national HIV programme accurately estimate the size of high risk, vulnerable and hard-to-reach
populations such as men who have sex with men and transgender persons? The question has long challenged government health authorities as
well as community-based organisations and advocates that support surveillance and data collection in countries with populations huge
and small alike.
The South Asia Regional Men who have Sex with Men (MSM) Size Estimation Workshop is bringing together over 40 participants
responsible for size estimation activities from Afghanistan, Bangladesh, Bhutan, India, Nepal, Pakistan and Sri Lanka; and additional
resource persons from Viet Nam, Bangladesh, India, and Sudan. Participants collectively represent government, academia, civil society
and the United Nations system. The workshop has been organized by the United Nations Development Programme Asia-Pacific Regional
Centre (UNDP APRC) and the Joint United Nations Programme on HIV/AIDS Asia-Pacific Regional Support Team (UNAIDS RST).
HIV figures continue to rise rapidly among MSM and transgender communities in the region. In India, HIV prevalence for
MSM is estimated at 7.3 percent, more than 20 times higher than that of the general population. In Nepal, it's 3.8 percent and for Sri
Lanka 0.5 percent -- also significantly higher than general population estimates. There are few countries with data on transgender
persons; but where it exists, HIV infections are disproportionately high.
"At a time of rising HIV infection, it's essential to get the estimation of vulnerable populations as accurate as possible
to design and fund truly effective prevention, treatment and care programmes," noted Edmund Settle, HIV Policy Specialist, UNDP APRC.
"As the recent UNESCAP High Level Meeting on HIV noted just two months ago, the Asia-Pacific region including South Asia has seen
impressive gains in addressing HIV, but the epidemic among these two key populations is still outpacing the response."
A key aspect of successful mapping is the active involvement of the communities themselves in helping count their own
numbers and feeding that information into an increasingly deeper pool of data, which in turn better equips policy strategists and
planners. This is exactly the sort of capacity building and community strengthening Project DIVA - the South Asia Multi-country
Global Fund grant - should encourage.
"The sharing and learning from real country experiences planned at this workshop is so important for fostering South-South
technical cooperation and assistance," said Amala Reddy, Regional Programme Advisor, Strategic Information, UNAIDS RST. "Workshop
participants have, or will be, supporting national size estimation activities technically, with the close involvement of a
number of community-based partners."
Stigma and discrimination stemming from hostile socio-cultural environments have long pushed MSM and transgender persons, already all but
invisible communities across much of this region, further to the margins of society. But there are innovative ways to attempt a more
accurate count. As countries such as India increase the number of HIV surveillance sites for these communities, and outreach
services for prevention and care are strengthened, a clearer picture is emerging, enhanced by increasingly sophisticated
mathematical modeling and extrapolation.
After country experiences on national size estimation activities are reviewed and shared at the workshop, and national participants are
updated on current models and methodologies with a focus on analyzing data, the aim is then to develop country-specific action plans to
be integrated into the upcoming Phase II programming of the South Asia Multi-country Global Fund grant.
"The significance of this process cannot be underestimated " said Shivananda Khan, Chief Executive of Naz Foundation International, a
regional partner within the South Asia Multi-country Global Fund grant. "Improving national reporting will provide quality strategies
to shape MSM and transgender-related HIV programming; ultimately containing and hopefully reversing the epidemic among our
communities. To the question 'Am I being counted?' we will endeavor to answer, at long last, with a resounding "Yes.'"
The South Asia Regional MSM and Transgender Size Estimation Workshop, "Strengthening National Reporting on HIV among MSM
and Transgender Persons," has been organised under Project DIVA ("Diversity in Action, Supporting Communities, Reducing Vulnerabilities").
This Global Fund Round 9 programme aims to support in-country MSM and transgender community systems strengthening, engage in policy advocacy
initiatives, and strengthen strategic information on HIV-related issues of these highly marginalized populations. Population Services International
(PSI) Nepal is the Principal Recipient and Naz Foundation International (NFI) is the regional partner. UNDP Asia-Pacific Regional Centre is the regional
technical assistance provider.
For more on Project DIVA, please visit http://www.nfi.net/downloads/
HIV Policy Specialist
UNDP Asia-Pacific Regional Centre
Tel: +66 818 369 300
Regional Communications Adviser
UNAIDS Regional Support Team
Tel +66 2 680 4127