Overview

The Multi-Country Western Pacific Integrated HIV/TB Programme supports efforts across 12 Pacific islands countries to scale up and strengthen their responses to HIV and tuberculosis (TB) through prevention, diagnosis, treatment, care and support services. Special attention is given to key and vulnerable populations to address health disparities and barriers to accessing services.  

Donor: Global Fund

Implementers: UNDP serves as the interim Principal Recipient, working in close partnership with Ministries of Health, civil society organizations, academia, and bi- and multilateral partners.  

Technical assistance: World Health Organization  

Period: 1 January 2024 to 31 December 2026

Countries covered: Cook Islands, Federated State of Micronesia, Fiji, Kiribati, Nauru, Niue, Palau, Samoa, Republic of Marshall Islands, Tonga, Tuvalu and Vanuatu

Context

Despite progress in reducing communicable diseases and improving child and maternal health in Pacific island countries, health disparities persist, even in countries with well-established health systems. Vulnerable populations face challenges such as limited access to services, stigma and socio-economic inequalities. The COVID-19 pandemic further disrupted essential health services, impeding progress toward health goals and widening the gap for underserved groups.

Over the past two decades, HIV prevalence in the Western Pacific has remained low at 0.1 percent. However, the low prevalence in the general population masks high levels of HIV infection among key populations (men who have sex with men, sex workers, people who use drugs and transgender people) and their sexual partners. High-risk, unprotected sex behaviours are widespread in many Pacific island countries, and there is low HIV knowledge and low HIV-testing rates. Contributing factors include low HIV awareness, untreated sexually transmitted infections, high mobility, complex sexual networks, intimate partner and gender-based violence and stigma. Fiji accounts for 92 percent of known HIV cases and 91 percent of those on antiretroviral therapy in the region, emphasizing its central role in the Pacific’s HIV response.

TB continues to be a major health concern in the Pacific, with varying incidence rates across countries. The lack of comprehensive data collection, particularly in remote areas, contributes to challenges in effective diagnosis, treatment and control of the disease. The situation is further complicated by the significant presence of other risk factors such as diabetes, which is prevalent across the region, as well as by emerging health crises including the COVID-19 pandemic, which has strained health systems and service delivery.

What we do

The programme aligns with country priorities and global technical guidance, integrating HIV and TB responses into broader health strategies. Activities include:

HIV: evidence-based interventions targeting key populations aim to reduce HIV incidence, improve care and treatment, integrate HIV/sexual and reproductive health, and strengthen community-based organizations to deliver these services effectively. These approaches are in line with technical partner guidance and are tailored to the regional epidemiological context.  

TB: Building on previous grant cycles, TB interventions prioritize finding and treating undiagnosed cases, particularly in underserved areas, to address the region’s diverse TB burden effectively.

Expected results

HIV amongst the population of the Western Pacific is reduced by 2026 and the HIV incidence rate is maintained below 0.1 percent annually.  

The incidence and mortality from all forms of TB in the 12 Pacific island countries is reduced by 2026, thereby contributing to the 2030 END TB strategy.

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