Overview

The Multi-Country Western Pacific Integrated HIV/TB Programme supports national and regional efforts across 11 Pacific islands countries (PICs) to scale up and improve the delivery of human immunodeficiency virus (HIV) and tuberculosis (TB) prevention, treatment, care and support services, with special attention to key and vulnerable population groups, and to mitigate against the impact of COVID-19.

The current phase of the project covers the period 2021-2023, with funding from the Global Fund through a US$13,628,684 grant, including US$3,313,710 in Global Fund COVID-19 Response Mechanism funds.

The United Nations Development Programme (UNDP) is the Principal Recipient of the grant and implements the project in close partnership with 18 Sub Recipients (11 Ministries of Health and 7 civil society organizations), and with regional technical support from the World Health Organization and UNAIDS. The project operates in Cook Islands, Federated States of Micronesia, Kiribati, Nauru, Niue, Palau, Republic of the Marshall Islands, Samoa, Tonga, Tuvalu and Vanuatu.

Context

With their vast oceanic spread and multiple small islands with limited transport and communications, the Pacific island countries face unique challenges to provide adequate health services. The arrival of the COVID-19 pandemic has placed additional significant strains on their health systems. Health system procurement and supply chains have been challenged due to international and in-country travel restrictions and lockdowns. Financial, institutional and human resources have been reallocated for preparedness and response to the COVID- 19 pandemic. And emergency restrictions have affected community systems strengthening activities.

There are specific challenges in the Pacific island countries for TB control and ensuring universal access to quality TB care for all people, especially high-risk and vulnerable populations such as children and elderly people, people in poor communities and on remote islands, and people with co-morbidities and other risk factors, particularly HIV, diabetes and tobacco use.

In 2020, the 11 supported project countries had a combined estimated TB incidence rate of 143 per 100,000 population, compared to the Western Pacific region (which includes the Pacific, Oceania and parts of Asia) average of 93. The estimated HIV-negative TB mortality rate, although it has been reducing rapidly, is still high at 19, compared to the Western Pacific region rate of 4.5.

HIV prevalence in the Western Pacific region remains low at 0.1 percent. However, despite these low rates, HIV vulnerability is remains high due to factors such as widespread migration and mobility, dense sexual networks, a large caseload of untreated sexually transmitted infections (STIs), low knowledge about HIV and STIs, high levels of transactional sex and significant levels of intimate partner violence. Key and vulnerable populations – including men who have sex with men, transgender people, female sex workers, prisoners and seafarers – are the most affected groups, with challenges in relation to stigma and discrimination and ensuring their access to prevention and treatment services.

What we do

The overall programme goals are:

1. To halt the spread of HIV among the population of the Western Pacific and maintain HIV incidence rates below 0.1 percent annually.
2. To reduce AIDS-related mortality by strengthening HIV case finding and case management.
3. To reduce the incidence and mortality for all forms of TB in the 11 Pacific island countries, thereby contributing to the post-2015 global TB strategy.
4. To promote universal and equitable access to quality diagnosis and appropriate treatment of TB, multidrug-resistant TB, TB/diabetes mellitus and TB/HIV patients across 11 Pacific island countries.

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