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Bangkok , 6-8 February 2012 NAA, 24 th October and 31 st Jan 2011

Preparation Meeting Asia-Pacific High-level Intergovernmental Meeting on the Assessment of Progress against Commitments in the Political Declaration on HIV/AIDS and the Millennium Development Goals. Bangkok , 6-8 February 2012 NAA, 24 th October and 31 st Jan 2011.

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Bangkok , 6-8 February 2012 NAA, 24 th October and 31 st Jan 2011

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  1. Preparation MeetingAsia-Pacific High-level Intergovernmental Meeting on the Assessment of Progress against Commitments in the Political Declaration on HIV/AIDS and the Millennium Development Goals Bangkok, 6-8 February 2012 NAA, 24th October and 31st Jan 2011

  2. Agenda item 4: Review of regional implementation of the Political Declaration onHIV/AIDS and the Millennium Development Goals and efforts to ensure universal access, including regional follow-up to the outcome of the 2011 General Assembly High-level Meeting on AIDS. • addressed HIV in their implementation of the Political Declaration on HIV/AIDS and their achievement of the Millennium Development Goals; • MDG 6 has been met ; • Halted and reversed HIV prevalence among adult population from 1.8 in 1998 to 0.8 in 2010; • Need to be sustained

  3. Prevention • Current program coverage : EWs: 80-90% ; MSM :30%; IDU: 15% • sexual transmission among EW ( prevalence dropped NCHADS latest data; challenges : very diversified sex industry ; done : SOP COPCT for demand side and MCPI enabling environment to increase service delivery uptake (we are still officially on Tier 2 on Anti-Human Trafficking effort) ; condom use rate among clients ( see latest data of NCHADS) • Similar with MSM: SOP COPCT for MSM and TG and MCPI • Moving on right direction on EW/MSM; Capacity of NGO and CBO • IDU: The Program Framework in place including agreement to provide NSP through public health facilities and NGO out reach and referral ; MMT in place ; best practice model to scale cost-effectively. • PMTCT: Linked Response has enabled Testing and ARV access of 13% in 2006 to 50% in 2011; resources available from GFATM to scale up linked response over the next three years. • Challenges : As referred to MARYP 2010 assessment : with high self reported rate of STI and Unwanted pregnancies ; low condom use rate and poor utilization of sexual reproductive health and related services • Mobile population : Insufficient strategic information to guide programing which remains at best fragmented ( internal migration and military ).

  4. Care and Treatment • 92% coverage of eligible PLHIV for OI/ART ( Cambodia is one of 8 countries globally to achieve UA ) • System for CQI is now a common part of the Cambodian CoC . • Community and Home Based Care coverage is between 80%-90% of total need. • National network of Voluntary testing sites linked to CoC and Maternal Health Facilities. • CPITC with MARPs bringing service providers to Community to increase access utilization. • Plan to initiate treatment for HCV and HBV co-infections • The 3 Is implemented resulted in significant scale up of referral and treatment for TB-HIV co-infection. • CoC contributing to improvement in other health outcomes especially maternal and new born health and sexual reproductive health. • CoC contributing to health system strengthening e.g. integrated laboratory services at referral hospitals , expansion of pediatric health referral services.

  5. Impact Mitigation • Standards and Guidelines for the Care , support and Protection of OVC has been developed and disseminated. • NOVCTF has function effectively guided by National Plan of Action (NPA) • 6 priorities provinces has their own POVCTF ( BMC new Province) • National Social Protection Strategy has been made “ AIDS Sensitive “ . • MoSVY ‘s M&E system for OVC is under development. • National review of faith-based responses to HIV in Cambodia completed 2011

  6. Gaps and challenges through national laws and policies • Prevention : Dissemination of LHTSE is still limited; judiciary need to be oriented on commentary of LHTSE ( completed by M of Justice ); MCPI ( enabling environment policy approach ) requires further sustained investment for scale up. • Care and Treatment: Treatment predominantly supported by GFATM with significant risk for proposal rounds/ Cambodia needs a resourcing policy for HIV and AIDS. • Impact Mitigation: Turning the National Social Protection Strategy into effective programming ( cash transfer , social insurance , health equity fund and others ) that cover the poorest and most vulnerable PLHIV and OVC.

  7. Stigma and discrimination faced by people living with HIV. • Very low of discrimination reported in Health Care facilities • High level of political engagement through the First Lady as National Champion to eliminate stigma at the community level and in institutions. • Stigma Index conducted in 2011 and Socio-Economic Impact of HIV at Households level studied in 2011 : Recommendations and findings being utilized to develop and refine programs and approaches to further reduce stigma and discrimination. • Evaluation of National MSM framework and OP 2011: over the last 6 years , significant decrease of S&D

  8. Agenda item 5: Consideration of measures to promote multisectoral cooperation and build national capacity in addressing policy and legal barriers to universal access to HIV prevention, treatment, care and support. • Statement highlighting, where appropriate, a government’s efforts to address legal and policy barriers to universal access, particularly through multi-ministerial engagement. National experiences and lessons learned would also be welcome. • Multi-sectorial engagement of Mo Interior and Mo Health on SOP for Co PCT recently developed for prison setting; M o Health, NACD on SOP Co PCT for IDU/DU and roll out of community based treatment program; • MCPI with involvement Mo Int , local authority, Health Care Workers, MARPs ( continuous dialogue with Police Department , CBCA , and stakeholders on reinforcing Prakas 066 and 086 ) • Establishment of legal aid and education services for entertainment workers with support from RGC and engaging community and NGOs. • MoJ, NACD and stakeholders dialogue leading to inclusion of harm reduction in the revised National Drug Control Law.

  9. Agenda item 5: Consideration of measures to promote multisectoral cooperation and build national capacity in addressing policy and legal barriers to universal access to HIV prevention, treatment, care and support. • Development of a Commentary of LHTSE to guide judiciary and law enforcement agents for appropriate implementation of LHTSE. • NAA led the development of the National Guideline and Policy on MSM and TG in the response to HIV and AIDS. • SOPs CoPCT for Ews, MSM/TG and IDU/DU provide a program framework and policy guidance for MARPs. • Regular National Policy Audit undertaken ( 2007 and 2011 ) with key recommendations provided for gap filling and policy adjustment in line with current situation and response • National Gender and HIV assessment and recommendations leading to collaboration with MoWA on GBV • Cost effectiveness analysis conducted in 2011 for prevention, impact mitigation providing clear direction for improving investment and developing cost-efficiency in programming. • Cambodia- 3.0 developing pathway towards sustainability.

  10. Agenda item 6: Promotion of regional cooperation to accelerate the implementation of the internationally agreed commitments to achieve universal access to HIV prevention, treatment, care and support in Asia and the Pacific • 1) measures to implement the commitments contained in the Political Declaration on HIV/AIDS: Intensifying our Efforts to Eliminate HIV/AIDS and ESCAP resolutions 66/10 and 67/9; • (2) views on the regional framework proposed in the background document to support the implementation of the above-mentioned resolutions; and • (3) additional areas for regional cooperation to support the achievement of universal access to HIV prevention, treatment, care and support, including support from the UN system. • Collaboration with Mo SVY , Mini of Labour, Invalids and Social Affair of Viet Nam Rehabilitation Center in Sihanoukville • Cross Border cooperation for extending care and treatment to Mobile and border Populations . • Extending prevention in hot –spots border areas e.gBavet : Cambodia – Viet Nam, Poipet : Cambodia- Thailand • Sharing Cambodia best practice on HIV prevention ( linked response , CoPCT, CoC and MCPI) ; Learning from Viet Nam on MMT, NSP in public health facilities • COMMIT( Cambodia , Myanmar, Thailand , Viet Nam , Lao PDR, China ) for regional collaboration on Anti- Human Trafficking and sexual exploitation, and labour trafficking • Faith Based Collaboration • Other Ministries • Fiscal space : 2031, NASA

  11. TRIPS Cambodia has adopted specific legislative provisions regarding the 2016 transition period. The law, in Article 136, provides that patent protection for pharmaceuticals will not come into effect until the expiration of the 2016 transition period. Data exclusivity ( EU demanding data exclusivity ) In 2015 Cambodia will begin to transition from LDC. Cambodia in the transition • 2 draft laws and one sub-decree drafted which give some protection for access to generic medicines. • Technical support has been requested to undertake a scoping mission to determine future action that Cambodia needs to take to secure exceptionality to TRIPS. • ( a working group is needed to review the current status of IP law in respect of TRIPS. • Determine steps / actions required by RGC to increase protection under the existing IP legislation)

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