Groundbreaking progress in understanding AIDS epidemics in Asia and the Pacific
By Karen Emmons
13 October 2010 - When the Evidence to Action HIV & AIDS Data Hub opened its online website in 2008 to collect all available HIV and AIDS data from 27 countries in the region, only two of them had either a national website or even a central database of their own. Today there are 20 national AIDS or related websites, some of them that borrow content from the Data Hub.
Compared to data collection five or even three years back, there has been groundbreaking progress among countries in the region. Says Amala Reddy, who as the UNAIDS Regional Programme Advisor for Strategic Information helps manage the Data Hub, “There is a real improvement in countries in understanding the need to know what’s happening, where the infections are geographically and who is vulnerable.”
But despite the huge increase in data, interpreting it remains a critical weakness. “What often happens in countries,” Ms. Reddy explains, “is that there are three to four agencies collecting different data but no one is synthesizing any of it and coming out with messages. No one puts it together into one picture and explains what it means for policy makers and what it means in terms of priorities.”
UNICEF set up the Data Hub service in collaboration with UNAIDS, the World Health Organization and the Asian Development Bank to encourage the collection of information within countries and to be a central repository. It would then give back both national and regional pictures of what is known and what it all means.
Two years since its launch, the Data Hub is well on the way towards that vision.
Flagging the gaps
For the 27 countries in the region (including Hong Kong Special Administrative Region), the Data Hub offers access to strategic information on HIV prevalence and epidemiological status, vulnerability and HIV knowledge, risk behaviours, the economics of AIDS and the national response.
Through data triangulations, the Data Hub can help government officials identify missing information, such as data on adolescents or children, gaps in AIDS spending or lack of up-to-date surveys.
The information is organized by subgroups – populations at higher risk – and disaggregated by age and sex. The datasets also track data on the HIV status of pregnant women, children and young people. The website also includes links to AIDS publications from around the region.
However, access to the latest data or even all the possible data is proving difficult.
Ms. Reddy explains the Data Hub works only with information that is publicly available, but that “there’s a lag between the latest data and government approval.” She believes this is a hurdle they will overcome as governments, especially policy makers, benefit more and more from the analysis.
“We’ve been doing a good job to establish trust with governments through the Science and Technical Advisory Group [STAG] and national data focal points. We still need to do more to promote the sense of national ownership we want to achieve and use of data by policy makers,” Ms. Reddy says.
The STAG consists of 15 experts in public health, epidemiology, behavioural science and health economics working in the Asia-Pacific region who were selected by the Data Hub Secretariat. The experts provide scientific and technical guidance in the analysis, collation and dissemination of data.
Making an impact
What the Data Hub does produce is having impact, according to Wing-Sie Cheng, UNICEF Regional Adviser for HIV and AIDS who co-manages the Data Hub through the joint secretariat involving the four partners.
National programmes in Indonesia, Maldives, Nepal, Pakistan, Philippines, Sri Lanka and Viet Nam extensively use its products for meetings, for developing funding proposals and on their websites. When the health minister in Nepal inaugurated the country’s national AIDS e-library on HIV strategic information, he highlighted the need to liaise with the Data Hub.
Forthcoming analysis will look at barriers to preventing mother-to-child transmission on a regional overview basis, with case studies from a few countries.
In its analysis for UN agencies, the Data Hub has highlighted the rising wave of infection among Asian men who have sex with men and the continuing high HIV infection rate among injecting-drug users, indicating the need for better programme coverage for these affected populations.
The Data Hub increasingly provides services for regional meetings, such as the regional consultation on sex work this month in Bangkok. The Data Hub is providing capsules on sex work in 11 countries for the consultation.
The Data Hub also shows government officials how they are faring in comparison with other countries, which, says Ms. Cheng, actually matters to them.
Adds Ms. Reddy, “The advantage we have is to put things into a regional perspective – that’s a unique thing we’re doing.”