Combat HIV/AIDS, Malaria and Tuberculosis in Lao PDR
HIV prevalence has been generally low over the past 15 years, but Lao PDR cannot afford complacency. HIV incidence is increasing, unlike in some neighbouring countries, with an estimated 1,096 cases of new infections in 2015, up from 957 new cases in 2014 and 617 new cases in 2012. HIV prevalence also is increasing in sub-groups of key populations such as sex workers, people who inject drugs (PWID) and men having sex with men (MSM) classified as transgender who reported selling sex. Heterosexual contact (88%) and MSM (8%) account for the majority of HIV transmission from 1990 to 2013. Transmission from mother to child (4%) and injecting drug use (less than 1%) account for only a small proportion of cases.
The overall knowledge of HIV remains low, and lower still among women, knowledge levels have not increased significantly from 2000. Knowledge of HIV/AIDS is much lower among those living in rural areas without road access, those with no education, those from the poorest quintile and amongst the ethnic groups living in remote areas. The knowledge differentials between rich and poor, and educated and uneducated are much starker than those between men and women. Condom use rates are reported to be high in commercial sex but are lower in casual sex. Nationally representative data on condom use is lacking.
The country lags behind in two out of three global targets for HIV treatment scale-up beyond 2015.
- Around 71 percent of the estimated number of people living with HIV (PLHIV) in Lao PDR currently know their HIV status, against the 2020 global target of 90 percent;
- 47 percent of PLHIV in Lao PDR who know their status are receiving ART, while the 2020 global target is 90 percent;
- 78 percent of those on ART have suppressed viral load.
Lao PDR is facing resurgence in malaria that threatens the steady progress made against the disease in the previous decade. From 2000 to 2011, malaria cases and deaths declined by around 50%, but from December 2011, malaria outbreaks in the south of the country led to a sharp rise of confirmed cases and deaths. Case incidence increase since 2011 is associated with an influx of migrant workers in the south of the country. The increasing trend in malaria cases continues. There were 50,663 confirmed cases in 2014, although the number of recorded deaths dropped to four for the entire country in 2014. Bednet coverage still needs to improve. Surveys in 2012 in selected areas found that over 80 percent of children under age 5 slept under a bednet of some kind. A 2016 survey in the three high malaria burden provinces of Champasak, Sekong and Attpeu found 74.3% of children under age 5 sleeping under long-lasting insecticidal nets (LLINs). Treatment rates among young children with confirmed malaria remain high, generally well over 90 percent.
Tuberculosis (TB) prevalence, although declining, is much higher than previously estimated. Following the results of the first national TB prevalence survey (2010-2011), the WHO re-estimated TB statistics for Lao PDR. The new estimates showed the prevalence of all cases of TB to be 1.9 times higher than previous estimations. The revised WHO trend model indicates that Lao PDR had more than halved the prevalence of all forms of TB from 1990 to 2014. TB incidence has also declined; mortality due to TB, however, does not seem to have declined. TB detection needs to be urgently improved. The TB survey and the programme review suggest that many TB cases remain undiagnosed and untreated and that only around one-third of all TB cases are detected. However, the TB treatment success rate is high at over 90%.
Source: Report of UN Resident Coordinator in Lao PDR.