MDG 6: Combat HIV AIDS, Malaria and Other Diseases

HIV prevalence in the general population in Lao PDR remains low, but varies considerably between risk groups and locations. While knowledge of disease transmission is high, there is still a big gap between knowledge and desired behaviors. Correct and consistent used of condoms is low and STI levels continue to be high among sex workers. As Laos is surrounded by countries with high HIV prevalence, and is experiencing an increase in mobility of its working-age population within and across its borders, the threat of an expanding HIV epidemic in the country remains real.

A large proportion of Lao population is exposed to Malaria and the early 1990s noted an increase in the morbidity rate. Since then there has been an appreciable drop which may be largely due to the increase in number of people sleeping under insecticide-treated bednets. Death rates from malaria fell from 9 per 100 000 in 1990 to 0.4 in 2006. Still a lot of ground has to be covered to meet the MDG target. Considerable progress has been made in tuberculosis case detection and the MDG target seems to have been achieved by 2005.

Combating Malaria and tuberculosis on a sustained basis requires new drugs to fight the malarial parasite that has become resistant to the drug, and the emergence of new strains of tuberculosis that are multi-drug resistant and are also associated with HIV infection. The national Malaria control programme revised its treatment policies in 2004 to include Artemisinin based combination therapy (ACTs) as the first line of treatment for uncomplicated malaria. Monitoring of routine sentinel drug resistance currently shows no resistance to ACTs in Laos.

Meeting the targets: While the prevention of new HIV infections will remain the priority in the Lao PDR, care and support services, including ARV, need to be scaled up. The full package of services needs to be expanded and sustained among appropriate target populations. Blood transfusion services need to ensure that proper cross matching is done, and that proper guidelines are followed in administering blood and blood products.

Combating malaria and tuberculosis needs to be continued on a sustained basis. In addition, funding and donor support for TB and malaria control needs to be more diversified. New drugs are required to fight the malarial parasite that has become more resistant to the traditional treatments. Availability of insecticide-treated bed nets need to be expanded through both government distribution and social marketing.

There should be efforts to strengthen cross-border malaria control. There is a need for early detection and effective treatment of malaria through comprehensive primary health care approaches. Community participation is also critical to ensure early detection.

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