“Community data on uptake, barriers, and retention is often underutilized in funding, legal, and policy reform aimed at meeting community needs. To address this, we must empower community health services to be grounded in lived realities. We also need to invest long-term in grassroots initiatives and sustain PrEP within national health systems, all while being guided by the actual needs of the communities we serve.”
These powerful words from Kao Phubet Panpet of the MPLUS Foundation – one of Thailand’s leading community-led organizations providing stigma-free HIV and PrEP (Pre-Exposure Prophylaxis) services – highlight a key challenge in expanding access to this essential HIV prevention tool in Asia: understanding and addressing the specific needs of communities most affected by HIV.
PrEP services across Asia have expanded in recent years, especially among key populations at high risk of HIV, largely due to international aid from initiatives like PEPFAR and The Global Fund. While these investments enabled pilot programs and community outreach, reliance on external funding has left many efforts vulnerable. Integration into national health systems remains limited. To ensure sustainability, governments must strengthen ownership, mobilize domestic resources, and fully embed PrEP within national healthcare infrastructure.
More recently, the outlook for PrEP programs in Asia has become increasingly uncertain. Significant foreign aid reductions – following an unanticipated U.S. government executive order earlier this year – have disrupted services in several countries. These cuts have stalled outreach, limited access for vulnerable populations, and halted planned program expansions. In response, regional governments must urgently act to secure continued access to this life-saving, proactive HIV prevention measure. This issue was the focus of the SKPA-2 Learning Series webinar, “Sustainable PrEP and the Future of PrEP Financing in Asia”, held on 20 May 2025.
Webinar objectives:
- To understand the financing of PrEP across the Asia-Pacific region;
- To explore and understand aspects of sustainability for PrEP services in Asia (domestic funding, private sector engagement, innovative service delivery models);
- To discuss lessons learned from countries transitioning PrEP services from donor dependence to government-supported programs.
The webinar opened with Veronique Collard from the UNAIDS Asia Pacific Regional Support Team, who outlined the region’s HIV and PrEP funding landscape. She stressed the urgent need to boost prevention funding for key populations and reduce reliance on external aid. Recent assessments in five countries showed only 1% of PrEP spending came from domestic sources. She also highlighted wide disparities in HIV drug pricing, emphasizing that addressing cost barriers is essential for scaling up PrEP effectively and equitably across the region.
Huiling Pan from the SKPA-2 Program at Health Equity Matters shared lessons from PrEP roll-out efforts in Bhutan, Mongolia, and Sri Lanka under SKPA-2-supported initiatives, along with updates on current implementation status. Drawing on case studies, she also presented a range of financing options—from fully government-funded programs to hybrid models and private-sector initiatives, including innovative efforts by nonprofits and pharmaceutical companies. Huiling emphasized that financing PrEP and HIV services requires identifying those with the willingness and ability to pay, creating service delivery models for them, and reserving limited public resources for those who need them most.
A central focus of the webinar was a vibrant panel spotlighting community-led perspectives. Kao Phubet Panpet of Thailand’s MPLUS Foundation was joined by Prashu Ram Chaudhari of Nepal’s Blue Diamond Society and Wan Mohd Ikhtiaruddin – commonly known as Edx – from the Malaysian AIDS Foundation. Together, they shared success stories from their countries in delivering community-led PrEP services and described how funding reductions have challenged, but not stopped, their work. Panelists discussed adaptive strategies – including local advocacy, innovative partnerships, and policy engagement – to maintain access for key populations. They also reflected on government actions and shared advocacy experiences aimed at ensuring PrEP remains accessible and that community-led approaches continue to be recognized and supported.
“Blue Diamond Society and its sub-partners actively generated demand for PrEP among key populations. Although the initial phase was particularly challenging due to widespread stigma and negative perceptions surrounding PrEP, consistent promotional efforts by community-based supporters, peer navigators, social media community influencers, and BDS-operated dispensing sites, helped overcome these barriers. As a result, we directly reached 6,745 key populations with PrEP services. Across Nepal, more than 16,000 individuals have accessed PrEP to date,”
Prashu highlighted the efforts of his team on the growing success of PrEP uptake in the country, also thanks to the national commitment from the government.
The final question to the panel asked what gives them hope in their continued advocacy for PrEP access. Their responses reflected a shared optimism rooted in community strength. Edx from Malaysia specifically spoke of a growing sense of ownership, where individuals once hesitant about PrEP are now encouraging peers to access it. Panelists unanimously praised the dedication of frontline staff – many of whom go above and beyond their roles because they believe in PrEP’s life-changing and life-saving potential. This passion, they agreed, keeps the movement alive. As governments and donors redefine their roles and priorities, will they truly listen to the communities who have not only embraced PrEP but are leading its future? Can those in power meet this critical moment with the same urgency and commitment that communities on the front lines have already shown?
Published on: 01-Jul-2025
About the Contributor
Nicky Suwandi (He/Him/His)
Knowledge Management & Learning
APCOM, Thailand
Nicky led the demand generation initiatives during SKPA-1, and with his current position, he is aiming to facilitate discussions and promote cross-learning in the SKPA-2 project and beyond. In addition, his work is deeply rooted in creating meaningful changes for key population communities, specifically on HIV online interventions, pre-exposure prophylaxis (PrEP) and sexualized drug use or chemsex. Hailing from Indonesia, he is equipped with a degree in communication studies, and have experience working in a national network for men who have sex with men (MSM) and transgender women, which comprises more than 80 community-based organizations and support groups across the archipelago.
