Samoa, like most Pacific Islands is now facing with the reality of the increasing number of its HIV cases since the first case detected in 1990. Although it considered itself as a low prevalence country with a total of twenty two cases up to December 2009 however, it is critical for Samoa to offer treatment, care and support to those known to be living with HIV while at the same time preventing its further transmission.

Samoa has now a cumulative number of twenty cases, with six more identified in this 2 year reporting period 2008-2009. The routes of transmission which accounted for this increase is Mother to Child Transmission and heterosexual. However, considering the dramatic increase of Sexually Transmitted Diseases especially Chlamydia1 therefore poses a grave concern of how much we can do to minimize and contain the spread of these diseases. Simultaneously, it is through the same mode of transmission that HIV is transmitted from person to person, hence the short circuit of HIV transmission if the spread of STIs is not controlled.

Within this reporting period the Ministry of Health spearheaded the Second Generation Surveillance Survey for Ante-natal mothers, Youth (female and males) and Transgender in 2008. It was the second SGS carried out to determine the results of the SGS done in 2005 and to find any possibility for comparisons and differences that may have surfaced between two surveys. It was also highly invaluable to not only re-strengthen surveillance systems within the Ministry of Health, but also to gain more background information pertinent to behaviour change, the scope of STIs/HIV/AIDS intervention strategies in place, any significant increase of prevalence rates of STIs compare to 2005 results. Although only the SGS Survey results for ANC 2008 is endorsed, however, the picture it provides in terms of the increasing prevalence of STIs paints a dire need to put more emphasis on effective intervention strategies to address this dramatic increase at all levels.

The prevalence of STIs is high amongst those 25 years and below with 41% compared to 18% amongst those 25 years and over2. It was also found that at least 33% of ante-natal mothers tested had at least one STI including Hepatitis B3.

It is also imperative to mention that Samoa conducted its Demographic and Health Survey in 2009 which simultaneously assisted in consolidating and supporting results of the SGS Surveys, even though the features and characteristics of both studies differed significantly. Again although the results are in a preliminary stage but their significance in providing a current situation of our STIs/HIV/AIDS in terms of knowledge, attitudes, practices and behaviour (KAPB), is highly regarded. It is an important study that will further assist in ways to inform strategies for improvement of our HIV/AIDS programs.

Although considered as a very sensitive issue to be widely discussed amongst our own people because of our cultural and religious beliefs versus sexual activities involved, somehow, Samoa has come a long way in raising awareness and changing behaviours of our people towards these issues. This is in through strong community mobilizations, lobbying for political advocacy and support, advocacy at church level and school levels, getting the attention of young and active people through all sorts of media and peer education programs, mobilizing young girls and women about their rights for their safety and health and many other programs carried out by our sector partners. Nonetheless, it is obvious that despite of what we have done so far, the continued desire for more concerted and collective efforts from all our sector partners is even more important at this point in time. And as we present the core indicators stipulated in this report, we are also as the same time present a general overall picture of the HIV/AIDS epidemic in Samoa.

The core indicators are relatively for monitoring UNGASS progress are also appropriate on other grounds: 1) they will assess and evaluate the impact of our national response to HIV/AIDS epidemic 2) provide critical information of the effectiveness of our response at national and regional level, 3) outline the basis for monitoring the trend of the epidemic, related services and their outcomes, 4) guide our work in developing and designing appropriate intervention strategies to combat HIV/AIDS 5) will portray our level of commitment to the UNGASS, and 6) will show our commitment to the global response to fight HIV/AIDS.

This is the first time that Samoa is reporting its core indicators within the framework of UNAIDS guidelines. Therefore it is to be expected that there will be some limitations and deficiencies pertaining to some of the indicators that we will report on. For instance, data for a number of indicators is not available, some because the indicator is not relevant to the Samoan context eg: this is relating to IDUs or AIDS orphans. For many indicators, numbers are very small, and therefore not statistically valid. However, we take it into account that this report is an overall reflection of what we have done so far in our fight against HIV/AIDS, and what possible ways forward for more strategic actions deriving out of this report.

The main sources of funding for Samoa’s HIV programs is multilateral namely, the Global Fund to fight HIV, TB and Malaria (Samoa is only eligible for HIV/AIDS and TB components, and is now in line for its Phase 2 Round 7), the Pacific Response Fund (pooled funding mechanism that supports the implementation of national and regional HIV strategic plans, mainly from New Zealand and Australia), and provisions from the SWAp Project (a pool of funds from various overseas donor agencies, and from the Samoa government) which all in all have helped lifted the platform for our HIV/AIDS interventions now and into the future.