The number of people living with HIV/AIDS (PLWHAs) in the Pacific Islands region pales into insignificance compared with other regions of the world. However, these 22 small and remote island countries with a collective population of 8.5 million, cannot afford to be complacent about the problem. The challenge is not so much securing a plan to arrest the crisis, but rather having the resolve and political will to put the plan into action, or "walking the talk", as one political leader recently said.

By June 2001, 4,776 people in the region had tested positive for HIV. At least three of the 22 islands and territories have no registered HIV/AIDS cases. These figures are grossly under-reported, however, and the region is already in crisis mode. Papua New Guinea, the country with the most PLWHAs to date, admitted that they are expecting their figures to triple or even quadruple in the next few years.

All the countries and territories in the region are acutely aware of the threat of an HIV/AIDS pandemic. Tonga's Health Minister warned that although "the numbers of HIV/AIDS cases are relatively low in the Pacific region and in Tonga, this does not give rise to a sense of complacency."
High population mobility, increasing levels of unemployment and the alarming magnitude of sexually transmitted infections (STIs) are all risk factors for the spread of HIV/AIDS. This scenario, coupled with cultural factors and the lack of sophisticated technology for screening and testing may well point to under-reporting or lack of detection capacity. Other factors that make the region particularly vulnerable to the pandemic are:

• high population growth rates, particularly in urban areas, where 80% of the population are young people (15-25 years)
• the many social and economic problems
• cultural and geographical diversity, making communication difficult
• low literacy rates and hundreds of different languages and dialects

Despite an overall awareness of the threat of AIDS at political levels and the expressed political commitment, most Pacific Island states still have a long way to go in educating their people, including its journalists, especially in addressing the underlying prejudices and inequalities concerning HIV/AIDS. This is exemplified by a recent case, where a village called for all people living with HIV/AIDS to be deported to an uninhabited island. There is still an enormous task ahead, both in public and private sectors, to make Pacific Island societies "walk the talk".