Buddhism exerts considerable influence in much of South East Asia; Laos, a nation of 6 million, is no exception.

Despite the political upheavals of the last three decades and a spreading race towards development and modernisation, monks, nuns and temples still play a significant role in the community, providing spiritual guidance and rituals that mark events in the lives of individuals from cradle to cremation.

"Buddhism is deeply identified with the history and culture of people in the region," said Prudence Borthwick, HIV/AIDS section head for the UN Children's Fund (UNICEF). "Monks are influential figures in rural communities and can thus be powerful advocates for people with HIV/AIDS."

The Metta Dhamma Project aims to mobilise monks to lead communities in HIV prevention and AIDS care. Launched in 2001 by the Lao Buddhist Fellowship Organisation and the Lao Front for National Construction, with support from UNICEF and the government, it is already having an impact.

According to Singhalath, there are Buddhist organisations in every village, which report on the specific needs of the community, and know who is HIV-positive. "The function of the monk is to provide spiritual guidance to those living with HIV, providing them guidance to live a happier and healthier life."

The Metta Dhamma Project is active in six provinces, and the capital. It supports people with HIV/AIDS by offering home visits, meditation classes, traditional healing ceremonies and informal counselling. At the same time, monks conduct HIV prevention education by incorporating HIV messages into their preaching.

While faith-based organisations are not the usual partners in HIV/AIDS care and support, their position in society makes them powerful advocates in promoting community understanding. "Traditional rituals provide comfort, relieve stress and generate a sense of security in believers," Borthwick said.

Since the first case of HIV in Laos was recorded in 1990, the figure has climbed to 1,827 by the end of 2005, of whom 1,190 were still living with the virus. Almost 95 percent of all infections occurred by means of heterosexual transmission, 3.9 percent from mother to child, 0.7 percent in men who have sex with men (MSM), 0.3 percent from blood products, and 0.2 percent by using unsterilised needles.

Although the number of cases in the general population is low, health experts warn there is little room for complacency - making efforts like the Metta Dhamma Project all the more important.

The Buddhist response to HIV/AIDS throughout South East Asia is based on the Thai grassroots model, a product of that country's struggle with a generalised AIDS epidemic. Buddhist monks initiated prevention and care activities to assist the sick, widows and orphans in their local communities, and have continued to develop and provide care and prevention services since about 1992.

UNICEF Thailand began funding HIV/AIDS training for monks to expand the grassroots response, the Sangha Metta, an NGO established in 1998. UNICEF's East Asia Pacific Regional Office then sought to export the lessons from the Thai experience to Xishuangbanna, Yunnan, China.

After a period of advocacy and consultation, the Chinese government and UNICEF invited the NGO to conduct training in Yunnan from 1998 to 1999; UNICEF provided advocacy, training and technical support to other countries in the region over the next eight years. From 2000 to 2002, UNICEF worked with its country offices to introduce the Buddhist Leadership Initiative (BLI) in Cambodia and Laos, and the initiative was introduced in Vietnam, Myanmar and Mongolia between 2003 and 2004.

The BLI in all countries aims to work with the national government and religious structures, and has accomplished the initial task of advocating successfully to governments and senior Buddhist monks and nuns for ordained Buddhists to play a part in the national AIDS response, and in introducing and piloting the involvement of monks and nuns in the HIV/AIDS response at local pagoda/temple level in five Mekong countries and Mongolia.

This has been accomplished by orientation training and advocacy events, as well as the rollout of a regional strategy to assist monks in planning their response, Borthwick explained, noting that monks in all countries were now engaged in caring for people with HIV and building HIV resilience among young people, although the number of monks and temples involved varied from country to country.

According to UNICEF, the success of advocacy can be seen by the involvement and cooperation of the Departments of Religion and National or Provincial AIDS Committees - for example in China, where the Yunnan AIDS Bureau and the Sipsongpanna Buddhist Association have worked closely together to develop a nationally recognised model for community care and support programmes, or in Cambodia where the authorities are working with temples at the local level to increase access to antiretroviral (ARV) treatment for community members with HIV/AIDS.

In Cambodia, monks are playing a growing role in ensuring access to treatment for people with HIV/AIDS. One abbot reportedly took 17 people by boat from his remote temple to receive ARV treatment at the nearest provincial ARV treatment centre. In other countries, donation boxes are used to raise travel funds for people with HIV to access treatment.

In Laos, monks are cooperating with self-help groups to provide meditation and spiritual healing for people with HIV/AIDS, and developing an innovative curriculum for teaching 'Buddhist Life Skills to Young People'. In Mongolia, the newest country to join in the BLI, monks in the capital, Ulan Bator, have taken the lead in advocacy for people with HIV and AIDS by organising a candlelight memorial to commemorate those who had died of AIDS.

In reclusive Myanmar, the government still regards working with monks as sensitive, but Rattana Metta, a network of eight lay Buddhist organisations, was formed in September 2004 to initiate a coordinated response to HIV/AIDS. HIV prevention education, based on Buddhist teaching and using a peer education approach, was initiated in 2005 in a few townships in the capital, Yangon, and care and support has been introduced at a regular gathering of people living with HIV, where they can share their experiences and receive spiritual support.

The number of monks trained by the programme varies from place to place, from around 100 in Mongolia to 12,000 in Cambodia, but efforts for further expansion are underway. Cambodia hopes to extend its programme from nine provinces to 15 over the next five years, while Laos has expanded from three provinces to six. In Vietnam, a pilot project in two provinces is gradually being extended.

Borthwick said the lack of funds remained a problem in scaling up, especially in Myanmar, Mongolia and China. "These activities will be expanded to more townships in Yangon, and to Mandalay, one of Myanmar's most heavily AIDS-affected areas and a spiritual centre for Buddhism, if the project receives more funding."