By: Asim Nawaz Abbassi
World AIDS day brings a stronger commitment to bring down cases around the world. The situation in rest of the world is in line with the commitment of world leaders and activists that is to slow down the pace by creating awareness about the HIV epidemic but things here in Pakistan are different. It is painful to write that HIV/AIDS cases in Pakistan are rising. For Pakistan, it is a reminder that our strategy seems to be failing and it is time for some change in approach.
The reasons for rising cases in Pakistan are many. Being a low-income country unsafe health practices coupled with lack of awareness is the one among many reasons for the spread of HIV/AIDS. The attitudes in society on the subject, and a high use of drugs which lead to users relying on unsafe needles to inject themselves. The latest UNAIDS report on the global AIDS epidemic mentions Pakistan as a country reporting “sharp increases” in new HIV infections and rising AIDS-related mortality. Titled ‘Seizing the Moment’, the 2020 report highlights the scale of the HIV epidemic in Pakistan. The report points out that outbreaks in Sargodha (2018) and Ratodero (2019) have shown that unsafe medical practices are just as likely to infect the general population as the other factors. In both places, the reason for the spread of virus was the use of unsterilized equipment and infected syringes.
The improvement in the health systems with a special focus on awareness programs should be focused. A large number of people have limited access to healthcare services in Pakistan and are unaware of safe medical practices. Attitudes in society play an important role in fighting the spread of AIDS. But those infected are often shunned by society and this prevents many others from seeking medical help or intervention for their symptoms. These attitudes lead to spread of AIDS. For example, the lack of acceptance that non-marital sex is common in Pakistan suggests that people are not willing to accept on-ground realities. This has allowed the HIV epidemic to take hold, mainly among injecting drug users, male, female and transvestite sex workers as well as repatriated migrant workers.
UNAIDS report also highlights progress, notably in expanding access to antiretroviral therapy, it reiterates how important it is for countries to act with greater urgency to reach the millions still left behind. “HIV infections in Asia and the Pacific have declined slightly, with reductions in Cambodia, Myanmar, Thailand and Viet Nam offset by sharp increases in Pakistan and the Philippines,” the report states.
Another painful fact about the plight of HIV/AIDS is the late diagnosis and poor adherence to treatment. It is astonishing to know that about half of the key populations living with HIV are not aware of their HIV status. An overall rise in HIV infections comes at a time when there is a decline in political and programmatic commitment, alongside punitive laws and policies and rising stigma and discrimination that block effective AIDS responses. The bigger worry are street children. There are approximately 100 million street children across the globe and in Pakistan, it is estimated that 1.5 million are living on streets in highly vulnerable conditions. More needs to be done to protect them from the growing cases of HIV/AIDS. Children have time and again been put at risk. Who can forget the outbreak of HIV reported in Ratodero, where more than 1,000 children were infected owing to the negligence of one doctor. A significant number of HIV-positive cases have also emerged in about 20 districts of Punjab. What is sad is that the doctor who was arrested for medical negligence in Ratodero has been released on bail. This is not the message we need to give out.
If we really want to end the epidemic the government needs to make the commitments as it did for COVID 19. The policy revisit and research-based interventions need to be made by the government.
The writer is the Editor of ‘The Dayspring’. He can be reached at [email protected]