KARACHI, March 23: So far as AIDS is concerned, Pakistan is a low-prevalence and high-risk country, according to the Sindh and National AIDS Control Programmes. It is deemed a low-prevalence country because until September last just 1,972 Pakistanis had tested positive for HIV and full-blown AIDS. Of these, only 231 were of full-blown AIDS.
Because the prevalence of HIV/AIDS is quite low in the country, there is general complacency about and apathy towards the issue. What most Pakistanis don’t realize is that recent epidemiological trends suggest the possibility of Asia, particularly South Asia, becoming the epicentre of a HIV pandemic.
Our next door neighbour, India, is already experiencing an epidemic at least in some of its states, including Andhra Pradesh, Karnataka, Maharashtra, Manipur and Tamil Nadu. India is estimated to have more than 4 million HIV/AIDS cases, which is the second highest number of such cases after South Africa.
Many Pakistanis regularly travel to India. Some of these Pakistanis can easily bring the dreaded infection here. So can the Indians, for that matter.
We also don’t realize that Pakistan is among the countries where prevalence of both hepatitis B and C is very high. We should realize that the mode of transmission of HIV/AIDS is similar to that of hepatitis. What we need to understand is that if the prevalence of hepatitis can be high so can one day be HIV’s.
Sharing of syringes and other implements among the huge population of drug addicts in the country — numbering more than 4 million — represents another potential landmine. According to a study cited by the Sindh AIDS Control Programme, drug addicts in Pakistan are increasingly switching over to injectable drugs. This should set off alarm bells in all quarters concerned.
There’s also the issue of transfusion of unsafe blood. According to some studies, only about 20 per cent of the pathological laboratories regularly screen blood for hepatitis and HIV. The upshot of these studies is that the blood on offer at most of the laboratories is unsafe — nay downright dangerous.
A law on safe blood was drafted sometime in 1996, which became enforceable in 1997, but five years on there’s very little improvement, if at all, in the situation vis-a-vis safe blood transfusion. The experts have urged the government the look into the issue as soon as possible but to very little avail yet.
Then there’s an urgent need to register all pathological laboratories and diagnostic centres because only after such an exercise can we, as a nation, hope to ensure safe transfusion of all blood. This task, though initiated more than a couple of years ago, is yet to achieve the results desired.
According to a senior official of the blood transfusion authority, many laboratories and blood banks are not cooperating in this regard. As a result, more than half the blood units being transfused today are neither screened for hepatitis nor for HIV. This, no doubt, has a direct bearing on the future health of the country.
Another issue of importance is the peculiar demographics of the country. Unlike many countries, more than half the Pakistani population comprises people of less than 25 years of age. In other words, Pakistan is mainly made up of young people who may be more active sexually as compared to other age groups. This too has a bearing on the future health scenarios.
A related issue is the unethical and often illogical practices of most Pakistani doctors. For instance, there’s a tendency among doctors to unnecessarily prescribe injections.
This practice fuels the use of syringes. Many of the used syringes are subsequently recycled and reused, which is very dangerous, to say the least.
A study undertaken by the Sindh Aids Control Programme has shown that in more than 90 per cent of the cases, doctors unnecessarily prescribe injections, often on the insistence of the patients. In all these cases doctors, instead of guiding the patients, follow their ‘advice’. Needless to say the physicians charge a premium for this (dis)service.
Now, imagine if we only could somehow cut down, through awareness campaigns and training programmes, the total number of injections that are prescribed every year! Wouldn’t that make combating the menace of recycled syringes all the more easy?
It can be concluded from the above that even though Pakistan is at the moment a low prevalence country, chances of the spread of HIV/AIDS are quite high.
Another conclusion that can be drawn is that several initiatives would have to be launched simultaneously for us to get a grip on HIV and AIDS before it’s too late. Otherwise, the dreaded disease will grab us by the scruff of the neck.
It’s true that a new beginning was made in this regard at a seminar earlier this week during which representatives of the district government and some campaigning doctors vowed to wage a joint struggle against the HIV scourge. But we have seen hordes of such initiatives and campaigns come and go without even creating a dent in the bad situation.
So this time round what we need is a determined and resolute push that brings about changes in the people’s behaviour, not just in their opinions. Let’s pray and hope that our politicians, whose interests don’t always overlap those of the people they represent, allow good sense to prevail and a suitable response is mounted before it’s too late.
