December 01, 2006	Friday	Ziqa'ad 9, 1427

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LAHORE: Nov 30: As the world observes the International HIV/Aids Day on Friday (today), the number of HIV-positive cases is continuously rising in Punjab; it is no longer classified as a low HIV prevalence province.

This year, the day is being observed based on the theme 'accountability' to inspire citizens to hold their political leaders accountable for the promises they have made to check, stop and reverse the existing HIV and Aids prevalence trend. The millennium development goals set by the UN also demand that the spread of HIV and Aids be halted and reversed by 2015. The maximum spread of HIV virus in Punjab is being reported among Injecting Drug Users (IDUs).

According to reports, over 700 HIV-positive people, most of whom are IDUs, have been reported by different NGOs as well as the Punjab Aids Control Programme (PACP) all over the province. This, While the estimated number of people infected with HIV is much higher.

The PACP project director Dr Ali Razaque says that there are 80 registered Aids patients in Punjab and 62 of them are receiving anti-retroviral (ARV) medicines from the project's treatment centres at Mayo Hospital, Services Hospital and the public-private collaborative partner -- Shaukat Khanum Memorial Cancer Hospital.

He says the PACP has conducted a rapid situational assessment of vulnerable population in four cities of the province and registered some 6,500 IDUs, over 6,000 female sex workers and 4,600 male sex workers, including hijras and jail inmates. All these registered vulnerable people are being provided services to ensure that they develop safe sexual habits and get improved availability of services for sexually transmitted infections (STIs) so that the threat of the spread of the deadly disease is checked.

Until last year, Pakistan was being considered as a 'high risk, low prevalence' country for HIV/Aids because those most at risk, including long-haul truck drivers, female and male sex workers and IDUs, are a fact of life here. Prevalence of such risk factors is responsible for the rapid spread of the disease worldwide. According to the UNAIDS, there were approximately 100,000 people infected with HIV in the country. However, Pakistan was being considered a low prevalence country because the total number of confirmed HIV and Aids cases was just over 3,000.

Experts, however, believe that the reported cases and even the estimated number of cases are only the tip of an iceberg as there are a lot many HIV-infected people, who either do not know that they are infected or do not have the courage to show up at diagnostic centres.

Recent studies show that the HIV as well as Hepatitis B and C are spreading fast among the IDUs and could break out among the general population, if effective and focused measures were not taken. Because the mode of HIV transmission is the same as that of Hepatitis B, these diseases are affecting the people having unsafe sexual relations, using infected syringes, sharing shaving blades at the barber's, and using infected instruments for pricking noses and ears, among women, for instance.

The Punjab government is running a five-year 2003-08 Enhanced HIV/Aids Control Programme, and believes that there is still a narrow window of opportunity to control this disease. The PACP in collaboration with its 55 partner NGOs, which are working under the banner of the Punjab Aids Consortium, is working to increase the prevalence of safe behaviour and improved availability of services for the STIs among vulnerable sections of the population. It stresses on improving knowledge and practice of HIV preventive measures, including the use of high quality services by the general adult population.

SAFE BLOOD TRANSFUSION: The PACP is also responsible for implementing strategies to reduce the transmission of HIV and other STIs through blood and blood products by ensuring that a cent per cent screening against Hepatitis B, C and HIV is conducted before blood transfusion in all public sector hospitals. It is also working to strengthen the capacity of both public and private sectors for effective management of HIV/Aids prevention programme.

Senior health department officials say it is high time we considered all the risk factors as a clarion call for taking urgent and effective measures to prevent an HIV and Aids epidemic of a massive proportion in the country.

“Unless we take remedial measures at this point, when we have a window of opportunity and time is on our side, Pakistan being a developing nation will be unable to afford not only the health cost but also the social and economic implications of a full scale HIV and Aids epidemic,” they say.

In order to ensure safe blood transfusion, the PACP is funding the supply of equipment and diagnostic kits for HIV and Hepatitis-B and C to the Institute of Blood Transfusion Services Punjab for onward transmission to over 120 blood banks in public sector hospitals and 12 HIV surveillance centres in the province. Though the private blood banks are being monitored through the Provincial Blood Transfusion Authority, the officials concerned believe that the private blood banks are a major source of spreading HIV and Hepatitis B and C.

Most of the blood bank owners are involved in purchasing blood from IDUs and selling it to patients without getting it screened. According to a study, about 20 per cent of the transfused blood comes from professional donors. They say blood-borne diseases are being spread during transfusion at maternity homes, private hospitals' operation theatres, at the dental clinics, the quacks and those carving tattoos.

Experts believe that a robust awareness campaign highlighting the risk factors besides efforts to bring behavioural change in society with regard to the stigma attached to HIV and Aids could help control the situation.