October 04, 2008	Saturday	Shawwal 04, 1429

KARACHI, Oct 3: A go-slow or failure on the part of the federal government to understand the significance of projects has deprived the provincial Aids-control programme of a centre of excellence planned for HIV and Aids care and therapy for patients both in Sindh’s interior and Karachi.

Sources in the Sindh Aids Control Programme (SACP) said that the Jinnah Postgrduate Medical Centre (JPMC) was identified by the provincial aids managers for the establishment of a centre of excellence on its premises about one and a half years back to increase the provision of HIV-care services and provide antiretroviral therapy for patients testing positive to the deadly virus.

However, the centre plan could not materialize during the months as the JPMC administration decided to seek a clearance for signing a memorandum of understanding (MoU) on the subject from its controlling authority in the federal health ministry, which for reasons best known to it failed to act on time.

The fund allocated for the establishment and training of relevant staff has also lapsed as the Global Fund to Fight Aids, TB and Malaria, which was entrusted with the job of extending necessary supports to the establishment of the centre, has ceased to exercise due to the termination of its contract about three months back.

Tracing the history of the project that failed to take off, an Aids official said that during a thorough discussion between JPMC and SACP senior administrators, it was decided that the former would provide the centre with two rooms on its premises and facilitate liaison among the relevant departments.

However, after the retirement of JPMC executive director Dr Mashoor Alam – during whose tenure an agreement was reached -- things started changing and developments related to the proposed centre were further delayed because of the fact that JPMC officials had suggested to the new executive director that the new centre could be set up only when the SACP, the JPMC and the National Aids Control Programme (NACP) signed an MoU.

In addition to the delay on the part of the JPMC and SACP in drafting the MoU, the federal health ministry, which had been forwarded the MoU for clearance and vetting by the federal government’s law and justice division also paid no heed to the matter. For the first time a draft of the MoU was sent to the ministry of health in May 2007, followed by a request sent in August, asking for the draft to be examined on a priority basis. However, this drew no results, said an insider.

Now the JPMC has nearly forgotten the project, said a senior official of the hospital, while conceding the importance of a centre of Aids/HIV in Karachi, which has its share of high-risk groups such as intravenous drug users, overseas workers, male sex workers etc.

At present four centres, two of them in the private sector, are working as designated facilities for the integrated treatment and care/prevention programmes against HIV/Aids under the NACP and SACP in the province.

Experts and medical professionals believe that they are insufficient and there is an urgent need to establish such a centre in every tertiary care hospital in the province – which is home to about 50 per cent of the known Aids/HIV patients in the country.

Of the 456 HIV/Aids patients registered with the SACP excellence centres at Karachi and Larkana, 181 are receiving ART.

“The excellence centre at the JPMC could have helped address the surgical, eye-related or gynaecological requirements of its registered patients as well and reduce the chances of HIV/Aids patients mixing with other patients and the resultant knowing or unknowing spread of the virus,” said a doctor at the SACP.

The sad side of putting the JPMC project on the backburner is that now a full-time doctor, a counsellor and an outreach worker, recruited a few months ago, have been sent home. Had the project been commissioned, these professionals could be absorbed by the SACP in the long run as per the requirement of the project’s PC-1.

Alongside its other functions, the NACP was meant to provide antiretroviral medicines, including the first line regime for infected adults and children through the SACP to the centre for excellence, while the JPMC was supposed not only to provide two rooms and a waiting area to the centre of excellence but also treat patients at the proposed centre in accordance with the hospital’s policies, facilitate monitoring visits and allow access of facilities after receiving information about a visit.