THE first World Aids Day, Dec 1, was observed in 1988. For the bulk of the years since then, it seemed that the war against this disease would never be won. Finally, however, in 2010, the UN said that the world had turned the corner and the tide had been reversed. Given this context, then, it is unfortunate in the extreme that in Pakistan, despite local and international efforts, HIV prevalence is continuing to rise in 19 cities. On Friday, in anticipation of World Aids Day, WHO issued a statement expressing concern over Pakistan’s high rates of unscreened blood transfusions, and poor infection control practices in healthcare centres across the country. Other factors that raise the risk of HIV transmission are as endemic: un-sterilised medical equipment, the re-use of syringes by drug addicts and the lack of awareness on part of vulnerable groups.

It gets worse. Since 1987 when the first Aids case was reported in Pakistan, the spread has been progressive with it now reaching the status of a concentrated epidemic in high-risk groups. Its incidence in injecting drug users stands at 27 per cent and in transgender sex workers at six per cent; both groups have breached the five per cent threshold set as the division between a first- and second-stage HIV epidemic. Further, we have seen outbreaks in rural communities such as Jalal Pur Jattan in district Gujrat because of overlap between injecting drug use, unsafe hospital infection control practices, the demand for therapeutic injections and commer-cial sex. This is a frightening trajectory. Given the passage of the 18th Amendment, provincial governments must evolve their own strategies and divert funds. Stretched though they may be, addressing this issue is vital. Already mired in a battle against polio, Pakistan must do more on the Aids front too.

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