KARACHI: The United Nations Programme on HIV/AIDS (UNAIDS) has discussed the problem of HIV/Aids prevalence in Sindh with particular emphasis on Karachi with the governor, the chief minister and other senior officials of Sindh to adopt the ‘Fast-Track City approach’ over the next five years to end Aids epidemic by 2030, officials said on Thursday.

The UNAIDS mission was headed by its senior officials, including country director Dr Mamadou L. Sakho, who met the senior authorities recently with the last meeting held Governor House on Wednesday.

In its report presented to the provincial authorities, the UNAIDS said Karachi was facing the problem of the most common prevailing disease of megacities caused by overpopulation such as respiratory ailments, fevers, gastrointestinal infections, skin disorders, tuberculosis and many infectious diseases such as hepatitis, dengue, STIs (sexually transmitted infections) and HIV/Aids.

It said the load of HIV/Aids in Sindh was between 35 per cent and 40pc of the total cases reported in Pakistan.

“Karachi bears about 80pc of the total cases reported in Sindh. According to a report of 04th Round of Integrated Behavioral & Biological Surveillance conducted by CIDA-HASP in 2011, the prevalence of HIV/Aids among people who inject drugs is 42pc and among hijra sex workers (HSW) is 10pc”.

It said female sex workers had consistently reported relatively limited prevalence of HIV. “Although this population is at risk of STIs, evidence of heterosexual transmission of HIV in the context of sex work is still relatively limited in Pakistan.”

UNAIDS officials advised the authorities that if they jointly adopted the Fast-Track City approach over the next five years, the window of opportunity to end Aids epidemic by 2030 would be open.

The country director of UNAIDS Pakistan said the UNAIDS Fast-Track approach emphasised the need to focus on the cities and communities most affected by HIV with new sets of targets and recommends that resources be concentrated on the areas with the greatest impact.

The mission exchanged views on the fast-track approach to achieve HIV prevention, treatment and support in Sindh, particularly in Karachi, linking sustainable development goals pertaining to a strengthened HIV/Aids response.

At its meeting with the commissioner of Karachi, the mission discussed how the government of Sindh could strengthen its domestic HIV response and to reiterate the support of the United Nations.

According to the report, the Fast-Track Cities Initiative was aligned with the UNAIDS Fast-Track Strategy for ending the Aids epidemic by 2030. The UNAIDS Fast-Track approach emphasised the need to focus on the counties, cities and communities most affected by HIV and recommended that resources be concentrated on the areas with the greatest impact.

It said UNAIDS-Pakistan took that initiative in the context of the Paris declaration on fast tracking HIV response in major cities.

“This initiative requires immediate response and approach which should be locally relevant, tailored and evidence based to reduce the number of new HIV infections, creating enabling environment for people living with HIV/Aids by curbing stigma and discrimination and easy access to treatment and social services to end Aids-related morbidity and mortality.”

Officials said in the first phase of the Fast Track City approach, UNAIDS-Pakistan selected Karachi.

“Karachi is spread over an area of 3,530 square kilometres, and population of 20-21 million, including an estimated 45,000 new legal and illegal migrants every month from various parts of the country and abroad,” said the officials.

They said during the meeting between UNAIDS and senior provincial authorities, it was decided to develop a Karachi City Focus Strategy Plan on HIV/Aids.

“The primary objective of this step is to develop a coasted city focus plan for the megacity that has synergistic linkages to the Pakistan Global Fund grant and expansion of focus and targeted interventions in areas or locations where HIV services are lacking or failing to reach key populations.”

Officials said the main focus would be on exploring new venues of HIV/Aids intervention and resources required for the execution of the city action plan.

Published in Dawn, March 4th, 2016