LAHORE: An official report on the performance of the Punjab AIDS Control Programme (PACP) for the prevention of AIDS in Punjab has exposed the loopholes, inefficacy and mismanagement in the manner the health authorities/managers are running the programme.

The report concluded that the programme has blatantly missed almost all the physical targets assigned to it. The programne aims at improving the health status of the population of Punjab by keeping the HIV/AIDS at the current low level (below 0.1pc) among general adult population.

The third-party evaluation report by the Punjab government’s planning and development department paints a dismal picture of bad governance and disregard to consequences of not meeting the physical targets in the original plan i.e. the PC-I. It unveiled the inaction of the health department in responding to the AIDS crisis and poor performance of the PACP.

The report also raised a question over the transparency of the huge spending made by the PACP to achieve the targets.

The Supreme Court had recently ordered that all the possible interventions should be started by the federal and the provincial governments by shifting focus to the preventing diseases.

Says programme misses almost all the targets

As per PC-I (2016-19), the programme had a target of providing preventive services (service delivery packages) to 25,000 female sex workers in 2016-17. Out of which, only 685 (2.7pc) were provided with such packages and Rs14.9m(89.48pc) were spent out of set financial target of Rs16.6m.

In 2017-18, out of 50,000 targeted female sex workers, only 1,518 (3pc) were provided with preventive services and Rs0.43m (2pc) were spent out of Rs19.8m.

The cumulative achievements of targets in preventive services from 2016-18 in female sex workers account for 4.4pc (2,203/50,000) and transgenders/male sex workers account for 4.6pc (2,318/50,000).

This analysis clearly shows that achievement ratio was very low in providing service delivery packages to the sex workers.

The situation was also pathetic regarding targeting the drug users and TB patients, the most vulnerable segments of the society, which should have got the maximum coverage under the given programme.

The report says the injectable drug users (IDUs) account for 0.8pc (398/50,000); truckers account for 20pc (22,257/110,000) and the HIV screening for TB patients account for 0.15pc (317/210,000), respectively.

Furthermore, no (0%) targets were achieved in mapping of most-at-risk populations (MARPs), integrated biological behavioural surveillance (IBBS), antenatal clinic (ANC) surveillance and special investigation, states the report.

As far as establishment of new HIV/AIDS treatment centres is concerned, only six (15pc) treatment centres were established from 2016-18, the report unveiled another drawback of the programme .

“The results reveal that the PACP has not only failed to achieve the set physical targets in the PC-I but also major discrepancies and violations in financial management by overspending at multiple occasions were observed in financial targets and no appropriate justifications were provided to the validation team such as almost 90% budget was utilised in achieving less than 3% physical target in female sex workers (FSWs),” the report reads.

Similar, discrepancies were observed in most of the budget allocations where the programme has overachieved/overspent in financial targets whereas the physical achievements are even less than 10pc.

The programme had procured STD medicines and HIV rapid testing kits; however, it was unable to provide the exact number of kits/medicines provided to the beneficiaries, indicating not only poor programme management but also confirming that the programme needed major reforms to uplift standards in reporting and overall performance in running a programme in a professional manner, reads the report.

Some senior officials are of the view that even the new government also has so far failed to address the structural issues of management in the PACP. They suggest that this programme should be placed under the specialised health department due the specialised nature of interventions to control AIDS before its turning into a generalised epidemic like the hepatitis viruses.

Published in Dawn, November 24th, 2018