KARACHI, July 28: The cases of Human Immuno deficiency Virus have assumed the proportions of a 'concentrated epidemic' among the injecting drug users of the metropolis and to deal with the situation a broad based policy was badly needed.

This was observed at a meeting, organized by the Sindh AIDS Control Programme on Wednesday. The meeting was chaired by UNDOC programme coordinator and attended by the chief of the National AIDS Control Programme, the chief of Sindh AIDS Control Programme, Enhanced HIV/AIDS Programme Director, and representatives of various NGOs involved in harm reduction schemes.

The chief of Sindh AIDS Control Programme, Dr Sharaf Ali Shah, disclosed that around 3,735 injecting drug users were tested for HIV in the last one year in Sindh. Among them, around 199 injecting drug users were discovered HIV positive, he said adding that this shows that more than five per cent were positive.

He further said that out of 1,757 IDUs, tested during the first half of this year in Karachi, around 147 or 8.4 per cent, were found HIV positive. Referring to a study carried out in 2000, he said that the total number of injecting drug users was 60,000 in the country. "This figure seems to be on the lower side," he remarked.

"I say this, because we have observed that most heroin addicts have switched over from inhalation to injecting the drug." He was of the opinion that the cocktail of addictive chemicals in vogue among heroin addicts, could only be injected and not inhaled.

Referring to a preliminary study, Dr Sharaf Ali Shah said that the number of IDUs in Karachi alone ranged between 15,000 and 20,000. "The total number of IDUs in Sindh, on the other hand, was between 25,000 and 35,000," he added.

He said that some beds were set aside in the public sector hospitals for detoxification and treatment of addicts in the past. "However, there is no government hospital or clinic at present in which such services are provided," he added.

Describing various harm reduction schemes under which the IDUs are educated about the dangers in sharing needles, Dr Sharaf Ali Shah said that these schemes were aimed to reach some 8,000 addicts in all. "We must upscale our efforts in this area immediately to achieve the goal," he stressed.

He was of the view that efforts should be made to expand the coverage of harm reduction schemes and at least 80 per cent of all IDUs must be reached under these schemes.

He recommended that studies must be undertaken to determine the total number of IDUs in the province. Similarly, he added, chemical analyses of the drugs in use should be carried out so that effective antidotes could be prepared for them.

The non-governmental organizations working for the rehabiliation of injecting drug users should be trained properly and efforts should be doubled to stop the supply of drugs to the addicts. The demand of drugs must be reduced through adequate interventions, he added.

Also present at the meeting, National AIDS Control Programme chief Dr Asma Bukhari observed that she and her colleagues were dismayed over the situation in Karachi, in particular, and Sindh, in general.

At this point, Dr Sharaf Ali reminded her that Sindh stood out among the provinces as a grey area simply because a lot of work had already been carried out in the province.

He said, "Who knows what the situation is like in Punjab and other provinces. No tests have been carried out in those provinces. While in Sindh a grant of five million rupees had been approved for a medical centre in Larkana, where the treatment of drug addicts would be allowed."

Dr Bukhari reiterated that Karachi remained her biggest concern and said that the provincial AIDS control programmes were free to come up with their own initiatives to deal with the situation.

Regarding the harm reduction schemes, she regretted that these would stop getting funds from the DFID in May 2005. She said that alternative sources of funding should be tapped to ensure sustainability of the schemes.

During a break in the meeting, Dr Bukhari told Dawn that the National AIDS Control Programme would do everything in its power to help bring the HIV epidemic in Sindh under control. To a query, she said by the end of this year her office would be supplying anti-retroviral drugs to the people living with HIV.