KARACHI, Nov 30: Although there are only 2,000 reported cases of Aids in Pakistan, including 600 in Sindh, it is widely believed that the actual number is in the region of 70,000. The first case of Aids was reported in Karachi in 1986.

This was disclosed by the manager of Sindh Aids Control Programme, Dr Sharaf Ali Shah, while talking to Dawn on Saturday.

He added that in view of under-reporting of Aids cases, the World Aids Day, which is observed all over the world on Dec 1, would be based on the theme “Stigma and discrimination”.

The Sindh Aids Control Programme had made arrangements for a walk from the Liaquat National library on Stadium Road to the mausoleum of the Quaid-i-Azam on M.A. Jinnah Road on Sunday, he said.

According to Pears Medical Encyclopaedia, Acquired Immune Deficiency Syndrome, or simply Aids, is a disease caused by a Human Immunodeficiency Virus, referred to as HIV. “Unrecognized before 1981, its precise origin is unknown, but the most severely affected part of the world is Africa. It is transmitted sexually; originally identified in the US among homosexuals, it is now clear that it can be transmitted from man to man, man to woman, woman to man and by an infected mother to her unborn child. It can be transmitted by the transfusion of infected blood or by the use of infected needles, as when needles are shared between intravenous drug abusers. It has a long incubation period.”

Dr Shah said that while generally the incubated period of Aids was long — ranging from eight years to 12 years — in Pakistan it was a bit less, primarily because of weak immune systems of people. Besides, in children it was even lower, he explained.

He recalled that the previous year — when the theme of the Aids campaign had been “I care...do you?” — the Sindh Aids Control Programme, in collaboration with six United Nations agencies and at least 70 non-government organizations and a large number of local communities, had organized cultural shows, music programmes, cricket and football matches, dramas and printed literature on Aids to create awareness of the disease.

“At least 3,000 doctors and 120 nurses took a three-day course on a part-time basis,” he said. He added that the annual grant of the Sindh Aids Control Programme was Rs10 million.

Doctors point out that as there is no official mechanism for drawing information about such cases from the numerous unrecongnized health centres, a majority of such cases go unreported. Furthermore HIV-infected patients prefer to remain anonymous for fear of bringing shame and disgrace to their families.

They add that the absence of an efficient counselling and support structure makes the situation even worse. Awareness building is also necessary to inform people about infected needles and skin- piercing equipment as potential causes of some of HIV infections.

WHO OBSERVATIONS: Globally, the HIV/Aids epidemic is likely to escalate out of control with economic and social consequences that are far worse than witnessed previously in the world unless the epidemic is vigorously tackled, World Health Organization sources said here on Saturday, adds APP.

According to them the WHO is conducting meetings and workshops in all its regions in order to assist the participating countries in developing common surveillance strategies for sexually transmitted infections, including HIV/Aids.

The countries are also being encouraged to develop their own control mechanisms and systems, and obviously there is no room for complacency. WHO is also helping countries through providing them with technical support, carrying out operational research and ensuring safety of blood.

The routinely used passive reporting systems are usually inadequate to provide useful information on incidence and prevalence, and may be misleading. It is, therefore, crucial that effective surveillance systems be established to generate reliable information that can be used to devise the most effective interventions to counter HIV/Aids and also monitor their efficacy and impact.

The WHO/UNAIDS strategy has called for the development of “second generation surveillance” aimed at integrating data from biological and behavioural surveillance. The surveillance system needs to be tailored to the epidemic state of each country so that the information derived can be useful for targeting surveillance and intervention activities.

Bio-medical surveillance and behavioural data can provide early warning of a possible epidemic in areas where HIV is uncommon; provide information for designing focused interventions in sub-populations with high-risk behaviour; help monitor the success of the response and provide information essential for planning care and support.

There is also a need for a massive scaling-up of our current efforts in the fight against HIV. Despite falling prevalence rates in some countries and advances made in treatment and care, the global HIV/Aids epidemic shows no sign of abating.

This year World Aids Day theme “Live and let live “ for 2002-2003 focuses on eliminating stigma and discrimination, which pose as major obstacles to effective HIV/Aids prevention and care.

World Aids Day is commemorated around the globe on December 1 to evaluate progress made in the battle against the epidemic and bring into focus the remaining challenges.

Stigma and discrimination continue to fuel the HIV/Aids epidemic hampering prevention and care efforts. Many communities respond to HIV/Aids with ignorance, fear, denial and intolerance.

People living with HIV/Aids and their families have to deal with a traumatic health crisis as well as the negative responses they encounter in daily life.

HIV/Aids started as a mysterious infection among gay white men but over two decades it has exploded into the worst epidemic humanity has ever faced and is now afflicting as many women as men. Ominously, the disease is also starting to take its toll on agricultural output and is worsening the food crisis in some of the world’s poorest areas.

According to the UNAIDS, it will have killed 3.1 million people by the end of this year, five million more have been infected with the deadly virus and 42 million people, half of them women, are living with HIV/Aids.

It is also mentioned that by 2007 the world will have to find about $15 billion a year to successfully treat and combat Aids in low and middle income countries.

In his message on world Aids Day 2002, Dr Peter Piot, UNAIDS executive director, has remarked that as the world enters the third decade of Aids, it is becoming clearer than ever that this is the most devastating disease humanity has ever faced.

Driven by stigma and inequality the global epidemic makes ever deeper inroads into human security. He poignantly notes that this year, for the first time in the epidemic’s history, the number of women living with HIV has risen to 50 per cent of the global total.

On World Aids Day we need to remind ourselves of ways in which stigma and inequality push women to the end of the treatment queue, exacerbate HIV risks, sustain sexual violence and deprive girls of schooling. Yet we also need to remember that women’s organizations’ support and community education has been one key to success against the epidemic.

The good news, Dr Pilot remarks is that even the most severe HIV epidemic can be turned back, when HIV prevention and care are tackled seriously through community-wide efforts with the full support of governments, community organizations, religious institutions, and business.

In every continent across the world, from cities and rural areas, we have examples of safe behaviours resulting in markedly lower HIV rates. The extension of access to care is slowly gaining momentum, and brings hope to millions.