KARACHI: UNAIDS fears that Pakistan could face more HIV outbreaks, like what they are having in Ratodero area of Larkana at the moment, from other parts of the country in near future if “re-use of unclean needles and unsafe blood transfusion procedures remains in practice in the country” and quacks continue to inject people with lethal viral and bacterial infections including HIV and Hepatitis.
“This is not the first outbreak of HIV in Pakistan as earlier such outbreaks have been reported from Sargodha and Jalalpur Jattan areas of Punjab and now they are seeing this (outbreak) in Ratoderoa area of Larkana. But this can also happen to other areas of Sindh and Pakistan as practice of re-using needles and unsafe injection and blood transfusion is common throughout the country”, said Dr. Maria Elena G Filio Borromeo, UNAIDS Country Director for Pakistan and Afghanistan while talking exclusively to The News on Tuesday.
UNAIDS Chief to Pakistan and Afghanistan, who is currently on a visit to Karachi and Larkana to assess the situation after recent HIV outbreak in Sindh, said the last HIV outbreak in Asia was reported from Cambodia in 2014 when a cluster of HIV infections in Roka, Battambang province were reported, adding that investigation revealed that it was due to unsafe injection practices by unlicensed medical practitioners.
“We need to educate the people and the general practitioners as well that there is no need of injections and IV drips in most instances. We need to reduce the demand for unnecessary injections and IV drips. There is a need to rationalize the use of injections, needles and IV drips”, Dr. Borromeo maintained.
As many as 445 people including 356 children and 89 adults have so far been tested HIV positive since April 25, 2019 in Ratodero area of Larkana and experts believe that sharing of needles and IV drips, mostly by the quacks is the root-cause of the latest outbreak. National and international experts fear hundreds more could be infected with HIV in the area as well as surrounding towns and cities due to unsafe medical practices by the quacks.
Urging provincial governments of Sindh and other provinces of Pakistan to introduce auto-destructible or auto-lock syringes that could not be reused by the quacks and medical practitioners, she said Sindh assembly has even passed a law regarding use of auto-destructible syringes and added that strict monitoring on the implementation on the law is required in order to prevent further infections and save the lives of thousands of more people, especially to the children in the province.
Dr. Maria maintained that children as young as two and seven months old had been tested HIV positive in Ratodero area of Larkana, and it would change the course of their future lives. They need to take antiretroviral therapy (ART) for life and in addition to psychosocial support, she added.
She noted that the first report of new HIV infections among children came from the local media, hence there is a need to strengthen current HIV reporting and monitoring system. The Sindh Government quickly responded and is carrying out voluntary HIV testing in medical camps. Those tested HIV positives are immediately being linked to treatment.
As far as treatment is concerned, UNAIDS Country Director to Pakistan and Afghanistan said that the Global Fund is currently providing 100% of the ART in the country, free of charge. However, this will end in December 2020 and it would be strategic for the federal and provincial governments to start planning now, to sustain it beyond 2020.
“UN is ready to bring in experts from abroad and introduce best practices which have resulted in preventing such outbreaks in other high risk countries but local authorities would have to prepare mid-term and long term strategies to prevent such outbreaks in future and deal with the existing burden of people with HIV/Aids in the country”, she added.
According to UNAIDS, HIV infection had increased by 57% in Pakistan from 2010 to 2018. While other countries like India and Cambodia had successfully reduced its new HIV infections because of effective prevention program, countries like Pakistan and Philippines continue to show an upward trend.
The UNAIDS official also held talks with Sindh Health Minister Dr. Azra Pechuho and other government officials on the recent HIV outbreak in Larkana and assured the Joint United Nations Program on AIDS’ (UNAIDS) collective support in carrying out a scientific investigation of the outbreak, linking those tested HIV positive to treatment, implementing of education, prevention program as well as reporting and monitoring to prevent such outbreaks in the country in the future.
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