HIV positive patients now have easier access to viral load testing facilities   

NACP staff likely to get salaries by February 2017;
GFATM assures release of more funds during 2018-20 for expansion of outreach services

Islamabad

Viral load testing, which is a crucial test for monitoring patient response to treatment of AIDS, is currently available in only three cities of Pakistan. In order to fill this gap, the National AIDS Control Programme (NACP) will now be availing the Aga Khan University Hospital’s (AKUH) 200 plus nationwide network of collection units to collect blood samples from far-flung areas. Tests will be performed free of cost at the state-of-the-art AKUH laboratory in Karachi and results will be shared with treatment centres as well as NACP.

The national programme manager of NACP Dr. Baseer Khan Achakzai shared this piece of information with ‘The News’ here on Tuesday. He shared that viral load testing facilities are currently available in Islamabad, Lahore and Karachi only. Patients from other areas resultantly have to face a lot of inconvenience in terms of access. “The measure will enable continuity of treatment as AIDS patients have to get this test done every six months,” he stated.

According to Dr. Baseer, free viral load testing services will now be provided to over 0.102 million suspected HIV/AIDS patients, including 17,224 registered HIV patients. Elaborating on the economics of the arrangement, Dr. Baseer said, “NACP will pay Rs1,500 per patient to AKUH from resources allocated to it by the Global Fund Against AIDS, TB and Malaria (GFATM). The same test costs around Rs15,000 in any private laboratory.”

Pakistan is the second largest country in South Asia in terms of the HIV epidemic, standing only a few steps behind India and Nepal. Until recently, Pakistan was classified as a ‘low prevalence high risk’ country but is now in a ‘concentrated phase’ of the epidemic with HIV prevalence of more than 5% among injecting drug users (IDUs) in at least eight major cities. However, the country still has a window of opportunity as current estimates indicate that HIV prevalence among general adult population is still below 0.1 per cent. According to latest estimates, there are approximately 102,000 cases of HIV/AIDS in Pakistan.

“We currently have 17,224 registered HIV cases; among them, 8,133 are on treatment based on their viral load (of these, 6,778 cases of HIV have been registered so far in Punjab, 5,646 in Sindh, 2,085 in Khyber-Pakhtunkhwa, 2,189 in ICT and 526 in Balochistan),” Dr. Baseer shared.

NACP is also providing services through 11 Prevention of Parent-to-Child Transmission (PPTCT) Centres, where pregnant HIV positive mothers receive support. With PPTCT intervention, the mother-to-child transmission in Pakistan has declined from 45% to 1.35%,” Dr. Baseer revealed. Progress is also underway on the establishment of an Early Infant Diagnosis facility in collaboration with Unicef to enable diagnosis of HIV in newborns of HIV positive mothers, facilitating early initiation of treatment in positive newborn babies. “There was not a single case of mother-to-child transmission in 96 deliveries conducted at the Pakistan Institute of Medical Sciences (PIMS) during 2016. Same is true of Khyber-Pakhtunkhwa where no positive case was reported in 89 deliveries,” Dr. Baseer said.

NACP takes pride in the fact that it faced no HIV drug shortages during 2016. “This has improved the confidence of the community, leading to registration of 3,500 more cases in 2016,” Dr. Baseer said.

Referring to future plans, Dr. Baseer said, more intensified and coordinated approaches will be implemented to address HIV and AIDS related issues. “However, no effort can succeed in the absence of a significant change in public behaviour. It is imperative for people to understand that a person affected by HIV&AIDS is an entitled to lead a dignified life as any other citizen. We need a change in mindsets; a shift from rejection of the patient to rejection of the disease,” the NACP chief stated.

Dr. Baseer highlighted the need to fast-track actions and close the gap between people who have access to HIV prevention, treatment, care, and support services and those who are being left behind. “Only through joint efforts can we may transform tragedy into opportunity, and can break the conspiracy of silence to reach to the marginalised, particularly young women and adolescents. To do this, we need to ensure that health systems are strengthened to provide the essential services that are needed,” he maintained.

The GFATM has assured release of more funds during 2018-20 for expansion of outreach services to far-flung areas through satellite clinics. The promise has been made in view of progress achieved during 2015-16.

Dr. Baseer was asked why the staff of NACP, including him, has not received their salaries for as long as 6 months, and how this is affecting the performance and service delivery of the programme. He said, “As many as 18 people in NACP have not received their salaries since July 2016. The PC-1 of HIV/AIDS, as well as TB and malaria exhausted on June 30. Although a new PC-1 was prepared in June and approved by secretary health, the Planning and Development Division suggested that a joint PC-1 for all three diseases be developed as a coordination unit and submitted. It took time to prepare a joint document due to the difference in response of each disease; however, the joint PC-1 has been approved by the Department Development Working Party (DDWP), and has now been presented to the Central Development Working Party (CDWP). Only upon approval of the PC-1 will payment of salaries resume,” he narrated, hoping it will materialise by February 2017. Delayed release of funds has not, however affected the supply of drugs, thanks to GFATM.