UNAIDS fears more HIV outbreaks in Pakistan in coming days

UNAIDS fears that Pakistan could face more HIV outbreaks, like what they are having in the Ratodero area of Larkana at the moment, in other parts of the country in the near future if “reuse 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 the Ratodero area of Larkana. But this can also happen to other areas of Sindh and Pakistan, as the practice of reusing needles and unsafe injection and blood transfusion is common throughout the country,” Dr Maria Elena G Filio Borromeo, UNAIDS country director for Pakistan and Afghanistan, told The News on Tuesday in an exclusive interview.

The UNAIDS chief to Pakistan and Afghanistan, who is currently on a visit to Karachi and Larkana to assess the situation after the recent HIV outbreak in Sindh, said that 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 the 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 rationalise the use of injections, needles and IV drips,” maintained Dr Maria.

As many as 445 people — 356 children and 89 adults — have so far tested HIV-positive since April 25 this year in the Ratodero area of Larkana, and experts believe that the sharing of needles and IV drips, mostly by 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 in the surrounding towns and cities due to unsafe medical practices by quacks.

Urging the governments of Sindh and other provinces of Pakistan to introduce auto-destructible or auto-lock syringes that could not be reused by quacks or medical practitioners, Dr Maria said the Sindh Assembly has even passed a law regarding the use of auto-destructible syringes, and added that strict monitoring on the implementation of the law is required in order to prevent further infections and save the lives of thousands of more people, especially the children in the province.

Dr Maria said children as young as two and seven months old had tested HIV-positive in the Ratodero area of Larkana, and it would change the course of their future lives. They need to take antiretroviral therapy (ART) for life 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 the current HIV reporting and monitoring system. The Sindh government quickly responded and is carrying out voluntary HIV testing in medical camps. Those tested HIV-positive are immediately being linked to treatment. As far as treatment is concerned, the UNAIDS official said the Global Fund is currently providing 100 per cent of 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. “The UN is ready to bring in experts from abroad and introduce the best practices that have resulted in preventing such outbreaks in other high-risk countries, but the 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 per cent in Pakistan between 2010 and 2018. While other countries like India and Cambodia had successfully reduced its new HIV infections because of effective prevention programmes, 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, implementation of education, prevention programmes as well as reporting and monitoring to prevent such outbreaks in the country in future.