The AIDS trap

Fears are widening that HIV/AIDS may be spreading beyond Larkana and to other populations around the country. The Sindh AIDS Control Programme has said it will attempt to ascertain the spread among higher risk populations by screening transgender persons and prisoners at places that are seen to be at risk. These include Khairpur, Sehwan, Dadoo and Thatta among other places. UNAIDS has also voiced the fear that Pakistan could face more HIV outbreaks, pointing out that these have been detected before outside Sindh in Sargodha and Jalalpur Jattan in Punjab. The organisation warns that the use of unclean needles, unsafe blood transfusions and procedures by quacks would result in people acquiring potentially lethal infections including HIV and hepatitis. UNAIDS has suggested a mass campaign to educate people and general practitioners, driving them away from the unnecessary use of injections and IV drips. Both are used frequently in the country, and, according to experts, without any real need. Since April this year, 445 people, including 356 children, have already tested positive for AIDS in the Rato Dero area of Sindh. Other cases continue to emerge and experts fear the number could be in hundreds.

The collapse of civic agencies in Karachi and other parts of Sindh adds to health risks, with the Supreme Court asking the Sindh government and the chief minister to remedy the state of civic affairs in Karachi. Lack of fumigation, abundance of garbage heaps and uncontrolled dumping of medical waste are all risk factors in the spread of infection. Discarded syringes are frequently repackaged and resold in many parts of the country or used by drug addicts, contributing to the spread of viruses and bacterial disease.

We do not yet know the extent of the HIV/AIDS outbreak in the country. It is however now obvious that the situation is a grave one. UNAIDS has advised that laws pertaining to the safe disposal of syringes and other medical material be strictly adhered to and people warned against the sharing of needles and other medical equipment. We also need a full-scale assessment of how many people are already infected by HIV and also other common infections including hepatitis. The availability of therapy needs to be made known to people so that the impression that HIV is an untreatable disease be ended. So far, those being tested have voluntarily agreed to undergo the test. However, long-term anti-AIDS programmes and screening plans need to be put in place, with UNAIDS warning that India, Cambodia and Pakistan are among the countries that continue to show an upward trend in terms of new infections and could be vulnerable to a large-scale epidemic in the very near future.