he World Health Organisation has identified human immunodeficiency virus as a persistent global public health challenge that has claimed an estimated 42.3 million lives to date. Transmission continues in every country, with an estimated 39.9 million people living with HIV by the end of 2023 and over 630,000 deaths from HIV-related causes in the year.

The World AIDS Day, observed annually on December 1 since 1988, serves as a global platform to raise awareness, foster solidarity and combat the stigma surrounding HIV/ AIDS. Under the theme - Take the Rights Path: My Health, My Right - the WHO has called on global leaders and citizens to address the inequalities that hinder progress in ending the epidemic. Access to healthcare is a fundamental human right. Ensuring that everyone has access to HIV prevention, treatment and care services — regardless of their background, gender or location — is essential to achieving this goal. Protecting the right to health requires making healthcare services universally available and accessible.

As part of the United Nations Sustainable Development Goal 3, the global community aims to eliminate AIDS as a public health threat by 2030. Achieving this goal requires addressing systemic inequalities and ensuring that prevention, diagnosis and treatment services are accessible to all. Preventative measures, such as practicing safe sex, regular testing, avoiding shared needles and minimising exposure to blood and bodily fluids, are critical in reducing the risk of infection.

Despite decades of progress, HIV/ AIDS remains one of the most pressing global health challenges. In 2023 alone, an estimated 1.3 million people acquired the virus. Barriers such as stigma, lack of education and limited access to healthcare continue to impede efforts to control the epidemic.

In Pakistan, the HIV epidemic has transitioned from low prevalence to a concentrated epidemic. According to UNAIDS, as of June 2024, an estimated 297,052 people in Pakistan were living with HIV. High-risk groups include injecting drug users; men who have sex with men; transgender individuals; and those exposed to infected blood. Unsafe injection practices have been a significant driver of the epidemic, contributing to the spread of HIV as well as hepatitis B and C. Unlike many other countries, Pakistan faces challenges in ensuring the use of disposable, single-use syringes and proper disposal of medical waste. Adopting WHO-recommended practices, such as using new syringes for every injection and immediately discarding used needles in sharps containers, is critical to controlling the epidemic.

Despite ongoing efforts, the rate of HIV infections in Pakistan has risen significantly in recent years. The prevalence of HIV among injecting drug users has exceeded five per cent, marking a concentrated epidemic. Marginalised communities are particularly vulnerable, as stigma often delays diagnosis and treatment, leading to further transmission. Factors such as low literacy rates, lack of awareness, unhygienic medical practices, unsafe sexual behaviours and economic instability contribute to the rising rates of HIV in the country.

Barriers such as stigma, lack of education and limited access to healthcare continue to impede efforts to control the epidemic. 

The problem extends beyond just unsafe injections. Other unsafe practices, such as those prevalent in barber shops, including the re-use of blades and razors; lack of effective disinfection of instruments; and unsafe ear and nose piercing and other invasive procedures like tattooing are significant risk factors for the transmission of hepatitis B, hepatitis C and HIV. These deeply rooted cultural practices require a comprehensive approach to promote the adoption of standard operating procedures and infection control measures.

Unsafe blood and blood product transfusions, as well as variations in the quality assurance procedures in laboratory screening, have also contributed to the spread of these infections, as standards in this regard were only introduced in the country about a decade ago. A strong commitment is needed by the healthcare providers and institutions for adopting these standards in true spirit.

The National AIDS Control Programme, established in 1986-87, focuses on reducing the prevalence of HIV through early diagnosis, education and behaviour change. The programme aims to increase knowledge and promote safe practices through effective communication strategies. Collaboration with stakeholders, including healthcare providers, policymakers, and the media, is vital to achieving these objectives. The programme also emphasises safe blood transfusions, early diagnosis and reducing the stigma associated with HIV/ AIDS.

At the provincial level, the Punjab AIDS Control Programme has implemented several initiatives, including setting up screening camps for high-risk groups such as bus and truck drivers, jail inmates and transgender individuals. The programme has also established Pakistan’s first exclusive transgender clinic at the Fountain House, Lahore, and provides a toll-free health helpline 1033 for information on HIV/ AIDS. These efforts aim to improve access to care and reduce the stigma surrounding the disease.

The Punjab Healthcare Commission has a significant role in addressing the epidemic by ensuring quality healthcare services and patient safety in public and private healthcare establishments. The commission has developed minimum service delivery standards for all kinds of healthcare facilities including laboratories, requiring them to implement quality control systems as well as infection control programmes with the use of protective equipment, and safe handling and disposal of medical waste. Recently introduced standards and guidelines include standards for dialysis centres; addiction treatment centres; and registration of aesthetic clinics are also steps in protecting the public from the spread of HIV and other infections.

Ms Winnie Byanyima, executive director of UNAIDS, said in her message of the Day, “On World AIDS Day 2024, it is time to redouble our efforts, to fast-track our actions and close the gap between people who have access to HIV prevention, treatment, care and support services and people who are being left behind”.

The writer is a playwright and a freelance journalist. He can be reached at pashajaved1@gmail.com and his blogging site: soulandland.com