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Fears more HIV outbreaks in Pakistan

Dr. Abdul Razzak Shaikh,

The fresh cases of HIV are increasing day by day at Ratodero-Larkana and presently figure rises more than 547, which is an alarming situation.

Joint United Nations Programme on HIV/AIDS (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 the last HIV outbreak in Asia was reported from Cambodia in 2014 when the cluster of HIV infections in Roka, Battambang province were reported.

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 the near future, if re-use of unclean needles and unsafe blood transfusion procedures remain 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 in Ratodero area of Larkana. But this can also, happen to other areas of Sindh and Pakistan as a practice of re-using needles and unsafe injection and blood the transfusion is common throughout the country, Dr. Maria Elena G Filio Borromeo, UNAIDS Country Director for Pakistan and Afghanistan while talking exclusively.

UNAIDS Chief to Pakistan and Afghanistan, assessing the situation after the 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 was 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 for 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.

As many as more than 500 people including children and 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. 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 to the children in the province.

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. It has been 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 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.

According to UNAIDS, the 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 the future and deal with the existing burden of people with HIV/Aids in the country.

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 an effective prevention program, countries like Pakistan and the 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.

On Monday PPP Chairman Bilawal Bhutto Zardari presided high-level meeting regarding the cases of HIV in Ratodero- Larkana, and Minister Health Dr. Azra Pecuho visited the Ratodero on Tuesday to monitor the situation. The crackdown has been also started in the whole district against Quacks and lot of people has been arrested. The Center for HIV treatment has been activated in Larkana CMC Hospital under control of Sindh Aids control Programm.

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