Number of HIV-infected people all over Pakistan exceeds 165,000, raising questions over NACP performance

LAHORE: The number of HIV-infected people in Pakistan has crossed 165,000, posing serious doubts over the performance and efficiency of the National Aids Control Programme (NACP). The program appears to have failed to stop the spread of the disease.

As per data released by NACP, however, the number of patients who have been registered with HIV is only 23,000. A surprising thing to note in this regard is that NACP has been quoting the same figure for HIV patients for the past five years. However, the rise in the number of HIV cases, despite billions of rupees granted to NACP, is extremely concerning.

In its written reply submitted to National Assembly, the health ministry has maintained that immediate measures are being taken for patients inflicted with HIV, including the provision of medicines and steps to stop the disease from being communicated from parents to their young children. The ministry has established 35 centres throughout the country for treatment of aids. However, as per the officials of the health ministry, negligence during blood transfusion and use of syringes affected by the virus in the hands of drug addicts are also contributing factors for the spread of the disease.

According to statistics released by United Nations Global HIV Aids Control Program, a total of 36.9 million people in the world are affected by the deadly virus, of which 25 per cent remain undiagnosed. According to the UN report, the highest number of these people belong to East and South African states, with 19.6 million cases.

In west and central Africa, the number of HIV cases is 6.1 million, while 5.2 million people in the Asia Pacific, 2.2 million people in western and central Europe and North America, 1.8 million people in Latin America, 1.4 million people in east and central Asia, 0.31 million people in Caribbean states and 0.22 million people in the Middle East and North Africa have also contracted aids. According to the global index for aids, Pakistan stands at 35th position with the most number of patients affected by the disease.

According to statistics released by the National Aids Control Program, the number of HIV cases during the past year has increased by 35,000. In 2018, the number of patients affected with aids was 130,000, which in the current year has surpassed 165,000, while an estimated 20,000 cases are being added every year, from which sixty per cent are from Punjab. According to the NACP report, Punjab has 75,000 cases of aids, followed by 60,000 in Sindh, 16,322 in Khyber Pakhtunkhwa, 5,275 in Balochistan and 6,675 in Islamabad. In addition, about 2,500 HIV patients belong to Azad Jammu and Kashmir and Gilgit-Baltistan.

Only 23,757 people inflicted with aids have been admitted or are undergoing medical treatment in different AIDS Control Centers of the country. The registered patients reflect only 7 per cent of the total HIV cases in the country, from which 15, 115 cases represent drug addicts who have contracted the disease through the use of infected syringes. These patients are being administered ARV therapy for medical treatment.

The rate of diagnostic testing for Aids is also ten per cent less, as compared to diagnostic tests for other diseases, raising alarm bells for policymakers and public health professionals in general. According to the report, the number of registered HIV aids patients in the federal capital is 2,500, while 11,000 people in Punjab, 8,000 people in Sindh, 2,370 people in Khyber-Pakhtunkhwa, and 1,334 people in Balochistan are registered for the disease.

According to the report, a total of 18,220 men, 4,170 women, 564 boys and 426 girls and 379 transgendered individuals are registered for the disease. According to the National Aids program, the virus has been confirmed in more than 1000 jailed prisoners all over the country. The Aids virus was found in 480 prisoners of Punjab prisons, 296 prisoners in jails of Sindh, 181 prisoners of Balochistan prisons and 56 prisoners of KP.

According to the report, more than 6,000 patients have been afflicted with this disease and died as a result of it all over the country. The federal capital Islamabad, Punjab's Lahore, Faisalabad, Sheikhpura, Rawalpindi, Sargodha, Rahim Yar Khan, Multan Chinniot, DG Khan, and Sindh's Karachi, Larkana, Hyderabad, Sukkur, Mirpurkhas, Sanghar, Qambar ShahdadPur, Benazirabad are the places most affected by Aids.

In Balochistan, the areas of Quetta, Zhob, Loralai, Pishin, Qila Saifullah, Noskhi, Qila Abdullah, Lasbela, while the areas of Peshawar, Kohat, BANNU, Charsadda, Swat, Lakki Marwat, Abbottabad, Malakand division, Mansehra, Mardan, Hangu and Chitral in the K-P are among the affected cities.

According to the report, the National Aids Control program has opened 25 Aids Treatment Centers all over the country, which tries to prevent the transfer of Aids virus from the mother to the baby during pregnancy. 33 HIV treatment centres have been formed, while 11 new treatment centres will be formed, suggest reports.

In Punjab, Primary and Secondary Health Department Additional Secretary and Punjab Aids Control Programme Project Director Dr Asim Altaf told The Express Tribune that the programme has registered around 12,000 HIV patients in the province, of which around 7,500 are getting free medical treatment. He highlighted that the program has taken various initiatives to prevent and halt or contain new HIV infections and improve the health and quality of life of people living with HIV in Punjab.

Dr Altaf highlighted that Punjab is the first province in Pakistan that has established a BSL-3 Advanced Diagnostics Laboratory which provides a complete package of services and is equipped with latest flow cytometry machine, gene expert, CD4 count machine, and has the capacity to perform viral genotyping and HIV resistance testing for initiating or switching ART.

The program, in partnership with the Walled City Authority of Lahore (WCLA) and Akhuwat Foundation, has initiated a project in the city’s red light area for children of unknown parentage and families of people with high-risk behaviour. In addition, the program has started Pakistan's first-ever clinic for transgender persons at Fountain House, and set up HIV screening centres in 38 jails in Punjab.

The program has also partnered with the Lahore University Management Science (LUMS) for research in bioinformatics and analysis of epidemiological data. The program offers scholarships to MPhil and PhD students doing research on HIV and has provided training to healthcare providers on HIV treatment, counselling and stigma reduction in 15 districts at DHQ, THQ and teaching hospitals across Punjab.

He further highlighted that the program is providing services to 22,709 injecting drugs users, who have the highest prevalence of HIV/Aids (between 20-35%). The program registered all those injecting drug users in prisons during mass jail screening activity, and the National Aids Control Program runs a national program for their rehab implemented by Nai Zindagi.

Similarly, the program provides services to 13,461 transgender people. The program works in collaboration with Akhuwat Khawaja Rehab Program and Khawaja Sara Society of Pakistan.

Dr Altaf said the program is also providing services to bridging population connected with these vulnerable segments. The program has tested 25,786 bus and truck drivers at 20 sites spanning 14 cities. It has screened over 89,009 jail inmates in 2017-18 covering all prisons, and this is an ongoing activity which is still underway in different districts. The program has also screened 174,000 TB patients for HIV, including those at sentinel sites. For the general population, the program has been organising health week and other awareness-raising programs. In 2018, during a mass screening campaign, the program tested 667,424 people for HIV.

Protection

Avoiding sexual indiscretion is paramount. If a syringe needs to be injected then make sure the syringe is new. Transfusion of blood should only be carried out if necessary, and after making sure that the blood is free of HIV. Aids does not spread by shaking hands, eating food and walking with an Aids patient. Hence, there is no need to run away from this disease.

If treatment is not carried out after the diagnosis of the HIV virus, then threats of other diseases like a bacterial infection, cancer, phlebitis and scrofulous increases. The HIV virus cannot currently be treated but can only be controlled, allowing the patient to lead a healthy life. There are 33 centres of HIV Aids which provide free test and medicines.

The Aids disease spreads due to a virus called HIV which is also called the virus that renders the immune system of the body useless. Usually, it is spread due to sexual indiscretion, or the use of an affected syringe, or any affected equipment that prickles the skin, nose, ear and those that are used in dental treatment. Equipment used for cutting hairs or shaving, or used during surgery may also spread this virus if they are affected. Aids is called the last stage of the HIV virus. If HIV is not treated, then the immune system is destroyed and it takes the shape of Aids.

The initial symptom of Aids can be a common cold which usually is not paid attention to. A patient of Aids may seem healthy for months or even for years. The patient gradually becomes a patient of Aids. Other major symptoms include loss of body weight by more than 10% within a short time or diarrhoea or fever that lasts more than one month.