Slow reaction to AIDS spread to have serious ramifications

The head of a private voluntary organisation working to help AIDS and HIV-positive patients in the northwest city of Peshawar, has warned of possible long-term ramifications if national health authorities continue to ignore the slow spread of the deadly illness. “If the authorities don’t do something about it, this issue will be thrust underground and will re-emerge as a full-blown epidemic in a couple of years; much as it has happened in some parts of Africa,” Maimoona Masood Khan, the chief executive of All Women Advancement and Resource Development (AWARD), told IRIN from the capital of the North-West Frontier Province (NWFP). “Instead of admitting to the constraints, the shortcomings within the system, they indulge in double-speak, quoting much lower figures than have been already ascertained at the non-governmental level,” Khan stressed, adding she thought it impossible for any progress to be made in combating the illness until the situation was accepted as it actually stood. The government was fully cognisant of the situation and had already instituted several measures to ensure that the disease’s spread was being controlled, Dr Asma Bokhari, the head of the National Aids Control Programme (NACP) told IRIN in the Pakistani capital, Islamabad. “The government has already allocated close to US $51 million to AIDS/HIV prevention programmes and, from 1 July, we have been targeting people who are most vulnerable and helping to provide them with the best treatment on offer,” Bokhari maintained. “In any case, the onus is not, and should not, be wholly on the federal government. The authorities in each province are doing everything they can to ensure that health measures are up to standard,” she added. There are an estimated 80,000 people living with HIV/AIDS in Pakistan but official figures, towards the end of last year, quoted close to 2,000 cases of HIV and 231 of full-blown AIDS in a report to the NACP. Hospital staff had also not been fully equipped to handle the growing trend of AIDS patients willing to come forward for treatment and negative social attitudes hadn't helped much, Khan said. “In mid-September, a teenaged HIV-positive expecting mother was denied treatment and treated very unfairly by different hospital staff, who also told us not to bring such patients, before some of the senior doctors at Khyber Teaching Hospital accepted the case,” Khan explained, adding that the young woman then gave birth to a girl, who appeared normal thus far but that doctors would have to wait until a “window” period was over before they could safely ascertain that the illness had not been passed on. Social attitudes also dictated how people, who had been infected with the virus, reacted to the thought of having to disclose the nature of their illness before they sought treatment, Haji Muhammed Hanif, the general secretary of the advocacy group, AIDS Prevention Association of Pakistan (APAP), told IRIN from the north-eastern city of Lahore. “People are scared to come forward and admit that they are suffering from AIDS. This is primarily because of social constraints, social attitudes which force the non-infected community to look down upon these people and treat them as pariahs,” Hanif said, adding that he felt there should be a better focus on raising awareness about the illness in society in general. “Since there is no such project in the works and because of the growing increase in cases that go largely unreported, this illness is slowly spreading everywhere. The government doesn’t appear to be fully involved in trying to help stop this process,” Hanif claimed, pointing to an increased role that, he felt, the NGO sector would have to play in raising awarenesss about the illness, as well as the better treatment such patients merited. In early September, seven new HIV-positive cases were identified in the southern Pakistani province of Sindh, bringing the total number of such recent discoveries to 24. The cases were discovered in Larkana, some 300 km from the bustling port city of Karachi. Earlier, in March this year, three HIV-positive patients were allegedly thrown out of a hospital in the NWFP due to discrimination, forcing Maimoona Khan to launch a scathing attack on hospital authorities, saying it happened because of “discrimination” and “ignorance of the disease”. Khan then wrote to Pakistani health authorities, calling for action to be taken against hospital staff. Khan’s fears about the illness being forced “underground” and coming back as a “fully-blown epidemic” in an earlier statement made to IRIN in March this year, had earlier been voiced by a medical doctor in April, 2002, who said AIDS was “under-reported”. “If they say prevalence is limited, it does not mean that we should relax about it. In our country, the pre-requisites are there for an explosion,” Saleem Azam, the president of the Pakistan Society, which deals with drug addicts and AIDS, told IRIN then from Karachi.