Islamabad -  World AIDS Day was observed on Monday as an opportunity to harness the power of social change and close the access gap between people who have access to HIV prevention, treatment, care and support services and people who are being left behind.

The World Health Organisation’s (WHO) Eastern Mediterranean Region comprising 22 countries including Pakistan is using the slogan “HIV treatment controls the virus. Treat for Life. Prevent for Life.” This is a call for action so that every individual living with HIV can enjoy the highest attainable level of health through lifelong access to good quality HIV care and treatment.

The antiretroviral therapy has become less toxic and easier to administer, and people living with HIV can take it in the right combination of medicines to control the virus and bring it down to undetectable levels. This keeps the immune system sufficiently strong to fight opportunistic infections and cancers. Thus people living with HIV can now live long, healthy and productive lives.

On this occasion, Dr Ala Alwan, WHO Regional Director for the Eastern Mediterranean, has affirmed, “HIV treatment reduces the virus to undetectable levels, and protects people against diseases. Secondary to the preventive benefit to individuals of reducing the virus to undetectable levels, there is a benefit to public health in general. Implementing ART programmes reduces the likelihood of transmission from people living with HIV to others. This is a major public health gain that will eventually result in curbing the HIV epidemic.”

“Effective HIV treatment will help people living with HIV to avoid the transmission of their infection to their uninfected partners. Similarly, once the level of their infection has become undetectable, pregnant women living with HIV can give birth without passing the virus on to their babies,” he added.

He has called for adapting health systems to ensure that even the least privileged and most marginalised individuals are not excluded, while monitoring the treatment success in individuals. The government of Pakistan has been maintaining a sustained response to the HIV epidemic since the late-80s or early 90s through the National and Provincial AIDS Control Programme, UN agencies specially UNAIDS, WHO, UNICEF, UNESCO and UNFPA, bilateral and multilateral donors, a large number of NGOs and CSOs operating at all levels. The Global Fund to fight AIDS, TB and Malaria has been financing a substantial portion of the HIV/AIDS response in Pakistan. Since June 2011, the Provincial AIDS Control Programs are leading the implementation of the policies, strategies and guidelines developed by them.

Pakistan falls under the category of a high-risk but low prevalence country for HIV-AIDS with a concentrated epidemic meaning that the prevalence in traditional risk groups exceeds 5 per cent. The National AIDS Control Programme estimates that there are around 100,000 HIV cases in Pakistan, with an overall general population prevalence ranging between 0.05 per cent - less than 0.1 per cent during the last decade.

However, the epidemic is expanding among the country’s estimated 150,000 injecting drug users.

According to Dr Michel Thieren, WHO Representative in Pakistan, Pakistan faces a continued risk of HIV transmission as a result of poverty, low literacy, gender discrimination, ignorance about modes of transmission and the stigma that prohibits people with risky behaviours from seeking HIV testing or care. He mentioned that WHO had been supporting the programne since the early 90s with a focus on enhancing capacity of national and provincial HIV/AIDS programmes, supporting policy development, strengthening HIV/AIDS treatment and monitoring prevention of HIV transmission in healthcare settings alongside blood safety, in addition to HIV testing and counselling, and diagnosis and treatment of other sexually transmitted infections. It also helps the programme in resource mobilisation.

Dr Thieren stressed that while the multi-sectoral effort involving a large number of agencies belonging to different sectors was yielding good results in Pakistan, there was a need for better monitoring, surveillance and coordination among other programs including those for tuberculosis control, maternal and child health, and lady health workers. This would result in proper documentation and eschew duplication of efforts, he added. He emphasised on the need for eliminating barriers to the provision of anti-retroviral drugs to needy patients with proper privacy and counselling, while pursuing a gender-sensitive and human rights-based approach.