Responding to the HIV epidemic in Larkana



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Ahmed (his real name) worries when he tells his story: his five-year-old son Mukhtar has just been diagnosed with HIV. Ahmed, a doctor working in a hospital in the southeastern city of Rotadero in Pakistan, had submitted Mukhtar to an HIV test when local media reported an increase in cases of HIV infection among the children of his region, in the province of Sind.

At the end of April, following warnings from a Ratodero doctor that a number of children in her care had been tested positive for HIV in a short time Health officials expanded HIV testing in Larkana district. After more than six weeks of testing, over 750 people have recently been diagnosed with HIV, with children accounting for 80% of confirmed cases. Amhed's son is one of them. Before the epidemic, just over 1,000 children were living with HIV throughout the country. Although further investigations are underway to uncover the cause of the outbreak, experts say poor infection control practices, including lack of sterilization and reuse of syringes and drops, may be a factor.

Mukhtar sits on his father's lap while Ahmed continues to tell his story.

"When I talked to my wife about it, she started asking me questions, where did it come from, why did it happen to my child, and how would it survive?" ? "Anxiety and fear grew in Ahmed's family and throughout the province. Every day, hundreds of parents line up in front of the testing sites and go to hospitals and clinics to have their children tested. Many of them understand HIV very little.

As an immediate response to the epidemic, the Sindh AIDS Program (SACP) has launched an extensive screening campaign by expanding HIV testing centers and establishing a new HIV testing center. Taluka Headquarter Hospital in Rotadero. These measures tested more than 26,000 people, mostly children. The Sindh Ministry of Health has also intensified its efforts to prevent the operation of unauthorized and informal medical practices. As a result, 900 unregistered clinics and blood banks were closed.

To ensure immediate access to HIV treatment, a new antiretroviral treatment center for children was established in Larkana and new health care providers were deployed. These efforts are saving lives as 356 people, including Ahmed's son, have already been enrolled in HIV care services and started antiretroviral treatment. "I was scared but my child was then given the treatment he needed," says Ahmed. "We must now ensure that antiretroviral therapy will continue to be available in our district."

The United Nations in Pakistan is working closely with the federal and provincial governments to provide on-site technical support to help local partners respond effectively to the HIV epidemic and reduce the impact of the crisis. With the full participation of the World Health Organization, UNICEF, UNAIDS, UNFPA and other United Nations agencies, the United Nations is providing support to the United Nations. implementation of the "Plan to Combat HIV Epidemics in Sindh from May 2019 to April 2020", which includes: and long-term steps to identify the causes of the HIV epidemic, combat them and strengthen the continuum of HIV prevention, treatment, care and support services.

A team composed of SACP and other national partners supported by the United Nations played the role of first responder. Subsequently, international support and expertise were commissioned by the federal government to conduct an epidemiological survey to understand the source, extent and chain of HIV transmission and make recommendations. The survey, whose preliminary findings will be presented on June 14, is led by WHO with the support of the Agha Khan University (AKU), the Field Epidemiology and Laboratory Training Program (FELTP), UNAIDS , UNICEF, Dow Medical University, Karachi. , Microbiology Society of Infectious Diseases in Pakistan.

The United Nations also supports national partners in the development of a community action plan that will involve communities at all levels to reduce stigma and discrimination and promote health education. . The SACP will train health workers in pediatric case management and sensitization and health education sessions will be organized with the participation of community-led organizations and religious leaders. Training sessions for local media on HIV reporting and coverage will also be organized. "We need to make sure that the root causes of this epidemic are addressed to prevent such tragedies from happening again," says Ahmed.

With 20,000 new HIV infections in 2017, Pakistan is experiencing the second fastest growing AIDS epidemic in the Asia-Pacific region, with the virus disproportionately affecting the most vulnerable and marginalized, especially key populations. . UNAIDS continues to advocate for a strengthened response to the epidemic.

"We need ongoing work with national and international stakeholders to effectively address critical gaps in the prevention of new HIV infections and to ensure the health and well-being of all people living with HIV." HIV in Pakistan, so that the country is not left behind. to end AIDS, "said Maria Elena F. Borromeo, director of UNAIDS in Pakistan.

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