“There is a significant amount of work that needs to be done to improve infection control and support the affected children and their families,” said UNAIDS Regional Director at a press conference held in Karachi, to present the preliminary findings of an investigation to ascertain the sources of the HIV outbreak in Larkana District.
"This work cannot be effectively carried out by the federal and provincial Governments alone. Civil society organizations, people living with and affected by HIV, private sector, religious leaders, media practitioners, development partners like the United Nations, everyone has a role to play. UNAIDS will continue to facilitate and coordinate within the UN System and other partners to ensure that the necessary support is provided effectively and efficiently,” added Murphy.
The preliminary findings presented during a debriefing and a press conference organized by the Government of Sindh offered a window into how more than 798 people have been newly diagnosed with HIV in Larkana District. Amongst the new cases, 82% are children under 15, with the majority being under the age of 5. The investigation, led by the WHO in partnership with a range of organizations from Pakistan including the Sindh AIDS Control Programme, Aga Khan University (AKU), the Field Epidemiology and Laboratory Training (FELTP) Program, the Dow University of Health Sciences, the Microbiology Society of Infectious Disease, and UN agencies, including UNAIDS, UNICEF and UNFPA, concluded that poor infection control practices, including a lack of sterilization and the re-use of syringes and IV drips, are the most critical drivers of the outbreak.
"I commend the leadership of the federal and provincial Governments, particularly the Sindh Ministry of Health, in quickly responding to the HIV outbreak in Larkana. However, it is urgent to address the root causes of the outbreak now; otherwise HIV will likely continue to increase and become a bigger development issue", said the UNAIDS Regional Director.
Among other actions, strengthening community education is critical to raise awareness about HIV prevention and tackle stigma and discrimination. The findings from a rapid assessment of HIV related knowledge and attitudes, which were also presented today concluded that information about HIV is minimal among the affected communities. Many parents and caregivers informed that they heard about HIV for the first time on the day their children were diagnosed or following the panic when the outbreak reports started coming out through the media. This lack of information created fear, misconception and misinformation. Families with HIV-positive children have been shunned and isolated, and some have lost their businesses.
To address this situation, UNAIDS together with UNICEF, UNFPA, WHO, and JSI Research and Training Institute, has supported national partners to develop a community response plan which will engage communities at all levels to reduce stigma and discrimination and promote health education. With UNAIDS’ and UNICEF’s collaboration, the Sindh AIDS Control Program has started to train health workers on pediatric case management and awareness, and health education sessions are being organized with the involvement of community-led organizations and religious leaders. Training sessions for local media on responsible HIV reporting and coverage are also being carried out.
During his mission to Pakistan, the UNAIDS Regional Director held separate meetings with local and federal authorities, including the Minister of Health of Sindh Province, Dr Azra Fazal Pechuho and the Special Assistant to the Prime Minister on Health, Dr Zafar Mirza. They discussed plans to strengthen the health sector and the HIV comprehensive response while stressing the need to empower local and provincial authorities to bring treatment and prevention services closer to the most vulnerable communities. Director Murphy also had the opportunity to meet with Maulana Fazl-ur-Rehman, President of Jamiat-ulema-Islam (F) and Rashid Soomro, General Secretary of (JUI-F) from Larkana, to discuss how religious leaders can play an important role to reduce stigma and discrimination and promote HIV prevention.
Since the outbreak was first reported at the end of April 2019, the United Nations in Pakistan has been working closely with the federal and provincial governments to provide on-site technical support to help effectively respond to the HIV outbreak and reduce the impact of the crisis. Murphy stressed the importance to continue to strengthen the HIV response for key populations in addition to the response to the HIV outbreak.
With 20,000 new HIV infections reported in 2017, Pakistan has 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 to ensure that the country is not left behind in the effort to end AIDS.