As the world commemorates World AIDS Day on December 1, a timely report from UNICEF has renewed concerns about the serious challenges Pakistan continues to face in understanding HIV and AIDS, removing the stigma associated with it, and providing adequate treatment for those infected. The report at hand is quite depressing.
According to the report, the disease killed 110,000 children and adolescents worldwide in 2021 while infecting another 310,000. According to a senior UNICEF official, ‘though children have long lagged behind adults in the AIDS response, the three-year pause is unprecedented. Over 300 children and adolescents die from AIDS every day.’ This is a serious matter, and we cannot dismiss the report’s findings because we believe they do not apply to our situation.
In fact, during the same time period mentioned in the report, Pakistan experienced a major HIV outbreak in Ratodero, Sindh, where more than 1,000 children were infected with the deadly disease due to medical malpractice in 2019. Fifty-two of those children died within two years, and the families of those who survived the disease complained of a lack of financial or public health resources to alleviate their children’s suffering.
Because of the associated stigma, AIDS and HIV present a particularly difficult battle. When the disease was first discovered many decades ago, it was widely assumed that unsafe sexual practises were the primary cause. This has left an indelible stain on a virus that can also be transmitted from mother to foetus, through unscreened blood transfusions, and, in Pakistan, through improperly sterile surgical equipment and the reuse of infected needles. Again, this last one carries the stigma of injecting drug users.
However, there are other examples, such as in Larkana, where the spread of HIV was detected among hundreds of very young children in a local community during a major outbreak in 2019. Following an investigation, it was discovered that almost all of the children had received injections from unethical “GPs”; in other words, the reuse of contaminated syringes appeared to be the primary cause. According to a study published at the time in the Lancet medical journal, “up to eight outbreaks of HIV had been reported in Pakistan in the preceding two decades, with more than half in a single district—Larkana.” In addition to the devastation caused by “quacks” or unqualified “doctors,” razor reuse was blamed.
According to Ministry of National Health Services data, recent reports in the media have raised the alarm about a “sustained growth” in HIV-positive cases this year. Experts are concerned that the disease is now spreading from those who were previously considered at risk to the general population.
The takeaway should be that the public needs to be educated about HIV and AIDS prevention as soon as possible. Pakistan needs informed HIV conversations to counter the moral panic that the disease is the result of “immoral practices.” Such attitudes dehumanise those who suffer from the long-term and painful consequences of HIV infection, compounding their psychological trauma and complicating efforts to track, contain, or eliminate the disease entirely.
