Pioneering community-led HIV/AIDS response across Pakistan

With an estimated 0.2 million people living with HIV urgent attention and strategic action are always required

Over the past years, the term ‘polycrisis’ has surged in popularity as a way to explain a macro-crisis of interconnected, runaway failures of Earth’s vital natural and social systems that irreversibly degrades humanity’s prospects (Polycrisis and long-term thinking, UNDP, August 2022).

With the Covid pandemic, a cost-of-living crisis, resurgent violent conflict and climate change, let alone the undeniable impact of human activity itself (the Age of the Anthropocene), these factors have all colluded to push global human development indicators into a regression in consecutive years, the first time since the human development index was first measured. Pakistan, like the rest of the world, is not immune. And on World AIDS Day, it is critical not to overlook the significance of addressing the HIV epidemic in Pakistan. With an estimated 0.2 million people living with HIV, according to the National AIDS Control Program’s official data, urgent attention and strategic action are always required.

It is now that policymakers could change the trajectory of HIV in Pakistan, a country that has seen AIDS-related deaths increase by nearly 500% since 2010. First, the political will that the Government of Pakistan has demonstrated is visible, not least in the ability to build the kinds of effective public-private partnerships that are required to tackle HIV. This HIV response approach maximises the strengths and comparative advantages of different organisations and networks. This includes the UN family, but also civil society organisations like the Aurat Foundation working to provide access to justice services to people affected by HIV, and the Health Services Academy, a leading institute of training and research in public health. Second, in the last year, Pakistan has introduced new HIV prevention technologies that have proven in other countries around the world to reverse the epidemic. These technologies are PrEP, which is a pre-exposure prophylaxis pill, and HIV self-testing. PrEP is available to communities most at-risk to HIV, which includes for example married, sero-discordant couples where one partner is HIV positive and the other one negative. HIV self-testing allows people to test in the privacy of their homes to know their status and then get linked to the free treatment services available if they are positive. People won’t access treatment unless they know their status.

Third, Pakistan has invested in a community-based HIV response. Evidence has shown that only by ensuring that people and communities are at the forefront — and centre — of the response will investments in prevention and treatment be effective. UNDP, in collaboration with the national and provincial AIDS Control programs and key stakeholders, has expanded the prevention services in Pakistan almost threefold from 16 to 53 sites, and from 9 to 19 cities in all four provinces of Pakistan. These services are delivered by more than 400 outreach workers that are from the communities most impacted by HIV. It is only by knowing communities that you can provide the vital prevention and care services tailored to the unique needs of the people being served.

This year’s World AIDS Day theme is Let Communities Lead. UNDP is proud to stand not only with the Government of Pakistan as partner in the HIV response, but also the communities of people most affected by HIV in ensuring that everyone has regular, safe and dignified access to quality HIV prevention services and life-saving HIV treatment. UNDP will work with all partners with full dedication and commitment for the communities most affected by HIV in Pakistan, and will contribute towards the reversal, and eventual end, of the HIV epidemic in Pakistan.

Published in The Express Tribune, December 5^th, 2023.

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