AIDS: Living in denial

On World Aids Day, which falls today, dedicated discussions channelled towards achieving goals and policies designed to counter the spread of this extremely devastating and clever bug, which shows no signs of slowing, are being held across the globe. One doesn’t need to be a rocket scientist to know that one can only tackle a problem if it is well-defined, or as in the case of HIV, well accepted. And here lies the crux of the problem of HIV/AIDS in Pakistan.

Society in general still refuses to accept this ground-reality. However hard we may try to hide and ignore it, the irrefutable truth is that HIV is a threat in our midst. UNAIDS latest figures put the lower end of (the number of) afflicted people in Pakistan at 0.1 million, but the actual number is expected to be much higher.

The bubble burst in 2004, when studies from injection drug users started to reveal a truly shocking picture. Drug users demonstrated astoundingly high incidences of HIV. The virus, which had been more or less dormant in Pakistan since the first recorded case way back in 1987, had finally burst out of its bubble and that too with a vicious ferocity. In Larkana, where the first epidemic was recorded, almost one in three injection drug user tested turned out to be positive for HIV.

Why then are we still ashamed to talk about AIDS in public? The fact of the matter is AIDS in Pakistan is still frowned upon, considered unholy and extremely taboo. Even the mere mention of HIV conjures up images of illicit sex and sin. For the most part, this attitude stems from unawareness but our ‘holier than though’ attitude is also to blame here.

Under this umbrella of societal disdain, it comes as no surprise that HIV continues to grow. The epidemic is following the course we have seen in other countries: the virus makes it through to high-risk populations and then makes over the bridge to the general populace. The high-risk population in our scenario is the drug user and the next step in the story is going to be a steep incline in infections in the general population.

It also comes as no surprise, when you only have 2.9 per cent of the GDP channelled towards the health sector, that there are hardly any avenues for treatment of those afflicted by AIDS. No doubt there is a significant treatment programme underway for AIDS patients at PIMS Islamabad, but the battle against HIV has to be fought more along the lines of prevention than treatment.

Due to lack of funds, the only viable solution for us in this context is to fight HIV/AIDS on the social side. This prevention battle does have a strong chance of success, as the progress of the virus is still in its formative stages. So, in a nutshell, we need to come out with massive awareness strategies and change our ‘holier-than-though’ attitudes. This would then translate into safe sex practices for the afflicted population and prevention of a further spread of the disease. Educational institutions across the country should also be encouraged to invest in research on HIV. Indeed, we are at the crossroads. Let’s not wait for the HIV tide to run us over as well.

Published in The Express Tribune, December 1^st, 2010.