What to do about AIDS?

There is a need to engage affected groups, prevent their ostracism and encourage voluntary testing and treatment.

In a country where illiteracy is rampant, erroneous and misleading views on health issues are understandable. One does not expect popular newspapers, however, to spew fallacious and potentially noxious editorials on such matters. On December 1, a day meant to highlight the Aids crisis and its victims’ plight, an Urdu newspaper contended that the disease spread primarily through moral depravity. It quoted unnamed ‘experts’ advocating the adoption of “Islamic principles” as a means of curtailing the worldwide epidemic. “It is true,” the paper asserted, “that the basic causes of the spread of Aids … are moral waywardness, nudity and obscenity.” Brilliant scientific exposition, one must say. Here’s the humdinger though: “which is why the disease is rapidly engulfing western populations in its folds.” The paper went on to expostulate that compliance with the “strict moral code of morals (sic)” that Islam offers is “a major means of controlling not just Aids but many other ailments.” And “it is impossible to control Aids without controlling moral turpitude.”

That the editorial is scientifically, logically and epidemiologically flawed is evident. For one, HIV, like Hepatitis B and C, is only partially spread through sexual contact. Contaminated blood and needles are a major means of its transmission, more so in Pakistan. Secondly, you can catch the virus even through lawful, marital, ‘Islamic’ sex if your partner has it. Thirdly, ‘Western’ countries — no matter how ‘nude’ or ‘obscene’ they may appear to our local scribes — have among the lowest prevalence rates (0.1 to 0.5 per cent) of HIV/Aids in the world; 90 per cent of all cases of HIV/Aids occur in the developing world. Fourthly, does the editorial mean to imply that only Muslims can successfully prevent this disease and you’re more likely to catch it if you happen to be a Hindu or Christian since you don’t follow ‘Islamic’ edicts? This is derisible. Lastly, one does wonder how a “strict moral code of morals” has prevented or controlled “many other ailments” in our very Islamic state. The leading cause of death in Pakistan is tuberculosis (TB) — the country ranks sixth in the world in terms of burden of disease for TB. Likewise, we’re among a handful of nations that have failed to eradicate poliomyelitis; of course, we also boast some of the highest maternal and infant mortality rates in the region.

Unfortunately, the editorial is more than just factually unsound. Its moral posturing and smugness can hurt efforts to control the disease and support its victims in the country. It reinforces stigmatisation of potential and actual victims of the disease, an attitude that prevents them from seeking diagnosis and/or treatment, and, inevitably, helps in spreading the disease. Pakistan still has a very low prevalence of HIV/Aids — about 0.1per cent, which translates roughly into 97,000 cases — but that’s largely due to the relative confinement of the disease to specific groups: injecting drug users and commercial sex workers (male, female and transgender). These are among the most deprived — not depraved, mind you — sects of our population, driven to their predicaments largely because of poverty and social inequity. Large-scale crossover of the disease to the general population is possible if erroneous and bigoted views about it persist. There’s a strong need to understand the disease to engage affected/vulnerable groups, prevent their ostracism and encourage voluntary testing and treatment among them. Those who have contracted the disease should be seen as patients, not recipients of some divine wrath. Is it a sin, after all, to have received a tainted blood transfusion or an accidental needle prick?

There is also a dire need to halt the semi-literate idiocy that some sections of our press exhibit on health matters.

Published in The Express Tribune, December 29^th, 2010.