National AIDS Control Programme Ministry of Health Government of Pakistan

National AIDS Control Programme Ministry of Health Government of Pakistan

Global, Regional and Pakistan Scenario

Global Scenario Number of people living with HIV/AIDS : 42 million Adults Women Children 38.6 million 19.2 million 3.2 million People newly infected with HIV : 5 million Adults 4.2 million Women 2 million Children 800,000 Deaths due to AIDS : 3.1 million Adults 2.5 million Women 1.2 million Children 610,000

Regional Scenario (Progression of the epidemic in South Asia) Low level :HIV <5% -any group/ any si te 198 6 199 0 Concentrated: HIV >5% in high ri sk group/ any si te Local ly generali zed :HIV >1% antenatal women/ any si te 199 4 199 9 U N AI D S/ 994 4 7 Octob er 1 999 Sour

> 4 million (people living with HIV/AIDS in South Asia) India 3,970,000 0.8% Pakistan 74,000 0.1% Nepal 34,000 0.5% Bangladesh 13,000 < 0.1% Sri Lanka 7,500 < 0.1% Bhutan < 100 < 0.1% Maldives < 100 0.1% (Source: STC, 2003 b)

Pakistan Window of opportunity

Pakistan Faces HIV Threat Regions HIV + AIDS Total Federal Centers 340 38 378 Punjab 398 43 441 Sindh 497 85 582 NWFP 352 53 405 Balochistan 180 12 192 AJK/ NA 18 04 22 TOTAL 1785 235 2020

Epidemiology (Age Distribution of 1785 HIV Carriers) 600 544 500 400 383 324 434 300 200 100 24 9 16 51 0 <4-5-14 15-19 20-29 30-39 40-49 >50 Don t Know

Epidemiology (Sex Distribution) 1800 1600 1548 1400 1200 1000 800 600 400 200 0 235 205 30 HIV Carrier (42:6) AIDS Cases (6:1) Male Female

Epidemiology (Modes of transmission) 800 700 600 500 400 300 200 100 0 745 608 287 56 34 25 25 MSM Het-Sex Blood Bi-Sex MTC IDUs Not Known

Impact of AIDS (affects people at their most productive age) 11-24 year olds 25-35 year olds 36-46 year olds (Source: UNAIDS, 2002)

High Poverty levels Low literacy rates Silence and denial Pakistani Scenario (Key Risk Factors ) Low spending on health and education High prevalence of risky behaviors Large number of internal and external migrants A high proportion of adolescents and young adults Gender inequalities

Poverty and AIDS (A Viscous cycle) Child removal from school Ignorance about HIV/AIDS Limited access to services Migrant labor Sexual exploitation Stigma/prejudice Infection/ Illness Loss of household earnings Increased costs

HIV/AIDS (A Developmental issue - Multi Sectoral Approach) Education labour Law Police Transport department Military Businesses Media

Global priorities MDG: Commitment to halt and begin to reverse the global spread of AIDS by 2015. UNGASS: By 2005, to ensure that at least 90% of young people aged 15-24 have access to information, education and services necessary to develop the life skills needed to reduce their vulnerability to HIV, and 95% by 2010 By 2005, implement measures to increase capacities of women and adolescent girls to protect themselves from the risk of HIV infection, principally through the provision of health care and health services, including sexual and reproductive health, and through prevention education that promotes gender equality within a culturally and gender sensitive framework

Enhanced HIV/AIDS Control Programme (2003-2008) 2008)

Scope 2003-2008 To be implemented simultaneously in all four provinces, AJK and Northern Areas Developed on evidence based information and scientific research

Goal Prevent HIV/AIDS from becoming established in vulnerable populations and spreading to the general adult population, while avoiding stigmatization of the vulnerable populations

Objectives Expansion of Interventions for Vulnerable Populations Improved HIV Prevention by General Public Prevention of HIV/STI transmission through transfusion of blood and blood products Capacity Building and Program Management

Expected Outputs <5% among any high risk group <1% among general adult population Blood safety and injection control Capacity building of both public & Private sector to combat HIV/AIDS

Challenges Low literacy Varying level of Provincial commitment Little experience of working with private and non-health sectors Lack of valid/ reliable epidemiological & behavioral data Accessibility to vulnerable and high risk groups Social & Cultural barriers Adolescent health - low priority Stigma, myths and misconceptions related to HIV/AIDS

HIV/AIDS Act now to STOP an epidemic in Pakistan