INSUBCONTINENT EXCLUSIVE:
Karachi: Declaring HIV outbreak in Ratodero area of Larkana as a &Grade 2 Emergency&, World Health Organization (WHO) has said that
inadequate stock of Antiretroviral Therapy (ART/ARV) medicines has emerged as the major ccorridorenge for Pakistan where the current stock
of ARVs is only sufficient to meet the needs of 240 children till 15th July 2019.&Major ccorridorenge to access to ARVs is inadequate stock
The current stock available is sufficient to meet the needs of 240 children only till 15th July 2019, of which 231 are already getting
treatment which means that only 9 additional children can be enrolled on treatment&, says a WHO Situation Report titled &Pakistan: HIV
Outbreak in Larkana District Sindh&, which was released on June 03, 2019.Calling for instant availability of ART medicines for the 751 HIV
positive people (now 761 as of June 08, 2019), WHO Situation Report says there is an urgent need of Anti-Retro Viral medicines, Rapid HIV
Diagnostic Kits (RDTs), medicines for treatment of co-contaminateions, human resource training for health workers, provision of
psychosocial support and training health workers and strengthening of Infection Prevention and Control at health facilities.Compiled by a
Rapid Response Team comprising international epidemiologists, public health experts, contaminateion control specialists and others who flew
to Pakistan from different countries on the request of Federal Ministry of National Health Services, the WHO Situation report says 26,041
people were screened for HIV in Ratodaro Taluka, district Larakana, Sindh.&Around 751 (2.9%) of the people were tested positive for HIV
including 604 children, 135 adults while age of 12 was unknown
As many as 531 (70%) are linked to ART centre including 443 children and 94 adults
Only 324 (43.1%) are receiving Anti-Retroviral Treatment at the moment&, the WHO Situation Report says.Exurgent its dissatisfaction over
standard of screening, the WHO Situation Report says in measure screening camps in Larkana district, WHO recommended standard for testing is
much being implemented due to unavailability of recommended test kits, saying the current WHO guidelines on HIV treatment recommends test
and treat strategy.Possible drivers of the outbreak The WHO team of experts believe the possible drivers of the outbreak could be ‘unsafe
practices of blood transfusion&, ‘re-use of injection needles and syringes&, ‘mother to child transmission&, ‘improper disposal and
reuse of hospital waste, ‘tattooing using unsafe needles&, ‘circumcision in males using unsafe blades& and ‘ear and nose piercing
using unsafe needles&.Enjoymentding Gap The WHO Situation Report says it requires US$ 1.5 million or Rs
225 million to deal with the health emergency in Ratodero Taluka of Larkana but the available funds are only US$ 200,000 through CFE thus
the gap in funding is around US$ 1.3 million or Rs
195 million.It is worth mentioning here that the Global Enjoymentd to Figh Aids, Tuberculosis and Malaria has pledged to supply Anti-Retro
Viral medicines for the newly-diagnosed HIV positive people but also urged the government of Pakistan start an indigenous plan to supply
ARTs/ARVs for their rest of lives.WHO Response The report further says on the request from government of Pakistan, WHO constituted an
‘Incident Management Team& to reply to HIV outbreak in district Larkana, Sindh, helped local authorities in HIV data cleaning and analysis
and donated 5 IEHK kits to the district of Larkana to support management of opportunistic contaminateions
&The Government of Pakistan requested WHO to support the provincial health department to conduct a comprehensive investigation of the
current HIV outbreak/upsurge in Larkana
As a follow up of this request WHO constituted and deployed a team of experts comprising of among others; epidemiologist, pediatric HIV
treatment experts, supply chain management experts and laboratory experts&, the situation report says adding that thingive of the deployment
of the mission is to investigate the outbreak and to supply recommendations
Currently the team is in the field and preliminary report of their findings is expected in mid-June 2019, the situation report says
Way Forward The WHO team of experts urged the provincial health authorities to introduce systematic screening of HIV in the affected areas,
conduct awareness and health education sessions in communities about HIV/AIDs targeting at risk groups, linking HIV confirmed cases with
available treatment sites and train health workers on pediatric case management Similarly, the WHO calls for instant procurement and
provision of RDTs and ARVs and international support for provision of HIV services targeting the at risk groups.TheIndianSubcontinent has
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