‘Causes of HIV outbreak not confined to Larkana alone’

KARACHI: An international team of experts who investigated the HIV outbreak in Ratodero, Larkana on Friday said the malpractices that led to the spread of HIV among children and adults are widespread in entire Pakistan and warned that if immediate measures are not taken, such outbreaks could be reported from other parts of the country.

“Unsafe injection practices including reuse of needles and intravenous drips and poor infection control at healthcare facilities have emerged as the leading cause of HIV outbreak in Larkana but these malpractices are not limited to Ratodero or the districts of Sindh province only. These malpractices by the quacks and the doctors are widespread in entire Pakistan and can lead to more such outbreaks in the country if not eliminated”, said Dr. Oliver Morgan, leader of an international team of experts and epidemiologists invited by Pakistan to investigate the HIV outbreak. The international team of experts from World Health Organization (WHO), Center for Disease Control (CDC) Atlanta United States and some other UN agencies on Friday gave a detailed presentation to the federal and health authorities in Karachi. Dr. Oliver Morgan recommended “as poor infection control and unsafe injection practices are quite common, testing facilities for the HIV as well as Hepatitis B and C should be provided at every health facility in the country.”

The UNAIDS Regional Director for Asia and Pacific, Emmonn Murphy, said as reuse of injections and intravenous drips has emerged as the major source of HIV transmission, it is imperative to educate people that they do not need injections and intravenous drips everytime they visit the healthcare providers as they could use oral medicines.

He, however, called for educating people and healthcare providers on infection control practices and added the HIV is now a treatable disease if the infected people take Anti-Retroviral Therapy (ARTs) medicines regularly, saying they could live normal lives with the help of ARTs and psychosocial support.

Health Advisor to the Prime Minister Dr. Zafar Mirza on Friday said the HIV outbreak in Ratodero must not be politicized and be taken as a wake-up call for the entire country. Addressing a joint press conference, along with Sindh Health Minister, Dr. Azra Pechuho, WHO official Dr. Oliver Morgan and UNAIDS' Dr. Eamonn Murphy, he said underlying causes of all blood-borne infections including HIV as well as Hepatitis B and C are not restricted to Sindh but are similar across the country. This, he said equally holds true for all communicable diseases and needs concerted efforts to avert situation turning into emergency with major focus on prevention.

Dr. Mirza on behalf of Prime Minister Imran Khan said the federal government stands by with the people of Sindh and is committed to assist provincial authorities in addressing the challenge. Reiterating that federal government would provide Sindh all needed support and assistance to address the health challenges, he said currently there is need for pediatric solution of ARV medicines for children inflicted with HIV. “Assistance or support needed in terms of diagnostics, in particular context of screening kits, and treatment would be duly facilitated by the federal government, Dr. Zafar Mirza pledged.

Referring to the findings of the international team of experts about causes of HIV in Ratodero, he said the hypothesis has reconfirmed the initial observation attributing the outbreak to reused syringes and infected needles.

This, the health advisor said demanded regulatory intervention, administrative measures to streamline therapeutic approach coupled with behavioral changes at community level.

“Sindh Health Minister has just shared with you the steps taken in the province and we hope this would work,” he commented. Mirza said provincial health care commissions should work coherently and in a coordinated manner. In reply to a question, he said many of the pharmaceutical companies in the country producing anti viral drugs are expected to be capable enough to come forward with ARV preparations following needed modifications.

Sindh Health Minister, Dr. Azra Pechuho explained the steps taken by the provincial government to address the challenge encompassing strengthening and activation of provincial health commission to address the menace of quackery and reported misuse of licenses issued to qualified medical practitioners.

The capacity building of Sindh Safe Blood Transfusion Authority and Drug Regulatory Authority coupled with strict vigilance to ensure safe disposal of hospital waste are said to be among other essential components of the efforts. Regular awareness cum training session for doctors, nurses and paramedics is said to be also part of the envisaged endeavor and that this is already initiated in Larkana and Karachi with other districts to follow soon.