Sindh struggles with HIV amid defunct commission and rising cases
By Mukhtar Alam
KARACHI: As the World AIDS Day approaches on December 1, Sindh faces a critical challenge in its fight against HIV/AIDS with the Sindh AIDS Commission (SAC) remaining inactive, despite the province reporting 5,444 new HIV cases in 2023 and 2024 i.e., a 22% increase over two years.
The SAC’s
inactivity is said to be a violation of the Sindh HIV/AIDS Control Treatment
and Protection Act, 2013.
A former
government officer, who for long remained a key associate in the AIDS control
functionary, said: “The obvious official neglect and apathy has turned the
Commission into a dormant and forgotten organ and it was never allowed to enter
its infancy”. He apprehended that the non-functioning of the SAC can be
challenged in court of law by any NGO, lawyer or media person.
Studies
and interviews of the quarters concerned conducted by this reporter revealed
that the much emphasised statutory body (SAC), which was installed much behind
its stipulated schedule, was never taken seriously by the government or the
notified commissione for the prevention, control, care, support and treatment
of HIV and AIDS in Sindh.
The commission,
which was supposed to play vital role in containing HIV spread in the province
could not make any stride at all, despite the disease assuming epidemic
proportion, with different integrated behavioural surveys emphasising remedial
measures on a priority basis.
Primary modes of transmission
In the absence of any indigenous monitoring and policy devising unit and insignificant funding from the provincial government, the so-called HIV management in Sindh mostly relies on foreign technical hands and financial support at all levels including the service delivery factor, with a continued fear that the virus may have exceeded the largely satiating threshold of 0.1% among the general population in the province, commented a member of the SAC’s first working body, requesting not to be named.
SAC was
initially tasked with the functions like developing and implementing public
awareness programmes about HIV and AIDS; devising and implementing HIV and AIDS
policies; establishing rules for counselling, testing, care, and treatment for
vulnerable population; monitoring the Sindh AIDS Control Programme (now
defunct); and recommending changes to the programme based on data and
surveillance.
In
compliance with the Sindh HIV/AIDS Control Treatment and Protection Act,
2013 to ensure the functionality of the SAC, the Department of Health
re-notified the commission on September 6, 2019.
PMA concerns
Dr Abdul Ghafoor Shoro, Secretary General of the Pakistan Medical Association, termed the absence of the Sindh AIDS Commission a “serious lapse” in the province’s commitment to tackling the epidemic. “The association demands immediate action from the government to revive the commission to address the growing HIV/AIDS crisis, as well as auditing the funds allocated for AIDS containment, and government’s accountability for reported negligence in addressing health needs.”
The PMA
observed that the commission’s dormancy stems from expired tenures of
officials, lack of operationalisation, and statutory validity issues,
emphasising that SAC has got the crucial role in combating HIV in the province.
Dr Shoro
stressed that the commission’s guidance and policymaking expertise were essential
for coordinating efforts, allocating resources effectively, and ensuring a
comprehensive approach to HIV prevention, treatment, and care.
Expert insights
A member
of the SAC Working Body (2019) Dr Sharaf Ali Shah said the commission became
dormant after one meeting called in compliance with the orders of the Sindh
High Court.
Dr Irshad
H Kazmi, former Additional Director, CDC-HIV/AIDS, Sindh, attributed the
commission’s limited activity to deep-seated issues in its foundation and
governance. “From the outset, its creation appeared more driven by ‘optics over
outcomes’, a recurring approach in Sindh,” he remarked, adding that with only
two meetings in five years, SAC’s oversight has been nominal at best, raising
questions about its efficacy and relevance.
Dr Kazmi
further said that appointing commission members with potential conflict of
interest compromised the objectivity needed to combat HIV spread effectively.
“Further, expecting a high level of productivity from leadership aged 75-80 is
unrealistic given the evolving nature and pace of the public health landscape.”
He
emphasised that duplicating accountability by making the commission as an
additional layer for the CDC HIV/AIDS, which already answers to multiple
forums, diverts focus and resources.
Dr Kanwal Mustafa, Additional Director CDC-HIV/AIDS Sindh, attributed the delay in SAC’s functionality to Covid-19 pandemic protocols and lack of coordination and commitment among the relevant authorities. She emphasised the need for taking the Sindh AIDS Commission’s guidance and policymaking expertise to combat HIV/AIDS effectively.
“SAC’s
advice is very much needed by the Sindh Communicable Disease Control -HIV
(CDC-HIV) programme on all matters related to prevention, control and treatment
of HIV/AIDS and also to monitor the compliance of 2013 Act, and other powers
and functions that deemed necessary, particularly related to discrimination on
the basis of HIV status.”
About
SAC’s inactivity and follow-ups, Dr Mustafa said the commission established in
2019 held first and second meeting on September 16, 2019, and February 4, 2020,
respectively, adding that Covid’19 necessitated suspension of all activities
from 2020 to 2021.
“On December
07, 2021 CDC-HIV Sindh had also delivered a letter to SAC, requesting it to
convene a third meeting”, the Additional Director added.
Courtesy: Social Track, Karachi.
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