13 years on, active Sindh AIDS Commission still not in sight
By Mukhtar Alam
KARACHI: Thirteen years after the Sindh AIDS Control and
Prevention Act, 2013 was passed, the province still does not have an active
institution to implement it.
The Act provided for a Sindh AIDS Commission (SAC) as the apex
body for policy, surveillance, and public reporting. The first Commission was
notified but met only once. Its three-year tenure expired without further
meetings. Since then, the health department has not notified a new composition.
The result is visible on the ground. There is no single authority
to collect HIV case information, verify outbreaks, or release periodic
situation reports. Hospitals maintain internal records. NGOs share field
observations. Media and experts quote “sources”. The public gets fragments, not
a provincial picture, according to health circles.
Health professionals say this gap is now affecting both tracking
and treatment. Without owned data and a coordination body, outbreaks are
detected late and prevention remains reactive. In districts where pediatric
clusters have been reported, the absence of a central reporting mechanism has made
it harder to identify sources and prevent further transmission.
Sources in the Sindh CDC-HIV note that the Commission has had no
practical efficacy since 2020-21. In its absence, provincial management on HIV
has come to rely heavily on foreign technical support and donor funding at all
levels.
As concern grows over recurring HIV outbreaks in Sindh, leading
public health experts have called for urgent reforms. They say the absence of
oversight and delayed data sharing are the main reasons the province’s response
continues to fall short.
Experts’ Panel: Revive SAC to Control HIV Spread in Sindh
Prof Dr M Rafiq Khanani, President of the Infection Control
Society of Pakistan, said the province’s response is suffering from deep
structural flaws that begin at the policy level.
He pointed to the Sindh AIDS Commission as a case of institutional
inactivity. “The Commission held only one meeting. Its three-year tenure
expired without any further meetings,” he said. He noted that the earlier Sindh
AIDS Control Programme had been working effectively with international donors,
NGOs, CBOs and the World Bank. “Replacing its role with the Sindh CDC-HIV has
made things worse,” he added.
According to Dr Khanani, recent programme assessments continue to
highlight the same recurring problems: fragmented governance, weak coordination
between national and provincial programmes, inadequate data integration,
outdated prevalence figures, limited impact of testing and prevention
campaigns, insufficient antiretroviral treatment coverage, and high treatment
drop-out rates.
A central concern, he said, is the absence of timely and public
data. “The whole point of an ordinance is that as soon as data is generated, it
should be made public. The government does ask us for data, but there is no
meaningful follow-up. Aggregate data is not shared openly or on time. This is
how HIV and hepatitis keep spreading,” he said.
He described the current system as “one-way traffic.” In his view,
as soon as hospitals, laboratories, field institutions or NGOs submit data, the
government should announce it — without revealing patient identity or location.
That information should then be shared with assigned officials and service
providers in the affected area so they can protect, educate and safeguard
communities.
Dr Khanani stressed that public and private institutions must work
together, on the same platform, to record infection and treatment trends in
real time and place them in the public domain. Only then can experts, NGOs and
other stakeholders coordinate effectively.
He called for district-level coordination that brings together
public health, laboratories, ART services, infection control, maternal health,
blood transfusion services, community organisations and healthcare regulators.
“Provincial and district systems need to know where undiagnosed infections are
concentrated, where new cases are emerging, and whether transmission is linked
to specific communities or healthcare settings,” he said.
He reiterated his long-standing demand that policies be developed
under a revived Sindh Health Commission, empowered to function under the
relevant Act of the Sindh government.
Prof Farhat Jafri, Director at the Pakistan Institute of Living
& Learning, said the Commission’s absence is being felt most acutely on the
ground as HIV outbreaks rise.
“The SAC was established under law to oversee HIV prevention,
treatment and policy. But it has been non-functional for a long period,
creating a vacuum that has left prevention and treatment systems without
direction,” he noted.
He added that essential services including testing, counselling,
treatment access and data collection are currently operating without proper
oversight. Urging immediate action, he called on the Sindh government to notify
and operationalise the Commission without delay. “This is not just an
administrative delay, it is a matter of lives,” he said. “In the face of
increasing HIV cases, the government’s indifference is glaring.”
A senior physician and former head of the province’s central
HIV/AIDS control initiatives, who requested anonymity, said HIV/AIDS remains a serious
public health challenge in Sindh, increasingly affecting both adults and
children.
“The rising number of cases is a matter of grave concern and calls
for immediate, coordinated and sustained action by the departments responsible
for prevention, control, diagnosis and treatment,” he said.
He noted that current response mechanisms are inadequate.
Preventive measures are not being implemented effectively. There is
insufficient awareness and screening, and clear weaknesses in monitoring and
follow-up of patients and high-risk populations.
“HIV/AIDS cannot be controlled through treatment alone,” he
stressed. “It requires strong prevention, surveillance, community awareness,
hospital monitoring, regulation of healthcare providers, and accountability of
the concerned departments. Sindh urgently needs a comprehensive,
result-oriented strategy to prevent further transmission and protect both
adults and children.”
On the Sindh AIDS Commission, he said its legal mandate is to
regularly advise the government on HIV prevention and control, develop policy,
launch awareness programmes, and plan welfare measures for affected
individuals, especially women and children. “That role is being badly missed
because the Commission is non-functional,” he added.
(Originally published by Social
Track, Karachi)
Photos: Official sources
Illustration: AI-generated
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