Daily Times

Ten years ago, the Journal of Pakistan Medical Association warned that the issue of HIV and AIDS was no longer a health issue but one of security. Especially given that Pakistan found itself in a high-risk neighbourhood. Back then, only Iran was low-risk, which may or may not be the case presently.

Fast-forward to today and one thing is clear: this is a security challenge that cannot be crushed by bombs and bullets. Or, indeed, US drones.

As global cases of HIV and AIDS decline — Pakistan remains one of the few countries that is bucking this trend. With as many as 130,000 people suffering from HIV in Pakistan, 42,000 of which — the highest number for any city — are in Karachi.

Reasons for this are varied. First of all, the port city has the highest population of prison inmates nationwide and the highest number of female sex workers as well; two groups said to be highly susceptible to HIV. Karachi also plays host to thousands of workers who migrate to the city to purse the urbanisation dream of necessity. Lack of economic opportunity often sees this group turn to intravenous drugs to numb the nightmare. These Injecting Drug Users (IDU) account for the highest increase in HIV cases in Pakistan. And then there is the matter of low levels of condom use. Not forgetting, too, limited safeguards when it comes to blood transfusions.

The city’s struggle with HIV may be termed a political battle. For decades, Pakistan’s largest city has been the playground of different power groups, whose only focus has been moneymaking and increasing turf power. Thus has Karachi gone from being known as a city by the sea to one wracked with lawlessness, violence and shocking income disparity. Coupled with this is the fact that it only has three treatment centres for HIV.

Not to be underestimated is the stigma surrounding infected patients. Women especially face allegations of bringing the disease upon themselves due to real or perceived ‘promiscuity’. A better response to this would be investment in sexual health education. Additionally, a concerted and co-ordinated awareness campaign is needed. This would dispel many myths about the infection and also inform future behavioural patterns. Something as innocuous as ear piercing can prove risky in the absence of sterilised needles, for example. That being said, a back-to-basics approach is required: investment in poverty alleviation programmes and functional literacy, both at the child and adult levels. This is where the media and civil society also have a role to play. Both must be at the vanguard of a campaign educating people on how to fight and prevent infection.

It is a matter of national security, after all.  *

Published in Daily Times, July 20th, 2017.