LARKANA:The former Provincial Program Manager, Sindh AIDS Control Program (SACP), Prof Dr Syed Sharaf Ali Shah, has said while talking exclusively to this Scribe from San Francisco on Sunday that HIV outbreak in Larkana was not unexpected and similar outbreaks can occur in other cities of Sindh even in other cities of other provinces. He said main cause of this outbreak is weaknesses in our health care system both in public and private sectors which need to be addressed on urgent basis.
He said government has complicated the whole issue, it has been mishandled and things are getting further complicated day by day.
He said he recommend some actions for Government to be taken forthwith which include (1) To stop HIV screening camps immediately as they will not serve any purpose rather will complicate the whole issue and create new problems, Why, because HIV counseling and testing is not a one time activity and it is not done in camps even in outbreak situation. (2) HIV testing requires privacy and confidentiality. (3) It is very necessary to link all identified HIV positive cases to care and support, therefore, you have to make all arrangements of treatment before testing a large number of people for HIV.
(4) HIV testing in camps will create panic and chaos. He further suggested what HIV testing strategy should be adopted: (a) Establish Voluntary HIV counseling testing Centers where ever necessary. They are already working at some places in the province, they just have to increase the number on urgent basis which is easily doable. He said you just need to train a paramedic or nurse in Pretest and Post-test counseling and HIV testing on rapid kits. (b) Engage General Practitioners of area train them in risk assessment for HIV and ask them to refer their clients who need HIV testing to HIV testing centers (care provider initiated HIV testing).
Train them on infection control practices and injection safety. (c) Strengthen all pediatric departments and medical departments at Districts Head Quarter and Teaching Hospital levels to provide ART treatment. Major weaknesses in health care system need to be addressed immediately (1) Postings particularly in vertical programs should be on merit (2) Allocate and release funds for HIV prevention and other projects (3) Usually funds are not released if released the releases are not timely. (3) Private health care system is totally unregulated for which Health Care Commission must be made fully functional and (4) Increase awareness of general public.
Prof. Dr. Sharaf Ali Shah is currently working as professor of Public Health at DIHE Karachi and Executive Director, Bridge Consultants Foundation.