Minister of State for National Health Services, Regulation and Coordination Dr Zafar Mirza has said that a 10-member team comprising World Health Organisation's (WHO) technical and professional experts would visit Pakistan to investigate the outbreak of HIV in affected area of district Larkana of Sindh.
Addressing a press conference here on Sunday, he said that the federal government contacted the WHO Headquarters and asked for their technical and professional support to investigate Larkana HIV outbreak.
The minister said that on the request of the government, a WHO high-level mission was coming to the affected area. He said that the international team was made to exactly reviewing the situation and ascertain the cause, advise on mitigation measures and ways and means of avoiding future recurrence.
"A total of 21,375 people had been screened so far, out of which 681 people had been identified as HIV positive with case detection rate of 3.2%. Most striking feature of this outbreak was the fact that children between the ages of 2-5 years were most infected followed by age group 6-15 years, he said.
He said the federal government had assured the Sindh government for federal ministry's support in provision of HIV test kits, diagnostics, living support and establishing three more treatment centres at Mirpur Khas, Nawab Shah and Hyderabad.
He said that the Federal Ministry on his advice started communication with various United Nations (UN) agencies for a proper follow up and support to this outbreak and accordingly a high-level meeting was convened here with all UN agencies, Civil Society Organizations and Sindh AIDS Control program (SACP) to deliberate upon the outbreak situation in Ratodero and coordinate a joint response.
The minister said that National AIDS Control Programme (NACP) supported the provincial programme in the areas of blood screening and HIV treatment. He said that the NACP is also providing assistance and support in specialised HIV investigations like CD4 (Lymphocyte) count and viral load testing by providing additional supplies and CD4 machines to Larkana.
He said that the NACP had supported the establishment of a Paediatric ART centre at Larkana by providing all reporting tools and HR (Data entry operator) in addition to the existing HIV treatment centre (adult) at Chandka Medical College Hospital.
The minister said that NACP technical team was sent to Larkana to coordinate with SACP in outbreak response investigation and management. He said that NACP was mobilising UN Partners included WHO, UINCEF and UNAIDS, besides Global Fund, to effectively address and halt the outbreak.
Dr Zafar said he also visited the Adult ART centre Larkana, where the HIV patients are being provided diagnostic and treatment facilities for the last so many years with the support of National AIDS Control Programme.
He said that he also visited the paediatric ART centre Chandka Medical College, newly established soon after this outbreak with the support of NACP and other partners.
"Unfortunately the high numbers of children between the ages of 2-5 years were reported in this outbreak," he said. The minister said he visited the HIV screening camps in Ratodero along with experts' team where he remained for a time to see the affected children and their families.
Dr Zafar assured that the federal government under the leadership of Prime Minister Imran Khan is on top of the situation in Ratodero. "We will not relent till we get to the bottom of this outbreak, provide treatment to each victim, help the Sindh health department and put in place a system to avoid such unfortunate occurrences in the future," he said.
The minister said that the team of experts while in field started HIV screening on one hand along with SACP and also held counselling sessions with HIV affected communities to ascertain the immediate cause of spread of HIV and to allay the fear and panic spread in the communities.
He said that with time large number of people turned to screening camps to get themselves and their children tested for HIV. The peculiar feature of this outbreak was the identification of very high number of children affected by this disease.
He said that an HIV outbreak was reported, by the local media, in Ratodero Taluka, district Larkana on April 25, 2019 as 15 children with complaints of persistent weight loss and fever, had been tested positive for HIV by a local physician in Ratodero.
"Blood samples of these 15 children were later sent to a referral laboratory of the SACP and as per the report shared by SACP, three of 15 cases were confirmed by Rapid Diagnostic Test on the first day." he said.
"On my direction, the NACP immediately responded to a request made by SACP to send a team to join the response and help in providing HIV screening kits. The national programme immediately sent 3000 HIV test kits to Ratodero," the minister said.
Over 600 people test HIV positive in Larkana Meanwhiel special health advisor Zafar Mirza said on Sunday over 600 people, most of them children, had tested HIV positive in a city in Larkana.
Concern grew after hundreds of people were allegedly infected by a doctor using a contaminated syringe in Rato Dero city and surrounding villages of Larkana district.
"Some 681 people, of which 537 were children from two to 12 years of age, had been tested positive for HIV until yesterday in Rato Dero," Zafar Mirza told a press conference in Islamabad.
He said 21,375 people had been screened in Rato Dero, adding that the increase in the number of patients testing positive for HIV was "a matter of grave concern" for the government. One cause being investigated by Pakistani authorities is the use of "unsafe syringes" on patients.
Mirza said: "Initial investigations reveal that used syringes are being re-packed, which may not only grow significantly the number of HIV cases but also other diseases."
The federal government is providing 50,000 HIV screening kits to Sindh. 'Drastic measures' Provincial health officials have also noted that patients are at particular risk of contracting diseases or viruses at these clinics, where injections are often pushed as a primary treatment option.
"The government will get to the bottom of the outbreak and fully assist the provincial government to provide treatment to all patients," Mirza said, adding that a team of experts from the World Health Organization was also scheduled to arrive soon to assist Pakistani authorities in ascertaining the cause of the HIV virus in the area.
"Prime Minister Imran Khan is going to unveil drastic measures to prevent the disease once we ascertain the cause of the spread of disease," he said.
Parents in the area fear their children's futures have been irreparably harmed after contracting HIV, especially in a country whose masses of rural poor have little understanding of the disease or access to treatment. Nisar Ahmed, the father of one of the affected baby girls aged just one, told AFP: "We are told to go to Larkana for medicine. I curse the doctor who has spread this disease to every child.
"Four of the children of my village have already been diagnosed HIV positive."
Pakistan was long considered a low prevalence country for HIV, but the disease is expanding at an alarming rate, particularly among intravenous drug users and sex workers.
With about 20,000 new HIV infections reported in 2017 alone, Pakistan currently has the second fastest growing HIV rates across Asia, according to the UN.
"According to some government reports, around 600,000 quack doctors are operating across the country and around 270,000 are practising in the province of Sindh," according to UNAIDS. Pakistan's surging population also suffers the additional burden of having insufficient access to quality healthcare following decades of under-investment by the state, leaving impoverished, rural communities especially vulnerable to unqualified medical practitioners.
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