HIV/AIDS
Towards universal access to prevention, treatment & care
December 1, 2009 was marked as the 21st anniversary of World AIDS Day. Together with its partners, the World AIDS Campaign set this year's theme for the Day as "Universal Access and Human Rights". Global leaders have pledged to work towards universal access to HIV/AIDS prevention, treatment and care, recognising these as fundamental human rights. Strong commitment, sustainable programmes and urgent action are crucial to augment the progress in access to HIV/AIDS services. The prevalence of HIV/AIDS has increased up to 7 percent among Injecting Drug Users (IDU) in parts of Dhaka city, which is termed concentrated epidemic. Although HIV prevalence is said low and it is less than 1% in other risk groups including sex workers, the risks involve in spreading HIV/AIDS are still very high. Despite dramatic developments in political commitment, funding and treatment provision, significant progress has not yet been made in prevention and eliminating stigma and discrimination. These are some major obstacles that hinder people to access HIV/AIDS services, especially Antiretroviral Treatment (ART). Even though injecting drug use is an important driving force behind the spread of HIV in Bangladesh; many of these people cannot access the services due to social stigma, lack of proper counselling, satisfactory rehabilitation programmes and their migrating nature. Again, sex workers cannot access proper services due to stigma, lack of condom use, risky sexual behaviour. There is an urgent need to increase coverage of targeted interventions such as 100 percent condom use for sex workers, needle–syringe exchange programmes and substitution therapy for IDUs. It has long been recognised that gaining the upper hand against AIDS epidemics around the world will require rapid and sustainable expansion in HIV prevention. Integrated prevention programmes with most at risk population (MARPs) like IDUs, female sex workers, men who have sex with men (MSM), vulnerable youth lead by Government can make a significant progress in fight against HIV/AIDS. The encouraging progress made in expanding access to treatment has not yet been properly matched with a parallel scale up of prevention. This is very crucial to ensure long-term success against the epidemic and the sustainability of treatment programmes. The health sector must play a much more effective role in HIV prevention, especially in expanding HIV testing and counselling, offering prevention services to people living with HIV/AIDS. Unless the gap in prevention, treatment and care is reduced rapidly, the epidemic will cause an irrevocable social and economic havoc in the region. Scaling-up of the HIV/AIDS strategy in the region involves developing a comprehensive response to HIV/AIDS as well as addressing the need to expand coverage geographically to reach more people. It also focuses on increasing coverage to different population types, improving the quality and scope of services, and ensuring that the involved systems are accountable. The ultimate goal is to guarantee the delivery of a comprehensive intervention and programme to reduce the transmission of HIV/AIDS and lessen its impact on individuals and societies. Established public private partnership for high quality prevention, care and support services intended for responding the HIV epidemic throughout the country. Many non-government entities are engaged in implementation of project activities in collaboration with national AIDS/STI programme. However, low prevalence rate indicates that prevention is possible and has worked. So, based on our experiences and lessons learnt, priorities in programmes would be continued to focus on most vulnerable and un-served key populations at full coverage with evidence base approaches. We hope to see that Bangladesh will make a significannt difference in halting the HIV epidemic through standard prevention model. For this, we need to implement effective, sustainable and strong comprehensive action plans for protecting the nation from HIV/AIDS. The writer is a development professional working on HIV/AIDS. E-mail: azampop@yahoo.com
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