Urgent steps needed to tackle AIDS
While global HIV prevalence--the percentage of people living with HIV--has levelled off, the number of new infections has risen in the country. Recently Bangladesh has been reported as one of the five countries in the Asia-Pacific region where HIV/AIDS infections are rising. HIV in high-risk groups
There is concerning proof that HIV infection continues to increase rapidly among the high-risk groups specially injecting drug users (IDUs). And nobody knows the actual figure of HIV infection in general population as we have no survey on them. The continued focus on high-risk groups has created a false sense of security and complacency in the general population including policy makers. HIV has already turned into a concentrated epidemic (spread at a rate of 5 percent or more) among IDUs [7 percent]. The country has entered near to the epidemic more or less but is still considered as low prevalence states according to current statistics. This statistical jargon of 'low prevalence' does not have much meaning particularly when viewed against large absolute numbers in some of the neighbouring countries of the region. The daunting epidemic burden and momentum however may be masked by the large population leading to low reported prevalence. So it is imperative for the country to depict the actual portrait of the country with a stronger empirical data and contextualise the problems faced in regard to HIV/AIDS and view them in correct perspective. In order to keep the prevalence low, Bangladesh needs a strong and effective policy through legal frameworks, coordination and strong HIV prevention, better treatment and care. Yet much more remains to be done to achieve the goal of universal access. Global coverage of many of the key interventions against HIV/AIDS remains low, and the growth in the number of new infections and people in need of treatment continues to outpace the capacity of health services to respond. Our financial resources also fall short of what will be needed to achieve universal access, and the sustained political commitment needed to tackle AIDS over the long term is still lacking in the country. Meeting the needs of affected communities will require a comprehensive response that addresses both prevention and treatment simultaneously. Working towards universal access by 2010 to achieve standard in HIV prevention, treatment, care and support is a very ambitious challenge. AIDS programmes will have to be equitable, accessible, affordable, comprehensive and sustainable. In the efforts to achieve universal access, country must face huge challenges. Stigma and discrimination continue to impede prevention and treatment efforts. Among the most important priorities is the strengthening of health services so that they are able to provide a comprehensive range of HIV/AIDS services to all those who need them. Somewhere HIV prevention programmes are not reaching the people most at risk of infection, such as young people, women and girls, men who have sex with men, sex workers and their clients, injecting drug users, and ethnic and cultural minorities. Current HIV prevention works but needs to be focused and sustained. HIV testing and counseling
Over the past 20 years, voluntary counselling and testing programmes (VCT) have helped millions of people learn their HIV status, yet a very few people in high risk groups of our country know that they are infected. Efforts are urgently needed to increase the provision of HIV testing through a wider range of effective and safe options. HIV testing is a critical entry point to life-sustaining healthcare services for people living with HIV/AIDS and service delivery models need to be expanded to testing in antenatal care, sexually transmitted infection clinics, in-patient wards as well as free-standing client-initiated testing centres. Treatment and care
After the first detection of HIV positive case in the country in 1989, the treatment and care are still inadequate. An infected person faces many inequities and discrimination in treatment and care. These are the very people who keep themselves away from seeking treatment for stigma and thus fuelling the infection to the general population. We need to ensure that the infection does not spread from this source, in order to stop the internal transmission. The infected persons should be educated on how to take care of himself/herself. But these people unfortunately are not getting any treatment or cannot buy costly antiretroviral (ARV) drugs; sometimes do not get even proper food or a place to stay. We need to give urgent attention to this matter. In the early years of AIDS when it was seen as 'gay disease', Africa failed to gain attention of the global health agenda that west did. They recgnised when it took more lives than any other disease. Failure of timely recognition of African episodes of AIDS delayed the response of the countries to crisis, making it the most AIDS-burden region in the world. Let us not leave ourselves open to a similar fate. It is the high time to rethink seriously. Action must not only be increased dramatically, but must also be strategic, focused and sustainable.
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