[Reader-list] Dose of Vigilance Helps Manage HIV, AIDS

[Shashidhar]

An interesting piece on the spread of HIV, AIDS in Bangladesh, someone from
Bangla should verify this data.. frankly 1745 cases in 20 years speaks of
either great efforts at combating the spread or of extremely poor
surveillance and services.

Entire article can be found on 

http://ipsnews.net/news.asp?idnews=53443

Dose of Vigilance Helps Manage HIV, AIDS
By Naimul Haq


DHAKA, Nov 3, 2010 (IPS) - It is one of the poorest countries in the world,
has a low literacy rate, and is next door to at least two countries that
have a considerable portion of their respective populations with HIV and
AIDS. Yet even having a large migrant population has not made Bangladesh a
hot spot for HIV and AIDS.

"Indeed, there is a host of factors that render the country highly
vulnerable to a surge in HIV (cases)," says Muhammad Abdur Rahman, head of
the National HIV/AIDS and STD (sexually transmitted diseases) Programme
(NASP). 

"But," he continues, "I think the government’s decision from the beginning
to act as a catalyst and recognise NGOs (non-government organisations) that
have real capacities to implement HIV and AIDS programmes were the key to
(its) success." 

Official data show that since the country had its first HIV case on record
in 1989, it now has some 1,745. Including unreported cases, the real figure
is estimated to be a relatively low 7,500. Overall, HIV prevalence rate in
Bangladesh, a country of more than 164 million people, is less than one
percent. 

By comparison, neighbouring India has 2.31 million people living with the
virus, while Burma, which has a part bordering Bangladesh, has 240,000. 

Experts agree that unlike its neighbours that did not pay close attention to
HIV and AIDS until it had become a major burden, Bangladesh recognised it
early and acted immediately to limit its spread. 

Indeed, the public and private sectors have been coordinating for decades to
establish strong prevention networks. 

"There are many partners that supplement the state’s responsibilities and
they acted early, particularly working with the groups
who engage in risky
behaviour," says Habiba Akter, executive director of the Ashar Alo Society,
a leading group working on HIV and AIDS issues. "(This) is why Bangladesh
still enjoys low HIV prevalence today." 

Rahman cites the importance of having the South Asian country’s print and
electronic media as "major partners in building awareness" about the
disease. The government has also made it a point to raise awareness and
knowledge about HIV and AIDS among the youth, making it mandatory for
secondary schools to include informal education about it. 

Comments journalist Mustafiz Shafi, also an HIV and AIDS activist: "There is
a general awareness about (the illness) among the population, especially
among the (youth) who are most vulnerable to HIV transmission." 

In addition, populations that are considered having behaviour most at risk –
such as injecting drug users and sex workers and their clients – are closely
monitored. And, says Rahman, "We have a very good system of reporting any
sickness, especially in garments factories and other similar factories where
young people work." 

"There are designated clinics where sick people can seek free treatment or
testing if reported ill," he adds. "All such sub-clinics are advised to send
information on any signs of risky behaviour and advise (people showing these
signs) to volunteer for HIV testing." 

"The government has a very strong monitoring and evaluation cell on HIV and
AIDS across the country," affirms Rahman. "We have been relying on such
strategies to fill any gap so that interventions are not missed." 

An important component to the country’s HIV and AIDS monitoring system is
the network of some 150 NGOs that coordinate and report regularly on newly
detected cases to the central data storing centre here in the capital. 

This system also helps people who are diagnosed with the disease find the
nearest organisation that would be able to give them advice and whatever
else they may need. 

"It was like being in mother’s lap," says a street vendor here who was
introduced to Ashar Alo shortly after he found out he has HIV. "The first
few sessions of counselling, peer education, and advocacy on positive living
were very helpful as I was almost lost." 

The Athar Alo Society was among the first NGOs in Bangladesh to establish
strong HIV and AIDS advocacy programmes across the country. Among others, it
works for rights-based support for people living with HIV and AIDS,
including social security. 

Still, NGOs and the government alike know that they cannot be complacent
despite their continued success against the virus. 

The street vendor working with Athar Alo is one reminder that they need to
remain vigilant. Poor and illiterate, the vendor was also an injecting drug
user. In the last national serological and behavioural surveillance done in
2007, injecting drug users in Dhaka were found to have an HIV prevalence
rate of seven percent, up from 1.4 percent in 2000. 

And while people from all walks of life in Bangladesh have heard of HIV and
AIDS, misconceptions persist about it. 

Thirty-five-year-old vegetable shopkeeper Mohammad Saidullah, says, "I think
a person (with) the virus should stay indoors as she or he may transmit it
coming in contact with others." 

"It is better to stay away from people carrying the virus," a 24-year-old
homemaker also says. "If you touch their sweat or drink from the same glass,
you may get the virus." 

Tasnim Azim of the International Health Research Institute points out as
well that people living with HIV and AIDS in Bangladesh are often at risk of
being denied the medical care they need. 

"(They) desperately need accessible and reliable clinical care," she says.
"At present, clinicians and hospitals are not open to providing services
especially if they require surgical care – even if it is minor surgery."
(END)