‘Getting to zero’ policy on infectious diseases

.
Afia Islam Lopa :

Every 24 hours, 7,000 people are infected with HIV and more than 1 million contract a sexually transmitted infection (STI) worldwide. Currently, 33.3 million people are living with HIV, among them 23% of all people living with HIV are under age 24, while 35% of all new infections happen among people between 15 to 24 years of age. Clearly, the need for quality HIV, AIDS, and STI services is more important than ever considering its unabated spreading worldwide.
While HIV treatment is not available in the world but some limited health care support could be considered as a treatment of this infection but that is becoming more widely available in developed countries, such treatment still eludes many people living in the world's poorest communities.
Current health care systems in most of the developing world struggle to provide even the most basic health services. In these places, not only the medication often unavailable, but health care providers are also unavailable, and those are available as health care providers are not adequately trained to help the patients with HIV infection. They have questionable ability to play their role to prevent HIV or STIs or to treat or counsel patients living with HIV or AIDS. Certainly this should not be treated as the disqualification the service providers but should be treated as the limitation of the country's whole health system.
Therefore two types of facilities need to be emphasised to prevent the people from getting new infection and to confirm the diagnosis of the patients who already have got HIV infection. The awareness raising activities to build the capacities of the people is including the health care providers on how to prevent receiving or transmitting the virus and importance of making HIV testing should be a routine part of health care. The World AIDS DAY is an excellent opportunity to spread this slogan nationwide. With giving importance of this view the theme for this year's World AIDS Day is "Getting to Zero - Zero New HIV Infections. Zero Discrimination and Zero AIDS Related Deaths". This theme is backed by the United Nations "Getting to Zero" campaign and runs until 2015. It builds on last year's successful World AIDS Day "Light for Rights" initiative encompassing a range of vital issues identified by key affected populations.
The vision for this year's World AIDS Day and beyond may be aspirational but the journey towards its attainment is laid with concrete milestones. Ten goals are selected for 2015 with the HIV concern which is given below
Sexual transmission of HIV reduced by half, including among young people, men who have sex with men and transmission in the context of sex work;
Vertical transmission of HIV eliminated and AIDS-related maternal deaths reduced by half;
All new HIV infections prevented among people who use drugs.
Universal access to antiretroviral therapy for people living with HIV who are eligible for treatment;
TB deaths among people living with HIV reduced by half;
All people living with HIV and households affected by HIV are addressed in all national social protection strategies and have access to essential care and support.
Countries with punitive laws and practices around HIV transmission, sex work, drug use or homosexuality that block effective responses reduced by half ;
HIV-related restrictions on entry, stay and residence eliminated in half of the countries that have such restrictions;
HIV-specific needs of women and girls are addressed in at least half of all national HIV responses;
Although the HIV prevalence rate is still low in Bangladesh (The last surveillance conducted in 2007 found national prevalence of HIV < 1%), However, high prevalence of risk behaviors, including unprotected sex between sex workers and their clients, needle-sharing among injecting drug users (IDUs), and the exponential spread of the disease in neighboring countries put Bangladesh at high risk of an HIV epidemic. The first person was diagnosed as HIV-positive in Bangladesh in 1989. According to government sources, there were 363 reported cases of people who were HIV-positive as of December 2003. Of those, 12.3 per cent are adolescents and youth (aged 15-24) and 3.7 per cent are infants and children. And till December 2010, there were 2088 reported cases of HIV and 850 cases of AIDS, among them 241 died. However, it is believed that the actual number of cases is much higher.
In many developing countries poverty and gender discrimination are both strongly linked to the spread of HIV/AIDS.
The underlying causes of the epidemic include poverty, gender inequality and high mobility of the population, all of which are present in Bangladesh, a densely populated country with about 130 million inhabitants. Most people live in rural areas (76.6 per cent), but there is continuous migration to urban areas.
Emigration to other countries for employment is also very common, particularly amongst younger people, largely to the Middle East, followed by Singapore and Malaysia.
Percentage of most-at risk populations that have received an HIV test in Bangladesh are Female sex workers, Male sex workers, Hijra, MSM,IDU, Heroin smokers, Rickshaw pullers and Truckers.
The results of the 4th round of the National Serological Surveillance has shown an alarming increased in HIV rates among injection drug users (IDU) in central Bangladesh, where Dhaka, the capital, is located. In this group of people, prevalence has jumped from 1.7 per cent in 2002 to 4 per cent in 2003. This is just short of the 5 per cent mark required for a situation to be identified as a 'concentrated epidemic'.
The report, released on 25 June 2003

19 June, 2013 Wednesday

‘Getting to zero’ policy on infectious diseases