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Endeavour

The Ticking Time-Bomb
What are we doing about the HIV/AIDS threat in Bangladesh?

Selim Jahangir

From expert opinions and periodic survey reports of the National AIDS/STD programme of the government of Bangladesh, one can infer that the situation is quite serious and the facts deserve wider dissemination in our society.

It is often said euphemistically that Bangladesh is sitting on a HIV time bomb, which is ticking silently in our midst. Maybe it is ticking very slowly at the moment but no one knows what might go wrong and trigger an explosion someday, maybe not too far into the future.

HIV/AIDS experts have identified the tale-tell signs of the killer disease in many people in Bangladesh, and they are imparting the knowledge through many ways and words. We have to stop, listen, learn and take appropriate measures so that we can avert that explosion.

The other day a major newspaper of the country "Prothom Alo" exposed some scary facts on the basis of a latest survey report of the National AIDS/STD Programme.

According to the report, in the capital city about 10.5 percent of intravenous drug users are now afflicted with HIV/AIDS virus, which, in plain English would mean, among the 2000 drug users 200 are faced with the possibility of developing into AIDS patients in future.

Experts like Prof. Nazrul Islam have termed this, "Concentrated Epidemic" in a small area. Well, maybe it is concentrated in a small area but we are not feeling comfortable about it at all.

One research report of ICDDR,B says that the rate of infection of HIV among the IDUs across the country is less than 1 percent. In Dhaka the average HIV infection rate among IDUs is 7 percent. And the unnerving fact is, there are about 40,000 drug addicts in the country and many of them are turning to pushing drugs into the veins with injection syringe and needle used by many.

We have heard of the dangers but what is being done to prevent the spread of HIV among the people of the country? It appears that there are some ongoing HIV/AIDS prevention programmes in the country that claim to have attained success in creating wider awareness among the common people, especially among the vulnerable groups, about the life-threatening aspects of HIV/AIDS.

In the battle against the disease, the GoB agency called National AIDS/STD Programme (NASP) is in the forefront, which is currently implementing the action plan known as National Strategic Plan for HIV/AIDS, 2004-2010.

The programme is being funded by the Geneva-based Global Fund, launched in Bangladesh in 2004, through signing of an agreement between Save the Children-US and the Ministry of Health and Family Welfare (GoB).

This financial support has proved to be crucial in our fight against the spread of HIV and providing medical service and other assistance to those already infected.

According to NASP, in a phase-wise financing, Global Fund has provided required funds for the implementation of Round-2 (2004-2009) to prevent HIV infection among the young people of Bangladesh, and Round-6 (2007-2012) to provide service and assistance to the high-risk population and vulnerable young people in order to prevent and control spread of HIV and service to those already infected with HIV.

For the implementation of these two projects Save the Children-US is working as Management Agency with the government organisations, 61 NGOs (national and international), non-government organisations, private sector and research organisations.

Under the supervision of National AIDS/STD Programme, Size Estimation and Mapping of the IDU and road/hotel/house based sex workers have been conducted in 54 districts of the country. The aim is to provide relevant information and services to the 10,000 IDUs and 25,000 sex workers through 70 and 100 drop in centres respectively.

The Global Fund To Fight AIDS Tuberculosis and Malaria (GFATM) or Global Fund is an international endeavour was initiated in 2002 to battle the scourge of these three diseases. The objectives of Global Fund are to reduce poverty in the developing countries of the world through prevention and control of these diseases; and assist these countries in achieving the targets of the Millennium Development Goal- MDG-6: Combat HIV/AIDS, Malaria and other diseases.

The slogan "Bachtey Holey Jantey Hobey" to create awareness about HIV/AIDS has become quite a household slogan by now thanks to widespread media publicity carried out by the programme.

Since no treatment of AIDS has yet been discovered, prevention is the only way to avid HIV infection. And getting correct information is essential for taking such preventive measures. This rationale worked behind NASP approving the slogan "Bachtey Holey Jantey Hobey."

What is most interesting is that a full chapter on HIV/AIDS has been included in the curriculum of SSC and HSC (from class 6 to 12) to create awareness among the young generation.

According to NASP, this is for the first time in Asia that HIV/AIDS related messages have been included in the English and Bangla textbooks from class VI to class XII. This was possible because of the understanding among the Ministry of Education, directorates under this ministry, Ministry of Health.

Under this program, 44, 375 teachers of 8, 875 educational institutes were believed to have been given the required training.

Another interesting finding is that through holding 354 advocacy workshops in the country, relevant messages have been disseminated among about 15 thousand policy makers, religious and social leaders and guardians. A campaign is titled, "Religious Leaders and HIV/AIDS" is also underway.

This is possibly the most important component among all the intervention programmes. A national benchmark for youth-friendly health care services has been agreed upon by the Ministry of Health and Family Welfare, Directorate of Health, Directorate of Family Planning, National AIDS/STD Programme, Civil Surgeons, World Health Organisation and other experts to extend required services through 124 government, non-government and privately owned health care centres.

In order to collect information concerning young people, a new column following national MIS format has been included. It needs to be mentioned that Bangladesh is the fourth country where youth friendly health services are being provided through government, NGO and private health centres.

At the same time, a Life Skill Learning programme to prevent HIV/AIDS is being carried out for nearly 100,000 young people through the youth clubs/organisations and NGOs enlisted with the Directorate of Youth. This programme is being carried out through 124 clubs, organisations and NGOs. The programme would help the youth have comprehensive idea about the risks of HIV/AIDS and thus protect themselves. The programme is expected to be scaled up in phases.

This endeavour has been successful in several ways. The programme has been able to significantly increase awareness about AIDS and HIV among the people, whether they belong to the high-risk groups or not. At the same time, the stigma and discrimination associated with the HIV affected, has reduced significantly. Condom use has increased among the high-risk groups and the rate of infection of STD has reduced.

While the programme has been fairly effective, we must not be complacent and the task of letting people know what the risk factors are and what can be done to prevent infections plus what to do if infected, must be carried on with diligence and commitment.