Ashfaq Yusufzai
PESHAWAR, Pakistan, Dec 7 2010 (IPS) – After testing positive for HIV, which caused him to be deported from the United Arab Emirates, Nazarullah probably found little reason to feel fortunate.
But the 28-year-old calls lucky the day he learned that Pakistan s 13 Antiretroviral Treatment (ART) Centres were opening their doors to Afghans with the AIDS-causing virus, and treating them for free.
I heard from a neighbour about free treatment and came here the very next day, says Nazarullah, who had been brooding in his Afghan home province, Jalalabad.
Nazarullah is only one of many Afghans with HIV/AIDS who have been crossing the border since October, when Pakistan agreed to have its ART centres treat without charge its next-door neighbour s citizens who have the illness.
Brokered by the Joint United Nations Programme on HIV/AIDS (UNAIDS), which will also foot the cost incurred, the programme is supposed to span three years.
The news about it has already caused joy among the HIV- infected patients in Afghanistan, says Dr Abdul Hakim of Afghanistan s National AIDS Control Programme (NACP). He says that about 70 Afghans 48 men, 18 women, and four children are currently receiving treatment here in Peshawar.
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The agreement is a blessing for the Afghan HIV patients because they would receive free treatment that would also do away with taboos and trauma associated with the disease in their country, says Oussama Tawil, UNAIDS country representative for Pakistan and Afghanistan.
In addition, he says, linkages would be established between the two neighbouring countries to take joint measures for prevention, treatment, care, and support for the patients across the borders .
Tawil says that a joint strategy to deal with HIV/AIDS has long been considered as appropriate for the two countries, which share a porous 2,400-kilometre border. Pakistan and Afghanistan also have socio-cultural ties that have helped lead to similar problems regarding their citizens with HIV/AIDS.
The profile of the epidemic in both countries is almost comparable, observes the UNAIDS representative.
Both countries, for instance, have a significant injecting-drug-user (IDU) population, which is considered to be among the sectors of society most at risk of contracting HIV. Up until 2009, in fact, Afghanistan was considered a low-prevalence epidemic country for HIV/AIDS, according to the latest UNAIDS report on the country.
But then 7.1-percent average sero-prevalence rate was noted among IDUs there, indicating that Afghanistan was entering into a concentrated HIV epidemic .
Afghanistan faces a high risk of an HIV epidemic, says Dr Naveeda Shabbir of the NACP of Pakistan.
She says this is because of almost three decades of protracted armed conflicts, huge numbers of people displaced internally and externally, poor economy, open borders, poppy cultivation and use of injecting drugs, and lack of blood safety and injection practices.
Pakistan, meanwhile, already had about 97,400 people with HIV/AIDS as of 2009, according to UNAIDS. About 21 percent of Pakistan s IDUs are estimated to have HIV.
We want both countries to adopt effective approaches and methods of implementing programmes in HIV, including ART, prevention of parent-to-child transmission (PPTCT), outreach for at-risk populations, community empowerment for HIV patients, and involvement of religious leaders to cope with the pandemic, which kills three million worldwide annually, says Tawil.
The free treatment for Afghans in Pakistan s ART centres is a good start for all these. Hakim also points out that such medical cooperation is not new to both nations.
Both terrorism-hit countries have already been cooperating with one another to wipe out the crippling ailment poliomyelitis, he says. But he concedes, Cooperation in the area of HIV/AIDS would prove (significant) as there is no facility in Afghanistan to treat HIV patients.
For Jamila, 33, the offer of free treatment has come just in time. A resident of Afghanistan s Herat province, she says she already had a high temperature and abdominal pain when she learned about Pakistan s offer.
My husband who died three years ago (infected me), she says. When I (heard) about the free treatment, I rushed to Peshawar and registered myself.
Programme proponents say those who want to avail of the treatment need only register with the Afghanistan s NACP and then go to any of Pakistan s ART centres, of which Peshawar has one.
Last September, a delegation from Afghanistan s NACP went to Peshawar to study how to replicate Pakistan s ART centres. A Pakistani delegation then visited Kabul the following month as part of efforts to help out Afghan health officials and personnel.
More Pakistani health personnel are scheduled to visit Afghanistan to train colleagues there on HIV/AIDS treatment. In addition, Pakistan is to assist in strengthening Afghanistan s treatment and counselling centres in Kabul, Herat, Kunduz, Mazar, Kandahar, Ghazni, Badakshan, and Nangahar.
Pakistan s own health workers note how the ART centres have helped reduced the trauma of those with HIV/AIDS.
At first, there was no specialised treatment due to which majority of the patients stayed away from hospitals, recounts Dr Hashim Ali of the ART centre at the Hayatabad Medical Complex here. At the hospitals, too, people with HIV/AIDS were looked down upon by doctors and health workers .
Now they are coming because they know they can receive treatment, he says. Now there are specialist doctors and nurses and psychologists who provide treatment and counselling to the patients.