FEATURES NEWS THE RISING NEPAL (DAILY)

Prevention And Control Of HIV/AIDS
An Urgent Need

By Jhabindra Bhandari

THE increasing trend of HIV/AIDS is definitely an emerging social problem of human life. Apart from the global challenge of poverty alleviation, the socio-economic impact of this alarming spread of the epidemic is a matter of serious concern worldwide. If the trend still continues, there is no doubt that the scenario of the problem will become even worse particularly in the poor developing countries.

Since its discovery in the early 1980s, HIV/AIDS has rapidly grown into a worldwide epidemic. If we look at the trend of its spread particularly in the poor developing countries, it will be the greatest threat to sustainable human development. Much more worrying point is that a huge amount of resources will have to be spent in the prevention and care in the years to come.

Even though the National Centre for AIDS and STD Control reports that the HIV/AIDS situation in Nepal is a little more than 1800, the reality is far worse than expected. It is estimated that the cases of HIV/AIDS have reached at least 35000. Despite the efforts of prevention and control, the problem is unfortunately on the rise.

The attempts of national and international community to fight against this social tragedy have drawn serious attention for the urgent need of multi-sectoral response. Understanding the nature of risk behaviour, it is clear that youths are specially at risk. And there is therefore a growing need to concentrate on the young people as a primary target.

Actually, the issue of HIV/AIDS is not perceived as a serious problem of socio-economic development. Furthermore it is equally important to note that the increasing social stigma associated with HIV/AIDS is adding fuel to the spread of the epidemic in most societies.

The most worrying part in most of the societies—the adolescents are poorly and inadequately informed about sexual matters and high risk behaviours. The youths who migrate for jobs and economic opportunities in the country is one of the important social factors contributing to high vulnerability of the problem. Thus, high mobility and migration, not only from rural to urban areas and vice versa, but also between different countries, has allowed the virus to spread more quickly.

One of the significant problems contributing to the spread of the epidemic is the growing problem of drug addiction among youths. The mode of HIV transmission through sharing of syringe among a number of the addicts is still increasing. Even though attempts of behaviour change interventions are taking place, there has been limited input and resources to reach the high risk groups for appropriate behavioural change.

It is important to note that the drug culture in many Asian regions reveals that youths are more addicted to injecting drugs. Injecting drug use is now common amongst young people, with users often sharing needles with others. And they are very mobile at the same time—thereby increasing the vulnerability of the infection.

Every year, thousands of women have been trafficked to different parts of India and other regions. After they contract the killer disease, they are compelled to return to their homes. There are terrible stories of trafficked women who have been infected with HIV/AIDS and diseases. At the same time, there is poor acceptance of the people living with HIV/AIDS in families and communities so that they have to lead a worse life.

Until recently, the impact of the growing problem of HIV/AIDS on infants and young children has been largely a neglected issue. This is primarily because at the beginning of the AIDS epidemic, children were not considered to be at risk of HIV infection. Later it was very clear that the virus could be transmitted from an infected mother to her baby during pregnancy, birth or breast feeding.

This is true that Sexually Transmitted Diseases (STDs) and reproductive tract infections increase the risk of HIV transmission. In a society like ours where interpersonal communication about sexuality and family planning is very rare, there is clearly delay in seeking health care for STDs in the health facilities.

On the other side, it is true that reproductive health services providing counselling, education on sexual health and better detection and treatment of STDS are still lacking particularly in rural areas. Therefore, community based interventions like condom promotion should be a matter of priority for behaviour change.

This is particularly encouraging to note that awareness raising efforts of NGOs in the field of HIV/AIDs have been very effective. Behaviour change intervention has been a core strategy in the fight against the problem. Still the important issue is that awareness raising programmes have not reached the very remote parts of the country effectively.

There are important strategies to address the problem of spread of HIV/AIDS and its socio-economic impact on individuals, families and communities. The District AIDS Coordination Committees (DDCs) need to play a key role in participatory planning and management of HIV/AIDS at district, village and community level. Advocacy to local elected representatives and policy makers help a lot to localise the national response.

Recognising AIDS as a threat to development emerging issues of HIV/AIDS should be a matter of priority agenda. There needs to be participatory operational research on issues related to migration, health seeking behaviour, human trafficking and harm reduction initiatives for effective planning and implementation of prevention and control programmes.

Promoting partnership with local NGOs and private sectors is another part of intervention that help initiate collective action against the epidemic. Therefore, capacity building of the DDCs, VDCs and local NGOs in planning, implementation and monitoring and evaluation of HIV/AIDS programmes is crucial. Past experience shows that social mobilisation is a landmark in prevention and care.

Networking with community based organisations and NGOs is essential for joint action to maximise the impact. Youth mobilisation for prevention and control of HIV/AIDS is extremely essential so
that the rate of increase of the infection will decrease. As there is a big challenge of care and support programmes to people living with HIV/AIDS, the joint efforts of government, NGOs and private sectors can only tackle the problem significantly. To accomplish this, strong political will and commitment is an urgent need for global action in the fight against the epidemic.

Other Stories