WHO experts reviewing medical facility records in Pakistan
27 August 2019 – The HIV outbreak in Pakistan, which infected 903 people in Larkana district of Sindh province, as of 4 July 2019, is most likely due to unsafe injection practices and poor infection control practices in health facilities. The Federal Ministry of Health of Pakistan requested support for an investigation into the situation to establish the extent of the outbreak, identify the causes, propose immediate response measures and to recommend programmatic needs.
WHO deployed an international team to investigate and control the HIV outbreak in Larkana from 28 May 2019 to 29 June 2019. Of those infected, 82% (741) are children under 15 years of age. Although preliminary findings indicate that unsafe injection practices and poor infection control are the cause of the large number of HIV infections among children, the local health authority, with the support of WHO, is currently undertaking a case–control study to identify the cause and the source of the outbreak and the outcome of the study is expected soon. To control the outbreak, WHO and health partners, including Pakistan’s Ministry of National Health Services, Regulation and Coordination, is planning to urgently scale up the treatment of patients who have tested positive, prevent further transmission and tackle the root causes of the outbreak, as laid out in a US$ 1 million response plan.
The response to the current HIV outbreak in Pakistan, is complicated by the shortage of antiretroviral drugs and diagnostic tests in the country. Current stocks are nearly depleted and only 50% of HIV-positive children have access to antiretroviral drugs. WHO and partners have mobilized additional HIV drugs and testing kits, including antiretroviral drugs from Ethiopia, while the Global Fund to Fight AIDS, Tuberculosis and Malaria is expected to procure and deliver antiretroviral drugs for 1000 children by the end of July. In the meantime, WHO and the local health authority procured and shipped over 50 000 testing kits to Larkana and sufficient medicines to treat 300 children for 3 months. WHO approved and released US $400 000 as part of the Contingency Fund for Emergencies to respond immediately to the outbreak and address urgent needs in the country.
To control the current outbreak and tackle the underlying causes driving high HIV infection rates, WHO and partners are focusing on improving case management, laboratory services, infection prevention and control, blood safety, surveillance, psychosocial support, and risk communication and community engagement.
HIV continues to be a major public health issue in Pakistan and worldwide. From 2010 to 2017, new HIV infections in Pakistan increased by 45%, one of the highest rates in the Region. There are an estimated 165 000 people living with HIV in the country.
