Nepal faced with grim reminder on the World AIDS Day

As the world observes the 19th AIDS Day with the theme of accountability, Nepal is faced with grim reminder of its increasingly difficult prospects in meeting the Millennium Development Goals (MDGs) as far as controlling the dreaded disease is concerned.

Of the eight MDGs, the sixth goal of halting and reversing the spread of HIV/AIDS, Malaria and other major diseases is going to become a tall order for Nepal. The incident of HIV prevalence has, instead, been growing from 0.29 percent of total population in 2000 to 0.5 percent now.

Besides, the country suffers from a concentrated HIV epidemic, "with prevalence estimated as high as 50 percent among certain most-at-risk populations" according to the UNAIDS office in Kathmandu. Injecting drug users, sex workers, men who have sex with men and migrants have the highest risk of exposure in this context, although prevalence in the general population is currently estimated at 0.5 percent.

According to the office, the largest number of cases in the last 18 months was reported among the 30-39 and 15-24 years old. Recent estimates show that 46% of HIV cases are among seasonal labor migrants, 19% clients of sex workers and 20% are wives of partners of HIV positive men. Young people are particularly vulnerable to HIV and form the largest proportion of most-at-risk populations.

"The vulnerability is further exacerbated by poverty, migration, gender inequality, ethnic or caste discrimination, political instability and civil conflict in Nepal."

In order to meet these challenges posed by the disease, various national responses have been made ranging from an initial focus on prevention concentrating on the coverage of key target groups, to treatment, care and support including STI treatment, voluntary counseling and testing (VCT). "By now, VCT services have been expanded to 65 points in the country from 9 points in 2004. The Antiretroviral Therapy (ART) that was introduced in 2005 has been scaled up to 7 sites by providing ART to about 500 people."

Despite these efforts the country is still not able to check the spread of the disease. "I cannot claim that the spread of the disease has been checked. Like other developing countries, we are also suffering from its spread," said Rajendra Panta, chief of the National HIV/AIDS and STD Control Center.

Furthermore, the social stigma that the disease carries has stopped a majority of people living with HIV from disclosing their status leading to a complicated situation.

In the year of 2006 alone, 4.3 million people were infected with the disease and 2.9 million died of it. "The latest global AIDS figures give us reason for concern and for some hope. Multi-drug and extremely drug resistant tuberculosis highlight new challenges in our collective response. The issue of women and girls within the AIDS epidemic needs continued and increased attention. At the same time there is evidence of positive trends in young people's sexual behaviours—increased use of condoms, delay of sexual debut, and fewer sexual partners," says Dr Peter Piot, Executive Director of UNAIDS, in a statement issued on this day.

Likewise, UN Secretary general Kofi Annan has also called on all world leaders to decide and declare that "AIDS stops with me."

"The challenge now is to deliver on all the promises that have been made -- including the Millennium Development Goal, agreed by all the world's Governments, of halting and beginning to reverse the spread of HIV by 2015. Leaders at every level must recognize that halting the spread of AIDS is also a prerequisite for reaching most of the other Goals, which together form the international community's agreed blueprint for building a better world in the 21st century. Leaders must hold themselves accountable -- and be held accountable by all of us," Annan states in a statement. nepalnews.com sd Dec 01 06