World Bank - June 5, 2003

Currently, the HIV prevalence rate in Pakistan is less than 0.1 percent. While the numbers remain relatively low, a failure to actively prevent HIV/AIDS in Pakistan could lead to a widespread epidemic. In response, the Government of Pakistan developed the National Strategic Framework for HIV/AIDS that set out the broad strategies and priorities for effective control of the epidemic, of which increased focus on vulnerable populations such as commercial sex workers, injecting drug users, and prisoners, is one of them. Hence, while the largest group of beneficiaries of the project are the general population of adults, many of the project's activities will focus on serving vulnerable populations.

"The project's objective is to prevent an HIV/AIDS epidemic from raging out of control in Pakistan and avoiding the resultant suffering, premature death, family devastation, and economic losses that stem from this disease," said Benjamin Loevinsohn, Senior Public Health Specialist at the World Bank, and task manager for the project.

Following the National Strategic Framework for the control of HIV/AIDS, adopted by the Government of Pakistan and its development partners in 2000, the project will be implemented by the National and Provincial AIDS Control Programs, and it is comprised of four components:

Expansion of Interventions Among Vulnerable Populations: Preventing the spread of HIV among these populations, particularly those living in large cities, will be critical and will be the project's highest priority. This component, which will be carried out by non governmental organizations, and private entities, includes behavior change communication aimed at improving the vulnerable population's knowledge, attitudes, and behaviors related to HIV; promotion of effective condom use; voluntary counseling and HIV testing; proper management of sexually transmitted infections (STIs); needle exchange, and promotion of safe injection practice; and empowering activities that allow members of the vulnerable populations to assert greater control of their lives.

Improved HIV Prevention by the General Population: This component includes behavior change communication aimed at the general adult population; advocacy to raise awareness of decision makers and opinion leaders about HIV/AIDS; targeted interventions for youth, the police, and sex workers; and improved and expanded management of STI cases.

Prevention of HIV/STI Transmission Through Blood Transfusion: To prevent the transmission of HIV and other STIs through blood transfusions, the project will support the establishment and capacity-building of provincial blood transfusion authorities, the implementation of a quality assurance system, the screening of blood for HIV and other STIs, and proper waste management for potential infected material.

Capacity Building and Program Management: To strengthen the capacity of the National and Provincial AIDS Control Programs and their NGO partners to undertake significantly expanded HIV prevention activities, the Project would support the strengthening of federal and provincial AIDS Control Programs and NGO capacity development.

"The project puts the delivery of services by non governmental organizations and the private sector at the center of the debate, and brings long-term institutional benefits to the people of Pakistan. If carried out well, the services provided by these organizations to the vulnerable groups could have benefits beyond simply preventing HIV," said Loevinsohn. "The project's activities would also build the self-esteem of these marginalized people and reduce their stigmatization and harassment."

The total cost of the project over the five-year period is estimated at US$47.77 million. The funds from the International Development Association (IDA), the World Bank's concessionary lending arm, will provide US$37.11 million, of which US$9.28 million will be a grant.

For More Information on the Bank's Activities in Pakistan, visit:http://www.worldbank.org/pk

For More Information on the Project, visit:

http://www4.worldbank.org/sprojects/Project.asp?pid=P074856

Contacts:

In Islamabad: Shahzad Sharjeel (051) 2279641

E-mail: ssharjeel@worldbank.org

In Washington DC: Karina Manasseh (202) 473-1729

E-mail: kmanasseh@worldbank.org

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