BBC News - Tuesday, 18 November, 2003
Paul Anderson, BBC Islamabad correspondent

Recorded cases of Aids and HIV infection are small compared to Pakistan's neighbour, India.

Until recently many government and religious leaders argued that was because of the moral and ethical values enshrined in the Muslim way of life.

Now they are waking up to the possibility that prevalence could sky-rocket, like in other Muslim countries.

According to the latest statistics, the prevalence of HIV infection in Pakistan is small - 70,000-80,000 people, of whom just over 2,000 officially have Aids.

But the figure is certainly much higher, according to Imran Rizvi from the charity Amal.

"These figures remain controversial," he says.

"We are very weak in terms of surveillance. I think we all are aware that our health infrastructure is weak and there are issues regarding HIV/Aids dealing with stigma and discrimination which prevent a lot of people coming forward."

And circumstances in Pakistan are no different from those in neighbouring India, where the virus has infected around four million people.

"Conditions that are prevalent in India, which have created this epidemic, are as prevalent in Pakistan," Imran Rizvi says.

"And India up to three years ago was in a similar denial mode.

"There are five or six conditions where HIV does thrive under. One is increased poverty levels, second is a weak gender status, third is increased IV drug use."

Mohammed Ahmed is HIV positive. He stepped on some used needles discarded in a junk yard four years ago.

"Some of my relatives look at me with suspicion," says Mohammed, 23.

"I used to love playing with children, now I do not show my affections at all because I can see their parents think they will get infected."

Religious belief

There is still a belief in influential religious circles in Pakistan that anyone with Aids has veered from the prescribed path.

Professor Mohammed Junaid from the Islamic University in Islamabad says Islam as a system has moral and ethical codes which "automatically control unethical behaviour, which certainly leads to Aids and many other diseases of these kinds.

"The ratio of the Aids disease infected people in Pakistan, it is much less than, for example, the non-Muslim countries."

That notion was common also among some government leaders who believed the infection figures were low because Islam's ethical values prohibit the behaviour which leads to infection.

But that is changing now and, according to Katey Grusavin from the UN's children's organisation, Unicef.

"Unicef sees that adolescents are an absolute key to getting the message out and preventing the epidemic from spreading like wildfire in the country," she says.

"South Asia is at a tipping point with the virus and there's a small window of opportunity which could be closing in Pakistan."

Ms Grusavin believes Pakistan has five years to put in place a strategy to combat AIDS - not much time for a country with a poor health infrastructure and big social obstacles.

But she says it could just be done.
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