InterPress News Service (IPS); Tuesday, 2 September 1997.
Tabibul Islam

Only 61 people have been detected with HIV, the virus that causes the deadly AIDS. Of these 10 are seriously ill and three are dead. Just nine of the total number infected are women, two of whom are sex workers.

This however is far from the reality, experts warn. For a country with a 120 million people, the numbers of those infected even according to the official National AIDS Committee, is closer to 20,000.

The authorities are finally waking up to the dangerous implications of the disease, after clinging to the belief that conditions for its spread, like sexual and drug induced behaviour, were less widespread in the country.

"The low prevalence of HIV infection in Bangladesh cannot be a case for comfort or complacency," declares Dr M. Zakir Husain, a health consultant. "All the predisposing factors may not be present, but there are enough to call for early energetic and unfaltering efforts."

A government blueprint to avert an AIDS disaster in Bangladesh that was unveiled in April, refers, for the first time, to the danger to those who do not belong to the so-called high-risk groups.

The World Health Organisation (WHO) estimates up to 700,000 people in Bangladesh could be infected in the next two years. Of them, between 16,000 and 62,000 will have developed the symptoms of AIDS or succumbed to the disease.

Because prevention is the only available strategy, awareness raising is now priority. "The population at large and the youth in particular must be induced to take all possible preventive steps to remain safe and protected," a government document states.

Sexually transmitted diseases, which can lead to HIV infection, are common, particularly among the poor. Blood for transfusion is not systematically screened for HIV. Blood banks depend on professional donors, who sell blood for the money.

And, according to the Health Ministry, there are 800,000 drug addicts in Bangladesh -- though most inhale and are not at risk of HIV infection, the numbers who inject drugs, sharing needles and syringes, are increasing.

With some two million Bangladeshis going abroad to work, mainly to countries in south-east Asia and the Arab Gulf, the possibility of their contracting HIV and infecting wives and others at home on their return is very serious.

In addition, there are more than 700,000 commercial sex workers, most of whom have little or no knowledge of the benefits of using condoms.

But only a small number of surveys have been conducted to test for HIV, and only some 300,000 people tested. Warns Dr Zakir Husain, "We could well be in the grip of an unexpected epidemic with little advance preparations and very meagre means of control."

"The single great folly would be to shelve it aside as merely a medical problem for the concern of the medical profession only," he added. "It is largely a social problem with great public health impact but even far greater social and economic impact."

The WHO and United Nations Development Programme (UNDP) have stressed on the fallout of the disease on economic growth, particularly in poor countries which do not have the resources to cope with a health crisis that most affects wage earners.

Studies conducted in India, Philippines and Thailand have clearly demonstrated the impact of HIV at the household level, and concluded that it is households, families and communities that will bear the full brunt of the costs of the epidemic. It is they whose resources will be drained, not to be replaced, by sickness and death.

Bangladesh's new anti-AIDS plan acknowledges the need to involve all sectors of society in stopping the virus. The plan aims to educate the public about HIV and AIDS; control sexually transmitted diseases; ensure safe blood supply and provide care, support and counselling for infected people.

Dr Badruddoza Chowdhury, a physician-turned-politician has raised the issue of HIV/AIDS in Parliament, stressing the importance of raising awareness, among the high-risk groups and other sections of people.

Implementation is expected to cost some 40 million dollars, most of which will be paid for by foreign donors. Health-related non-governmental organisations (NGOs) are expected to work with the government to implement the plan.

But the details are still being worked out. The National AIDS Committee should have details in place by November, which could if implemented without further delay, help in saving the lives of thousands. (End/IPS/ti/an/97)

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