InterPress News Service (IPS) - Friday, January 30, 1998
Tabibul Islam

At least six non-governmental organisations have been working for months in the port town 25-kms from Dhaka, promoting safer sex behaviour and raising awareness of risk generating situations.

CARE said their volunteers visiting a brothel in Tangail district have been talking to both sex workers and their clients. But the results are less than tangible. Only 7 percent of men agree to use the condoms that are distributed free.

"If we insist too much we stand to lose customers," shrugs a young woman in Tanbazar brothel, one of the country's largest and home to some 2,000 prostitutes. Some women understand the risk, but they cannot think of dictating to customers.

HIV/AIDS is spreading, but the prevalence rate here is much lower than in neighbouring India which is believed to have the largest number of people infected with HIV in the world. Only 83 people have been detected with HIV in Bangladesh, while India reported 56,409 people with HIV in May 1997.

The actual numbers are far higher in Bangladesh, experts warn. It could be closer to 20,000, and if unchecked one in every 200 people (population at present is 120 million) may be infected by the turn of the century, according to one estimate.

While Bangladesh was among the few countries who early on recognised the threat of HIV/AIDS, and consequently established the National AIDS Committee in 1985, it was only last year that a Strategy Plan was drafted.

Now the draft document is going through the governmental procedures of endorsement and a National Programme based on the new anti-AIDS strategy being prepared for implementation in July, health officials said.

Implementation is expected to cost some 40 million dollars, most of which will be paid by foreign donors. The government has sought the help of health-related NGOs to implement the plan.

"Bangladesh is at cross roads," said Dr. Nasiruddin of Voluntary Health Services Society. "If the country and the people take action now, they have the opportunity to save thousands of lives and millions of dollars."

Already a new surveillance survey is underway, launched in mid-December across the country, to estimate the magnitude of the problem. Health authorities are being guided by the United Nations Development Programme (UNDP), which is providing financial (six million dollars) and technical assistance.

The draft National AIDS Policy acknowledges the need to involve all sectors of society to combat the spread and impact of HIV. It aims other things to educate the public about HIV/AIDS and enable people with HIV to live and die with dignity, without discrimination and stigma.

At a meeting in Dhaka on World AIDS Day last December, Bangladesh Health and Family Welfare Minister Salauddin Yusuf reiterated the government's commitment. Observes Najmus Sadiq, UNDP programme officer: "Only recently has recognition come that HIV/AIDS is a human development problem and that it is intricately interlinked with factors like poverty, unequal balance of power ..."

There's a lot of work to be done. The well-known International Centre for Diarrhoeal Disease Research-Bangladesh (ICDDR-B) which also studies reproductive health issues, has reported a very low awareness of HIV/AIDS in the south-eastern region. Only 20 percent of women interviewed had heard of AIDS, and less than 5 percent of those understood its implications.

"A comprehensive AIDS education campaign would probably be the most effective approach towards preventing an AIDS epidemic in Bangladesh," ICDDR-B team members said in the survey report.

Risky sexual behaviour of men, a contaminated blood supply and sharing of drug injecting equipment are factors contributing to the spread of the AIDS virus in the country, but less widespread than in India.

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 number of injecting drug users (IDU) is rising.

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

The World Health Organisation (WHO) and 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 the health crisis that most affects wage earners.

Studies in India, the 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 brunt of the costs of the epidemic. It is they whose resources will be drained, not to be replaced by sickness and death.

Bangladesh health authorities are pinning their hopes on the Strategy Plan, which if implemented without further delay could save the country from disaster. (End/IPS/ti/an/98)

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