HYDERABAD SINDH:  HIV/Aids cases in Pakistan have climbed above 80,000 and a further rapid rise is likely unless swift action is taken, the government has warned.

Speaking in the national assembly, Mahreen Bhutto, parliamentary secretary for health, said the HIV/Aids control programme had not worked well over the past six years and its reputation was poor. But the government was working hard to spread awareness of the disease and the need for preventative measures.

HIV is spreading fast in South Asia, mostly through injecting drug users. Heroin and other drugs are easily available in the markets of Pakistan, smuggled in from neighbouring Afghanistan.

According to the Aids Control Authority in Sindh province, 60 to 70 per cent of HIV infection in Pakistan is spread through intravenous drug use, 20 per cent through male-to-male sexual contact, 6 per cent male-female contact and 0.1 per cent mother-to-child. Four per cent is due to other causes. Truck drivers and other workers help carry HIV from urban to rural areas. In the cities, the so-called “third gender” –  hijras, or lady-boys – are another big factor.

The health minister said members of parliament had a duty to spread awareness of HIV/Aids as they are not only leaders but often heroes in their home areas. “We will encourage their struggle,” she said. “They should address these issues in public. MPs can play a key role in educating the population.”

But the task of educating the people is not easy. Emerging from more than 30 years of dictatorship, Pakistan is still beset by corruption and inefficient institutions. Democracy is bringing change, but slowly.

The education system is still weak. Government sector education suffers from political interference. Fewer than 40 per cent of women are being educated, 50 per cent of men. In rural areas more than 80 per cent of women are uneducated and do not know about their rights – they may not even be allowed to leave their home. A backward, feudalistic society shuns education, so most farmers’ children are illiterate.

In Pakistan 30,000 women die every year during or after pregnancy – one every 17 minutes. In rural areas pregnant women are not allowed to go to hospital for delivery; unskilled village “Daies” do deliveries. So mortality rates are high. Few rural areas have women doctors, according to health worker Lachhami Bhatia, of the NGO “Hope”. She works in rural areas near Hyderabad. “In this complicated situation, how can you expect to spread awareness about HIV/Aids?” she asks. “People are not ready to accept that HIV is dangerous; mostly Pakistanis regard HIV as a disease of Europe.”

Pakistan has yet to conquer an earlier scourge, polio. Poor management is blamed. The latest anti-polio campaign was launched before 2000 but rates are rising despite the vaccination programme. Pakistan signed up to a Millennium Goal of becoming polio-free by 2015 but this target now looks unlikely.

Proud skipper Abdul Latif said he hoped his team’s seven-wicket victory over a Hyderabad youth team would help halt discrimination over HIV/Aids in cricket-mad Pakistan.

“This is not only Pakistan’s first HIV-positive team, but it is the first in the world,” said Latif, who contracted HIV when he was working in Dubai six years ago. “This shows that we can do anything that other men do.”

The team was brought together by Pakistan Society, an NGO working for the rights of people living with HIV (PLWHIV) and recovering injecting drug users.

Latif’s wife, Ume Kulsoom, who is HIV-negative, called the team “a candle for life” of PLWHIVs. She said that when she learned of her husband’s HIV-positive status “I felt as though I had become a dead body. People scorned and rejected me and urged me not to touch my husband, to keep away from him.

“But when the doctors gave me complete information it changed my mind. Now I provide full support to my life partner, we are living together, I am safe because we use condoms.”

A psychologist, Zaheer Ahmed, said cricket could fire enthusiasm and ambition in the life of PLWHIVs as well as help reduce discrimination. “The formation of this cricket team is a big step in making society aware,” he said. “Scientifically, Aids is uncured – but it is curable through education and awareness.”

Pakistan Society – half of whose members are HIV-positive – has been working in the HIV/Aids field for 15 years, providing condoms, clean syringes and education to PLWHIVs and drug users who are a major source of HIV infection. In Karachi, the nearest big city to Hyderabad, about one-third of the estimated 12,000 injecting drug users have contracted HIV.

But HIV/Aids statistics for Pakistan as a whole are disputed. UNAIDS says between 90,000 and 100,000 of the population are HIV-positive, most of them through use of dirty needles. But Dr Nasir Jalbani, Aids Control Authority manager for Sindh province, rejects these figures as much too high. He says they are only estimates, not facts, and that there are actually only 3,000 cases, of which 70 per cent are from drug use.

However, Dr Farooq Soomro, who works with drug addicts, challenges Dr Jalbani’s “facts and figures” and says that nationally there are more than 70,000 cases of HIV. He cites female sex workers as a major source, as well as truck drivers who spread infection from cities to rural areas. Some 80 per cent of the population do not use condoms, he says.

Pakistan’s HIV/Aids awareness programme is limited, Dr Soomro says; too few people know what it is and how it is spread.