HIV and AIDS: Present situation and future challenges

The virus is found in the body fluid of the affected person e.g. saliva, tears, and semen or vaginal fluid, etc. The virus has its maximum concentration in the fluid secretion of the sex organs. Other body fluids contain negligible quantity of the virus.

The virus does not survive in the open without a carrier for more than 10-15 seconds. The virus does not spread through water or air. As such, general mixing with a person of HIV positive or AIDS patient, like seating together, eating together, shaking hands, traveling together, hugging and kissing, eating with the same utensil, working along with, etc do not pose much danger of getting the infection. Coming in contact with the body fluid associated to sexual activities of an affected person is considered risky. The sex fluid of the affected person having maximum concentration of HIV virus may find an easy access to the blood stream of a healthy partner during the intimate and intense mixing that generally takes place during sexual activities. The healthy person may become infected as a result of unprotected sex with a HIV positive person. Here unprotected sex means sexual activity without taking due care to avoid mixing of body fluid of one partner in the blood stream of the other partner. By and large use of condom by the male partner ensures to protect against contamination during sexual intercourse.

There is another way of getting the HIV infection: that is through transfusion of blood. If a person receives blood of a HIV positive person during blood transfusion that person would become infected. Blood and blood products if used without proper screening for HIV virus always poses a risk of HIV infection to the recipient.

Considerable number of people from Bangladesh venture to different countries of the world for better employment opportunities. Expatriate workers from Bangladesh during their long abstention from home and family sometimes get involved with commercial sex workers in those foreign countries. Some of these countries have been identified to have prevalence of HIV and AIDS.

Bangladesh has got a very long boundary with its big neighbour India, the major portion of which do not have any natural barrier. As such, the border is porous and very frequent cross border movement take place both officially and also illegally. Large scale infection of HIV and AIDS has been detected in India recently with the bad news that the disease is spreading at an alarming rate there.

There exists a law in Bangladesh prohibiting transfusion of unscreened blood. But due to lack of screening facilities at all possible level blood is transfused in patients without proper screening in many cases. This at times become the cause of many infectious diseases including HIV/AIDS.

Unfortunately, the number of inter-venous drug users is reportedly on the rise in Bangladesh. Habit of taking the drug in a group sharing the same needle is also very common among the drug users in Bangladesh. This may be so because of poverty or/and due to ignorance of the drug users on the possible risk involved in it.

As per the latest statistics, Bangladesh has got a reported case of 365 (three hundred sixty five) HIV and AIDS infected person so far. But, as per UNFPA a UN agency dealing with the issue, the possible number of infected people at the moment as estimated is around 13,000. Of course, this figure of 13,000 infected people is a realistic estimation (and not definitely identified cases) based on all possible factors prevalent in Bangladesh society influencing the spread of the disease.

Though the prevalence rate of HIV and AIDS as has been identified so far is not significant, but the country runs the risk of HIV and AIDS epidemic due to the factors mentioned above which has created conducive environment for its fast spread. Considering all the above, Bangladesh may be termed as low prevalence but high risk country for HIV and AIDS.

Social stigma in respect of HIV and AIDS is extreme and extensive in Bangladesh as in many other countries of the world especially the developing ones. Any person detected as HIV positive, the first impediment that person faces is widespread and extreme social stigma. For fear of being discriminated at every step and also being subjected to inhuman harassment and sufferings, the main concern of that person becomes to keep his disease secret as long as possible. Under the circumstance, the person is not only denied of the treatment facilities to increase longevity and a normal health but also is forced to pose a potential health hazard for others around him with the potential for infecting those unsuspected healthy person.

It is very much essential from humanitarian and also from the social point of view that the infected person should be identified and be given all sorts of guidance and medication.

In Bangladesh the issue of HIV/AIDS received due importance when as back as 1985 a very high level committee e.g. National Aids Committee or NAC was formed to deal with matter. President of the country was the chief patron and the health minister was the chairperson of that committee. NAC have been continuing its activities through different sub-committees e.g. Advisory committee, Technical committee, Surveillance committee etc. In addition, ministry of health has taken up a project titled National Aids and STD Prevention Project or NASP. Some activities on HIV/AIDS are being carried out under that scheme.

So far, the main focus of all the governmental and non-governmental activities in this field have been on the prevention of further infection. It should not be considered unwise considering our low prevalence and high risk situation. But, associated social stigma must also be dealt with seriously by making the people aware about all related aspects of HIV and AIDS and getting rid of misconception and unfounded fear. In addition, friendly care and treatment facilities at an affordable expenditure should be made available to the infected person. These may ensure suitable environment which would enable the affected person to overcome the shame and fear associated with the disease. Only under that circumstance the affected person could come forward openly to reveal about the disease. This would enable them to get the necessary treatment and care and have a comparatively comfortable and longer life. At the same time, risk of further spread of the infection from affected person could also be minimised.

Considering all the above, few members of Parliament formed a group titled Parliament Members Support Group for prevention of HIV/AIDS and human trafficking in September 2003. The objectives of the group specifically on HIV/AIDS issues are for all the people of Bangladesh to raise awareness among the general masses by perusing through various means of communications, activities and manners both in the House and outside the parliament. They would promote regular meeting with key persons working on HIV/AIDS and persuade a just policy for the nation to help combat the social curse. The group would also like to contribute its talents to the government in formulating policy strategy on the HIV/AIDS, establish links among regional and international parliamentary groups working on the same to share experience an exchange ideas among the lawmakers worldwide, identify problems to implement projects on HIV/AIDS and help narrow the gaps among the organizations on these issues. As parliament members they would initiate parliamentary debates, give notices, if need arises, in the House, organize public and private meetings with different parliamentary standing committees, ministers and officials. In addition, the parliament support group would try to stimulate other lawmakers to undertake awareness programs at their own constituencies to make aware their own people through campaign and also oversee the activities of the programs initiated by different organizations, donors and the government and suggest, if necessary, to improve their quality of functions.

The above is a big agenda no doubt. But, the potential of the calamity is tremendous and compared to that our preparedness is very low at the moment. For that, not only that we the few fortunate chosen by the people of this country to decide their destiny should try to do whatever possible but set our goal to the maximum and leave no stone unturned to achieve that target.

G. M. Quader MP is Vice-Chairperson, Bangladesh Parliament Members Support Group on Prevention of HIV/AIDS and Woman and Child Trafficking.