Poverty Is Fueling HIV in Pakistan — And the World Needs to Pay Attention

By : Mahwish Arif, Journalist

The HIV epidemic that Pakistan is currently facing is being portrayed as a failed
medical crisis; however, really it is a product of an ongoing poverty crisis in the
country. The majority of the cases are occurring among those people who cannot
afford access to health care, those who do not know that they need to access it,
and those who have limited knowledge about safe medical practices. In many
places in Pakistan, especially among impoverished populations, poverty
contributes to poor health outcomes and creates an environment whereby the
transmission of HIV is easier to occur.

For families who reside in rural and slum communities and who are living in
poverty, getting to a certified medical doctor can be unaffordable. Families living
in remote locations might find certified doctors located at the nearest hospital,
which could be hours away. For those families who do find a nearby hospital,
many do not have the money to pay for private hospitals, and with both public
sector health care facilities in densely populated areas (where health facilities are
located) and public health centers overcrowded and poorly equipped; millions go
to informal and/or “street doctors”, where services are provided at a low cost and
often with unsafe practices. The risks to health occur as a result of using reused
syringes, utilizing contaminated equipment, and receiving unscreened blood
transfusions at these sites. Families might save money when they obtain health
services from unregulated practitioners; however, they pay for those savings with
their health.

Examples of the impact of this situation can be seen in Taunsa, Punjab and
Ratodero, Sindh. Both areas have seen outbreaks of HIV among many children,
many of whom were under the age of 5. These children contracted HIV after
receiving treatment for minor illnesses through local unlicensed practitioners. The
parents of these children relied on their local practitioners to provide essential
health services to their children because they were the only affordable option
available. These local practitioners have been unknowingly enabling the infection
of children in both areas.

The HIV epidemic in Pakistan continues to grow due to various causes related to
poverty. Many families do not have enough money to pay for medical care,
therefore they often resort to unsafe alternatives. There is a high rate of
unnecessary injections in the country, and in many parts of the country, these are
given with reused syringes. Many people do not understand how HIV is
transmitted, nor do they know what to look for when they are at a medical
facility. The stigma associated with HIV often makes people reluctant to seek
testing or treatment, particularly if they fear what their community may think of
them. Most treatment centers for HIV are located in urban areas so rural families
often have no way to get to these centers because they cannot afford to travel
there.

Although there is an increasing number of infections from HIV in Pakistan, the
global response to this epidemic has been minimal. The HIV epidemic in Pakistan
does not fit within the accepted model of HIV; it is a product of social and
economic factors, and the healthcare system does not protect the poorest
members of society.
To stop the HIV epidemic in Pakistan, improved access to safe and effective
healthcare, increased regulation of clinics, improved awareness of HIV
transmission, and reduced stigma need to be put into place. The HIV epidemic is
more than just a public health crisis; it is a crisis of social and economic injustice,
and as long as there are social and economic injustices in Pakistan, the HIV
epidemic will continue.