Pre-exposure Prophylaxis programme (PrEP) launched by the health department, government of Sindh in partnership with the United Nations
June 14, 2022
Karachi 07 JUNE 2022—The Health Department of Government of Sindh, in partnership with the United Nations in Pakistan, launched the Pre-exposure Prophylaxis Programme (PrEP) in Karachi today.
PrEP is considered a ‘game changer’ in the prevention of HIV. Even though it has been more than 10 years since the first evidence of the efficacy of daily oral pre-exposure prophylaxis (PrEP) was published, much of the PrEP scale-up is still highly concentrated in a small number of countries. Health Department, Government of Sindh in partnership with the United Nations in Pakistan, set a precedent in the country today by launching community-based- PrEP for key populations and sero-discordant couples. PrEP does not replace condoms but offers an additional HIV prevention choice. Community-based PrEP dispensation is critical because CBOs working in Sindh have outreach programs and can play a pivotal role in creating awareness and ensuring stigma-free access to PrEP programmes.
With support from UNAIDS along with WHO and UNDP, the Government of Pakistan developed guidelines and standard operating procedures for community and health facility-based dispensation of PrEP. The launch event was organized under the leadership of the Director General Health Services of the Health Department Sindh in partnership with UNAIDS, UNDP and WHO. Immediately following the launch event, a training will be held with ART Centre staff from around the Sindh province on ensuring effective and evidence-based PrEP services.
During an interactive dialogue session, Dr. Ershad Kazmi, Additional Director, CDC Health Department of Sindh shared that between 2010 and 2020, Pakistan has seen an increase of 84% in new HIV infections and unless we take bold steps today, we will not be able to halt further new infections and PrEP is a step in the right direction. Addressing the participants, he further emphasized that “PrEP offers a significant strategic opportunity to precision target prevention programmes for key populations. For the administering of PrEP to sero-discordant couples and key populations, formal linkages have been established between ART Centres and the outreach component of the current programme. This approach utilizes outreach workers at the frontline to engage individuals who are at risk for HIV. Their main task is to connect members from the community to public health services, so that they can be reached by HIV prevention programs that will now include PrEP. Outreach workers disseminate HIV prevention packages, provide safe sex education materials and support for behaviour changes, and most importantly, refer the community for HIV testing and counselling and created linkages with ART treatment centres.”
Ms. Yuki Takemoto, UNAIDS Country Director Pakistan and Afghanistan congratulated the Health Department Government of Sindh for formally launching the PrEP programme and said, “We are impressed by the political commitment and concrete actions by the government to address the needs of communities. Ensuring a supportive, enabling environment free from stigma and discrimination will help achieve the targets of the Sindh AIDS Strategy 2021-2025 and contribute effectively towards ending AIDS as a public health threat by 2030. Community outreach workers and counselors have the advantage of being able to reach key populations including hard-to-reach communities The integration of community-led HIV prevention programs and the meaningful participation of communities are critical to ensure that policies and services are responsive to community needs.”
Ms. Aliona Niculita, Officer In-Charge, UNDP Pakistan added “The HIV response in Pakistan requires bold leadership and evidence-based approaches. UNDP is proud to partner with community-based organizations, and the Sindh CDC and the National AIDS Control Program in bringing PrEP, an effective HIV prevention tool, to communities who need this service the most.”
Heather Doyle, Programme Manager for the HIV Global Fund grant at UNDP, participated in the launch on behalf of UNDP and added that “UNDP has been honored to work closely with Sindh CDC, UNAIDS and the community partners to push this initiative forward. We look forward to continuing this partnership so that everyone who needs PrEP has access.”
Several members from the community-based organizations and representatives from key populations participated in the launch and expressed hope that chances of new HIV infections will get reduced through PrEP uptake. According to research, when taken daily as directed, PrEP can reduce the risk of HIV infections by more than 90 percent. One community representative said, “Since we don’t have vaccination for HIV as we have for COVID 19, PrEP is a gift of medical science to the communities that can help prevent HIV among those who are at higher risk. While a vaccine or cure may one day end the HIV epidemic, PrEP is a powerful tool that has the potential to alter the course of the HIV epidemic in Pakistan in the coming years.”
The World Health Organization (WHO) recommends that people at substantial risk of HIV should be offered pre-exposure prophylaxis for HIV infection (PrEP). PrEP is the use of antiretroviral (ARV) drugs by people who do not have HIV infection in order to prevent the acquisition of HIV. WHO Representative in Pakistan, Dr Palitha Mahipala expressed that PrEP should not replace or compete with effective and well-established HIV prevention interventions, rather it should be an additional prevention choice in a comprehensive package of services that also includes HIV testing, counselling, provision of condoms, lubricants, ARV treatment for partners with HIV infection and harm reduction interventions for people who use drugs. While many people who could benefit most from PrEP belong to key population groups that may face legal and social barriers to accessing health services.
“PrEP is a novel approach to HIV prevention that requires continuing collaboration between patients and health care providers, as effectiveness requires adherence to daily medication and regular medical visits for monitoring, counseling and testing,” said Dr. Syed Faisal Mehmood, Associate Professor and Section Head, Infectious Diseases, Department of Medicine at Aga Khan University.
The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals.
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