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[ISLAMABAD] The Pakistan government has sought international help after more than 700 people, most of them children, tested positive for HIV in the southern town of Ratodero. The outbreak was thought to have been spread via reused syringes used mostly by unqualified practitioners.

“As part of key tasks, a WHO-led team will determine the factors behind the outbreak and suggest controlling measures, provide technical expertise in the areas of HIV testing, paediatric HIV treatment and family counselling,” Pakistan’s state minister for health, Zafar Mirza, tells SciDev.Net.

Mirza said the team, who reached Ratodero on Friday (31 May), would ensure enough supplies of rapid diagnostic tests and antiretroviral medicines for both adults and children, as well as single-use needles and syringes as initial investigations pointed to the use of repackaged syringes.

“Initial official investigations conducted by our organisation in collaboration with provincial and federal health departments point towards the re-use of infected syringes in the area and also unscreened blood transfusions”

Abdul Baseer Khan Achakzai, National AIDS Control Programme

As of 31 May, 728 people have been suspected of testing positive for HIV following mass screenings in Ratodero. Five hundred and ninety-five of them are children, 70 per cent of whom are between the ages 2 to 5 years of age, according to National AIDS Control Programme (NACP) officials. The outbreak is believed to be the world’s first such incident in terms of children being the major victims. Seventy-three women also tested positive for HIV.

Oliver Morgan, director of health emergency information and risk assessment in the Health Emergencies Programme of WHO, leads the 12-member international team of health experts from CDC Atlanta, Georgia, UNICEF, UNAIDS and the Global Outbreak Alert and Response Network to investigate the outbreak. They will try to trace the origin of infection and identify the exact source before it spreads further. Aside from the investigations, the medical team will also provide paediatric HIV treatment and family counselling. Provincial and federal health officials say quacks or unqualified practitioners, on whom the poverty-racked rural parts of the country depend, are behind the reuse of syringes.

“Initial official investigations conducted by our organisation in collaboration with provincial and federal health departments point towards the re-use of infected syringes in the area and also unscreened blood transfusions,” programme manager of the NACP, Abdul Baseer Khan Achakzai, tells SciDev.Net. “[Other reasons] could be poor infection prevention and unprotected sex.”

According to NACP, Pakistan already has 165,000 people living with HIV, but only around 25,000 were registered with national and provincial HIV programmes.

Long thought to have low HIV prevalence, Pakistan has, in recent years, seen the virus rapidly resurfacing among sex workers and intravenous drug users. According to UNAIDS, Pakistan has among the fastest rates of HIV spread in the Asia Pacific region with 20,000 new infections reported in 2017.
  
This piece was produced by SciDev.Net’s Asia & Pacific desk.

* This article was amended on 3 June 2019 to change "Rato Daro" to "Ratodero" on the second Speed Read.