PRE-EXPOSURE PROPHYLAXIS PROGRAMME 

Dr. Jassim Taqui

DG Al-Bab Institute for Strategic Studies

Islamabad, October 16, 2022: The Health Department of the Government of Punjab, in partnership with the United Nations in Pakistan, launched the Pre-exposure Prophylaxis Programme (PrEP) in Lahore yesterday.

 

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 Punjab in partnership with the United Nations in Pakistan, set a precedent in the country by launching community-based- PrEP for key populations and serodiscordant couples. PrEP does not replace condoms but offers an additional HIV prevention choice. Community-based PrEP dispensation is critical because CBOs working in Punjab have outreach programs and can play a pivotal role in creating awareness and ensuring stigma-free access to PrEP programs.

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 of General Health Services of the Health Department Punjab in partnership with UNAIDS, UNDP, and WHO. Before the launch event, training was held with ART Centre staff from around the Punjab province on ensuring effective and evidence-based PrEP services.

Dr. Awias Gohar, Project Director PACP 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 programs for key populations. For the administering of PrEP to serodiscordant couples and key populations, formal linkages have been established between ART Centres and the outreach component of the current program. This approach utilizes outreach workers at the frontline to engage individuals who are at risk for HIV. Their main task is to connect members of 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 behavior changes, and most importantly, refer the community for HIV testing and counseling and created linkages with ART treatment centers.”

Asim Raza, Additional Secretary of Coordination and vertical programs, primary and secondary Health Department of Punjab shared that “The Punjab AIDS Control Program has been providing free of cost counseling, testing and treatment services for more than two decades to people living with HIV. Given the recent expansion, the program now has its network of centers expanded to all 36 districts of Punjab. The program has forty-five centers that are located in teaching and DHQ hospitals. The program has its own advanced diagnostic bio-safety level 3 laboratory. It is stated with great pride that due to this laboratory the program provides free PCR and CD4 tests for HIV patients that are very expensive if done from any private lab. The dedication of the program and its staff is commendable. The provision of free-of-cost services such as testing and medication and the program's robust lost to follow-up mechanism are truly remarkable. Since July 2016 the program has screened 2,041,998 persons for HIV. The program since its inception has registered 35,976 HIV-positive persons and currently, 17,154 positive persons are on regular treatment. It is very proudly stated that the program has been successful in ensuring 204 HIV-negative births from HIV-positive mothers. In Punjab, the leading cause of HIV transmission is quackery. The re-usage of medical instruments by quack doctors and dentists causes HIV transmission and once a person becomes a carrier he is surely to transmit it to their spouse. This is why we believe that PrEP is groundbreaking as it will curtail the transmission of HIV between spouses. Used along with other preventive measures the results will be not short of remarkable. I would like to commend the community-based organizations present here for their services and support. They play a key role in linking community members to treatment centers and keeping them strong in face of every stigma and discrimination. We as a nation also must work on changing our behavior towards the stigma and discrimination that is present when it comes to HIV/AIDS. Many HIV patients never opt for testing and treatment due to the fear of this disease. It is our responsibility to create environments that are warm and welcoming so every HIV patient can get treatment without fear, stigma, and discrimination.