Bangladesh in Crisis Mode as AIDS Cases Skyrocket: Urgent Measures needed

Rabiul Alam, Dhaka

Sattar Hossain (not real name), a 38-year-old man from Kurigram, has been living with HIV for the past five years. He faces various challenges in managing his health, including medication adherence, regular check-ups, and emotional well-being.

The stigma associated with the condition has led to social isolation, impacting his mental health. Not only Sattar, there are lots of such HIV patients who pass a intricate life everyday with many already succumbed to death. 

Individuals living with HIV still continue to face pervasive stigma and discrimination.  Misinformation about the virus contributes to a climate of fear, hindering open discussions and fostering negative attitudes. The association of HIV with perceived risky behaviors exacerbates judgment, and cultural influences often contribute to societal prejudice. 

Despite legal protections, there is underreporting due to the fear of discrimination, leaving individuals without necessary support. Negative attitudes from healthcare providers further compound the challenges faced by HIV patients, discouraging them from seeking essential medical care. 

Besides, the country is still in the throes of a severe public health crisis, grappling with the highest number of AIDS-related infections and deaths in 2023, a distressing record since the first patient was identified in 1989. 

Last year, the country witnessed an alarming surge with a record 1,276 AIDS infections and 266 deaths, painting a grim picture of the escalating crisis. Among the infected, 1,118 are Bangladeshi citizens, and 158 are Rohingyas living in refugee camps in Cox’s Bazar, according to a report of the National Tuberculosis, Leprosy, and AIDS Control Program. 

Since the identification of the first AIDS patient in 1989, Bangladesh has recorded a total of 10,984 diagnosed cases and 2,086 deaths. However, the Directorate General of Health Services (DGHS) estimates that the actual number of people carrying HIV in the country exceeds 15,000, underscoring the magnitude of the challenge.

The report highlighted the regional distribution of infections, with Dhaka leading the list with 342 cases among Bangladeshi citizens, followed by Chittagong (246), Rajshahi (175), Khulna (141), Barisal (79), Sylhet (61), Mymensingh (40), and Rangpur (34). Among these cases, 850 are men, 278 are women, and nine are transgender persons.

According to another report by Bangladesh Bureau of Statistics (BBS), Bangladesh had around 14,000 patients of AIDS till mid 2022, the most advanced stage of HIV infection. Though the number is low, the country is at high risk because of neighbouring countries which have higher transmission rates and easy access to drugs. Of them, around 84 percent came under treatment. 

As Bangladesh grapples with this unprecedented surge, urgent and comprehensive measures are imperative. The government, in collaboration with international partners, faces the daunting task of intensifying efforts to diagnose, treat, and prevent the spread of AIDS. The situation underscores the critical need for heightened awareness, increased accessibility to testing and treatment, and a concerted commitment to combatting this escalating public health challenge.

Against the backdrop of the global commitment outlined in the UNAIDS 95-95-95 goals, Bangladesh faces a challenging landscape in achieving these targets by 2025. The ambitious goals aim to ensure that 95% of all people living with HIV know their status, 95% of those with the virus are enrolled in treatment, and 95% of those on treatment have their viral load suppressed. 

Bangladesh’s progress falls short, standing at 63-77-93, revealing a pressing need for intensified efforts and strategic interventions to bridge the gap and meet these critical targets.

In the year 2021 alone, the country reported 729 new AIDS cases and 188 AIDS-related deaths. The distribution of these cases among various demographics reflects a diverse impact, with 26% affecting the general population, 20% impacting migrants, 8% attributed to intravenous drug users, 26% affecting Rohingya people, 9% impacting the homosexual population, 7% among male sex workers, 2% in the transgender community, and 2% among female sex workers. These figures underscore the need for targeted interventions and a comprehensive approach to curbing the spread of AIDS across diverse populations.

In 2019,there has been a total of 919 positive people identified in 2019 and the virus killed 170. In 2018, 869 people were infected with HIV and out of that 148 died. Among the HIV positive population, 74% are male, 24 % are female, while 1% are transgenders.

According to a report of UNICEF, published some four years back, about 3.60 lakh adolescents are projected to die of Aids-related diseases across the world between 2018 and 2030. About 76 teenagers are projected to die every day if any additional allocation is made in preventing HIV, screening and treatment project. Currently, two adolescents are being infected by HIV in every two minutes.

Expressing deep concern over the surge in AIDS cases, DGHS Director General Dr Abul Bashar Mohammad Khurshid Alam said, “While Bangladesh has been successful in eradicating or controlling many diseases, it has stagnated in controlling AIDS. More emphasis needs to be placed on diagnosing and treating AIDS, and precautions must be taken to prevent its spread.”

However, alongside negative the country has some good news as well. In 2022, a total of 74,491 pregnant women underwent HIV testing as part of the Prevention of Mother-to-Child Transmission (PMTCT) program nationwide. Within this cohort, ART centers identified twenty-two new cases of HIV-positive pregnant women. Among the infants born to HIV-positive mothers that year (25 in total), an impressive 24 were born HIV-negative, showcasing the effectiveness of interventions. Only one newborn tested positive for HIV.

Data from the Directorate General of Health Services (DGHS) provides a broader perspective, revealing that, from 2013 to 2022, 238 HIV-positive mothers receiving treatment at ART centers gave birth to 224 HIV-negative babies. During this period, only 14 newborns tested positive for HIV. Bangladesh has achieved remarkable success, with over 95% of babies born to HIV-positive mothers being HIV-negative. 

According to Md. Akhtaruzzaman, Senior Manager of the AIDS/STD Programme at DGHS, the remaining 5% of positive cases can be attributed to delays or avoidance of treatment by the mothers.

Bangladesh confronts a crisis demanding swift and decisive action. Urgent efforts are needed to dispel myths, enhance awareness, and foster a more inclusive and supportive environment for people living with HIV.