Asian People’s Alliance for Combating HIV&AIDS

Dr.Saif-ur-Rehman, the Director of National AIDS Control Program, gave us his views on the HIV & AIDS scenario in Afghanistan.

What is the current scenario of HIV & AIDS in Afghanistan? What are the major challenges faced in the fight against this epidemic? What strategies have been adopted to tackle these challenges?

Afghanistan is considered to be a low HIV prevalence country but with many vulnerability factors; witnessing three decades of war, poverty, high mobility, increase in number of injecting drug users and long distance truck drivers. Currently Afghanistan has 505 HIV positive cases and estimated number according to UNAIDS is between 1000-2000 cases. The main challenge in Afghanistan is stigma and discrimination against HIV positive people. Others are low capacity in delivering the services and security situation.
Under the World Bank funded project we have the component of advocacy and communication which has been given to Constella Future to work on reduction of stigma and discrimination against positive people. National HIV and AIDS Control Program is in the process of building the capacity of national NGOs as well as the core staff in order to respond to the threat of HIV epidemic.
What is Afghanistan’s progress towards scaling up the health sector response to meet universal access targets for HIV prevention, treatment, care and support?

In Afghanistan, the health services are largely provided by NGOs while MoPH is playing stewardship role in this regard. Functionally the health system has been divided into Basic Package of Health Services (BPHS) and Essential Package of Hospital Services (EPHS).The BPHS has the following layers Health Post----Basic Health Center(BHC)----Comprehensive Health Center(CHC)----District Hospital(DH)----Provincial Hospital(PH).HIV testing and counselling has been included in CHC, District hospital and Provincial hospital. These centers are also providing condoms for family planning purposes as well as the STI care. Now this strategic document is in the process of revision; we are going to include ARVs also in these centers on need bases.
For civil society, what are the main barriers and opportunities to increasing coordination on HIV and AIDS support? Overall, what practical recommendations do you have about how the interests of civil society could be best promoted and protected within increased coordination on HIV and AIDS?

In Afghanistan the NGOs community is more active in delivering health services as they were doing it even during War time. In Afghanistan, we have HIV and AIDS Co-ordination Committee of Afghanistan (HACCA) in which NGOs, Civil society organizations, Governmental organizations, Donors have active role to play. Every decision is made through this forum. There are specific working groups which take the task of performing the specific tasks assigned to this group. eg. Surveillance working group overseeing the current activities of surveillance in the country. All the concerned NGOs have representation of these working groups.
What measures have the civil societies and governments taken to address the concerns of the women who are the most vulnerable group?

We have the national document on tackling HIV and AIDS in gender sensitive manner which is strictly followed by service providers in Afghanistan. Female sex workers have access to user friendly services in Afghanistan.
What are your strategies to develop HIV & AIDS programs in order to connect with wider like-minded organizations to share similar goals and experiences?

NACP has wide links with international and national organization which are committed to fight against AIDS. In Afghanistan we have involved religious leaders as well in the fight against AIDS.
How would you rate the government’s response in Afghanistan?

It is very proactive and the indicator for HIV prevention is included in the Afghanistan National Development Strategy (ANDS) which is a high level document for all the developmental programs in Afghanistan. (Maintain the HIV prevalence in the general population below 0.5% by the end of 2010 ANDS)
What is your message for the government, civil societies, NGO and INGOs in Afghanistan?

As we have the strong commitment to fight AIDS, we have to keep this up and have more co-ordination among ourselves as well as perform according to the international standards. We should try to avoid donor fatigue and avoid duplication and strongly believe on three one principles.