Nepal Faces Numerous Challenges in Achieving HIV/AIDS Millennium Development Goal, Inter Press Service Reports
A large gap between reported and estimated HIV/AIDS cases in Nepal makes achieving a target in the United Nations Millennium Development Goals of halting and reversing the spread of HIV/AIDS by 2015 a "far-fetched dream," Inter Press Service reports. In addition, despite $36 million in aid from the Global Fund To Fight, AIDS, Tuberculosis and Malaria, the country continues to face challenges in providing antiretroviral treatment to those living with HIV/AIDS, according to Inter Press Service.
National estimates show that 92% of HIV/AIDS cases in the country are among people ages 15 to 49, and 2007 figures indicate that 42% of all cases are among seasonal labor migrants, 15% occur among clients of commercial sex workers and 21% occur among wives or partners of HIV-positive men. In terms of treatment, the Inter Press Service reports that although Nepal has provided access to antiretrovirals and CD4+ T cell count tests since 2004 and 2005, respectively, the country still does not have the capacity to perform HIV viral load tests. There are 25 antiretroviral facilities in 25 of Nepal's 75 districts, and 1,920 HIV-positive people out of the estimated 70,000 living in Nepal have received treatment to date, according to the National Centre for AIDS and STD Control. Rajiv Kafle, vice chair of the Country Coordination Mechanism for HIV/AIDS, said, "For the effective implementation of [antiretroviral] drugs, viral load testing is very important along with introducing provider initiative counseling testing for effective result[s] rather than voluntary counseling testing." Kafle added, "Due to the low number of testing facilities, most of the HIV-infected people are unaware of it. There is a need for massive testing campaigning. Even though there is treatment availability, due to lack of testing, (the) majority of HIV-infected people are dying." Furthermore, the Inter Press Service reports that because of the low number of testing facilities, many HIV-positive people who have been taking antiretrovirals for years do not know if the drugs have been effective because a T cell count is needed to make such a determination.
Dirgha Singh Bam, secretary of Nepal's Ministry of Health and Population, said, "We are working on introducing various new strategies and technologies to achieve the Millennium Development Goals on HIV/AIDS. It needs collective efforts and more preventive program[s], which the government is working on."
Jeffrey Scot Morey, portfolio manager for the Global Fund, said that with the support from public and private partnerships, as well as Nepali people, it is possible to achieve HIV/AIDS targets in the MDGs. Morey said, "The national strategy is to increase the availability of voluntary testing and treatment," adding, "As effective programs are implemented and proposed and ongoing research is continued, more precise information will be available." Morey also said, "Reducing transmission among groups driving the HIV epidemic through high-risk behavior is crucial and needs to remain a focus of the response," adding that the number of people living with HIV/AIDS in Nepal continues to increase, along with those in need of care (Kshetry, Inter Press Service, 10/28).