Contacts:
Mehrin A. Mahbub (880-2) 8159001
email: mmahbub@worldbank.org Dhaka, December 07, 09: Despite Bangladesh’s vulnerability to HIV, an early action in launching community based interventions for high risk populations over the past two decades has kept HIV rates low, says a joint report of the World Bank and UNAIDS, launched today. HIV prevalence in Bangladesh remains below 0.1% in the general population.
The report titled “20 years of HIV in Bangladesh: Experiences and Way Forward”, takes stock of the experience with HIV in Bangladesh in the last two decades, summarizing what is known about the coverage and impact of HIV prevention services, including knowledge on risk and protective behaviors. In Bangladesh, HIV risk arises mainly from unprotected paid sex, sharing of used needles and syringes by injecting drug users, and unprotected sex between men who have sex with men. The report emphasizes the need for focused attention in two areas – injecting drug users and international returned migrant workers. While HIV prevalence in Bangladesh remains low, it has started to escalate amongst injecting drugs users in Dhaka, rising to 7% in 2007/08 in one particular neighborhood. An epidemic may also be emerging among female sex workers in towns bordering India. Socioeconomic status and gender inequality make certain groups like hijras and sex workers more vulnerable to HIV infection.
HIV infection was first detected in Bangladesh twenty years ago in 1989. The Government showed exemplary foresight in forming the National AIDS Committee in 1985, four years prior to the first case, and preventive measures initiated.
“Bangladesh responded early to HIV/AIDS even before the first case was reported in the country,” said Dr. Salil Panakadan, Country Coordinator of UNAIDS in Bangladesh. “We commend the initiatives taken by the Government of Bangladesh in preventing spread of the disease and the challenge now is to avoid complacency and carry on the good work even more vigorously.”
A state-of-the-art surveillance system was established in 1998 which has guided strategic and program decisions. Over the last 20 years, a fairly comprehensive set of policies, guidelines and strategic frameworks and a comprehensive panel of services have been put in place.
“The country needs to be concerned by pockets of infection which exist among high-risk groups. And some trends which bode well for the growth and development of Bangladesh, such as increasing cross-border trade and labor migration, bring with them risks of increased HIV infection within the general population” said Ms. Ellen Goldstein, Country Director of the World Bank Bangladesh “To keep the spread of HIV at bay, Bangladesh will need to further strengthen surveillance systems, better evaluate the effectiveness of targeted interventions, and scale up those that work”
HIV interventions are targeted at the high risk groups including sex workers and their clients, injecting drug users, hijras and men who have sex with men. HIV awareness and prevention information is also provided to the general population. Although condom promotion is the main thrust of HIV prevention programs for sex workers, Bangladesh has consistently documented low condom use by sex workers.
The report provides insights into the HIV/AIDS situation in Bangladesh, and highlights areas for urgent attention. It is based on 8 rounds of HIV sero-surveillance and 5 rounds of behavioral surveys as well as published and unpublished research. It highlights the importance of understanding and adapting to the local context. Further, local groups, particularly the high risk population needs to be actively engaged in the planning and implementation stages. The capacity of the Government agencies dealing with the response needs further strengthened. For more information on the World Bank in Bangladesh, please visit: http://www.worldbank.org/bd
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