National Action Plan for HIV outbreak in Pakistan
If I am on call and a patient of a different doctor goes into cardiac arrest, I won't waste time cursing that doctor calling this as his/her negligence because seconds would matter. Now that cross-cover patient is my responsibility & whatever happens to him or her in my time is on my shoulders. Imran & PTI are busy wasting time throwing the carnage of HIV outbreak on PPP all while more & more people in Pakistan continue to contract disease. Where is the resuscitation effort by PTI? I demand from PTI & PPP & PML (N) to end the blame game & take this matter as seriously as they once took terrorism seriously after the APS attack. This could be bio-terrorism for all you know. Think about it. How easy would it be for any RAW/ Mossad agent to act as a doctor using dirty syringes on our children on purpose to spread disease. It will be honestly very easy. Here is a plan I wrote down for PTI to enact to fight this health emergency.
1) Make and empower a CDC-like institution that can ensure to implement this plan.
2) Enrol ID (infectious disease) doctors as many as you can get in your team. Use Pakistani American & Pakistani European ID physicians if there are negligible in Pakistan.
3) Initiate a national prevention initiative right now
a) Flood media (electronic & paper) with HIV transmission "hows" in regional languages plus enrol all mosques & madrassahs in educating people about how HIV can be contracted. There must be announcements every day from every mosque's loudspeaker.
b) Crackdown emergently on quacks plus licensed practitioners plus hospitals plus dentists plus barbers plus salons. This must be done nationally. All illegal practitioners must be shut down right away within the next 48 hours. All licensed practitioners must be monitored to assess their machines & syringes. Dentists must be checked out first. This should be achieved within the next 2 weeks.
c) Ask all mosques to have people call hotline number to report any clinic or doctor that is using contaminated syringes or machinery on patients.
d) Test all pregnant women for HIV.
4) Diagnosis
Like we do the census we must do it again through every mosque in every corner of Pakistan. Collect all people in a community & do widespread screening in every corner of Pakistan. All patients of HIV must be recorded so as to ensure they are treated.
5) Management
a) we must make HIV meds in Pakistan. There is no other way to manage this crisis.
b) We must have an HIV desk in all DHQs with a trained physician who must register all patients, start treatment & ensure periodic follow-ups. If the patient is not showing up for his/her appointment, staff should visit him/her. Also Utilize LHW network to educate & ensure that HIV patients are taking their treatment & using precautions to prevent further dissemination.
DHQs must be supervised by team of ID physicians working for CDC to ensure quality of care is provided.
Let me be very straight-forward with you.
HIV treatment is very complicated because the virus mutates. In my medical training, if a patient is non-compliant & doctor is sure there won't be a follow-up guaranteed, that doctor would rather not treat that patient because of the increased risk of resistant strains that could arise from
non-compliance of the patient. If this non-compliant patient transmits the disease to a 100 more people, now you have the mutant resistant strain in 100 people from one. The medications of HIV have a lot of side-effects. These must be monitored in all patients as well. According to the
side-effects profile patient presents with, medications have to be shuffled around in HIV patients. The treatment is even more complicated than Hepatitis.
I see not just the government silent on this outbreak but also the medical community of Pakistan. There is a lot of hype & tweets on the KPK doctors' rights but what about the rights of those children who can't even pronounce or spell HIV & who will live with it for the rest of their lives. If we as a nation are going to use TikTok or youtube to only do cooking shows or pajama shows instead of reaping the true benefits of this 4th digital industrial revolution for useful entities, then we will be worse than we are right now.
-Dr FAB, MD
Chairperson
PakIslam Positive League
President Free Kissan Free Pakistan
Founder PUSH (Pakistan Peace Universal Strategic Hope) Institute
Founder FKG (Friends of Kashmir & Gaza)
Associate Professor Internal Medicine University of AZ
1) Make and empower a CDC-like institution that can ensure to implement this plan.
2) Enrol ID (infectious disease) doctors as many as you can get in your team. Use Pakistani American & Pakistani European ID physicians if there are negligible in Pakistan.
3) Initiate a national prevention initiative right now
a) Flood media (electronic & paper) with HIV transmission "hows" in regional languages plus enrol all mosques & madrassahs in educating people about how HIV can be contracted. There must be announcements every day from every mosque's loudspeaker.
b) Crackdown emergently on quacks plus licensed practitioners plus hospitals plus dentists plus barbers plus salons. This must be done nationally. All illegal practitioners must be shut down right away within the next 48 hours. All licensed practitioners must be monitored to assess their machines & syringes. Dentists must be checked out first. This should be achieved within the next 2 weeks.
c) Ask all mosques to have people call hotline number to report any clinic or doctor that is using contaminated syringes or machinery on patients.
d) Test all pregnant women for HIV.
4) Diagnosis
Like we do the census we must do it again through every mosque in every corner of Pakistan. Collect all people in a community & do widespread screening in every corner of Pakistan. All patients of HIV must be recorded so as to ensure they are treated.
5) Management
a) we must make HIV meds in Pakistan. There is no other way to manage this crisis.
b) We must have an HIV desk in all DHQs with a trained physician who must register all patients, start treatment & ensure periodic follow-ups. If the patient is not showing up for his/her appointment, staff should visit him/her. Also Utilize LHW network to educate & ensure that HIV patients are taking their treatment & using precautions to prevent further dissemination.
DHQs must be supervised by team of ID physicians working for CDC to ensure quality of care is provided.
Let me be very straight-forward with you.
HIV treatment is very complicated because the virus mutates. In my medical training, if a patient is non-compliant & doctor is sure there won't be a follow-up guaranteed, that doctor would rather not treat that patient because of the increased risk of resistant strains that could arise from
non-compliance of the patient. If this non-compliant patient transmits the disease to a 100 more people, now you have the mutant resistant strain in 100 people from one. The medications of HIV have a lot of side-effects. These must be monitored in all patients as well. According to the
side-effects profile patient presents with, medications have to be shuffled around in HIV patients. The treatment is even more complicated than Hepatitis.
I see not just the government silent on this outbreak but also the medical community of Pakistan. There is a lot of hype & tweets on the KPK doctors' rights but what about the rights of those children who can't even pronounce or spell HIV & who will live with it for the rest of their lives. If we as a nation are going to use TikTok or youtube to only do cooking shows or pajama shows instead of reaping the true benefits of this 4th digital industrial revolution for useful entities, then we will be worse than we are right now.
-Dr FAB, MD
Chairperson
PakIslam Positive League
President Free Kissan Free Pakistan
Founder PUSH (Pakistan Peace Universal Strategic Hope) Institute
Founder FKG (Friends of Kashmir & Gaza)
Associate Professor Internal Medicine University of AZ
