New HIV prevention strategy to target injecting drug users, gay men, sex workers

The Health Protection Agency’s (HPA) new national strategy on HIV prevention will scale up prevention programmes in key affected populations of injecting drug users, sex workers, men who have sex with men.

By 2016, the HPA aims to reach at least 60 percent of injecting drug users to promote the safe use of injecting equipment and consistent condom use with sexual partners.

The HPA aims to reach 80 percent of sex workers and men who are having sex with men to promote the consistent use of condoms.

The health ministry has previously said the Maldives was sitting on an HIV “time bomb” due to the lack of prevention programmes and specialised care for groups at risk.

The HPA has previously expressed concern over the prevalence of behaviors that increase risk of HIV spread such as promiscuity, unsafe sex and intravenous drug use.

There are nine individuals receiving treatment for HIV at present. The HPA estimates there are 32 individuals living with HIV in the Maldives. The figure could reach 123 by 2020 if prevention measures are not put in place, the agency said today.

Meanwhile, the Society for Health Education (SHE) has called for the integration of sexual reproductive health services and HIV prevention efforts.

“Integrating sexual reproductive and HIV prevention has the potential to stem an HIV pandemic. When vulnerable groups have increased access to and use sexual reproductive health services, it decreases the spread of HIV,” Shiyama Anwar of SHE said.

“Integration of these services provides a more comprehensive service that benefits both the clients and service providers,” she added.

According to the HPA, it currently only receives 15 percent of requested funds for HIV prevention, care, and treatment. The majority of the funds released from state budget are spent on treatment of infected individuals rather than on prevention.

The agency has called on the government to scale up sexual reproductive services and HIV prevention programmes, arguing interventions such as life skill programs for youth would only cost MVR350 per person while the state spends over MVR50,000 on each individual infected with HIV.

In the period between 2006 and 2013, 161 female victims of rape, which included underage girls became pregnant, HPA figures explain. The state spends MVR 174,000 on each child every year under state care. In comparison, providing quality contraceptives only costs MVR 1000 per person annually.

Meanwhile, the state spends MVR 22,900 per month on every individual receiving state care at drug rehabilitation centers. However, methadone or oral substitution treatment would only cost MVR14,400 and comprehensive awareness programmes would only cost MVR 800 per child, says the agency.

The HPA has called on the People’s Majlis to integrate services on HIV prevention, sexual reproductive health, and drug abuse, and grant service providers with adequate financial resources.

Related to this story

Health Ministry seeks to protect mothers and infants from HIV “time bomb”

“Worst fears over HIV coming true”: Health Minister

High-risk behaviour leaves Maldives at risk of HIV/AIDS “explosion”


New drug-resistant strain of TB found in Maldives “quite serious”: HPA

The Health Protection Agency (HPA) has warned that a new drug-resistant strain of tuberculosis (TB) that has appeared in the Maldives poses “quite a serious threat” to people’s health.

The agency’s comments follow a report released by the Ministry of Health on Sunday (March 24), revealing that it faces new challenges in order to control the disease in the Maldives.

According to the World Health Organisation (WHO), TB is an infectious bacterial disease that can be transmitted via droplets in the throat and lungs of the infected.

WHO states that drug-resistant strains of TB have become a major public health problem that has resulted from patients not fully completing the recommended six-month course of treatment.

HPA Public Health Program Officer Shina Ahmed told Minivan News today (March 25) that although the new strain of TB is “quite serious”, the particular strain found in the Maldives is not resistant to every drug available to patients.

“We have had a few cases come in now with the new strain. The most important thing we have to do is to continue and complete the course of treatment.

“Most of these drug-resistant strains are caused by patients stopping the treatment. We have enough drug supplies to give to them, but because the course goes on for six months, patients tend to go off taking the treatment towards the end,” Shina said.

Local media reported that the Health Ministry had revealed that 10,563 people had been registered to receive treatment for TB since 1963, out of which 5,256 people were said to have infected lungs.

Shina claimed that the majority of cases within the Maldives have been reported on the islands as opposed to Male’, and that in order to prevent the spread of the disease the HPA will be undertaking awareness programs.

An official from Indira Gandhi Memorial Hospital (IGMH) in Male’ stated that there was no need for the public to be concerned in regard to the spread of the disease, adding that there may have been only “one or two” cases found to have contracted the new strain.

“When we find a patient who is not responding to the prescribed course of treatment, there is always a second course they can take instead,” the official told Minivan News.

According to WHO, healthy individuals infected with TB are not often affected by any symptoms as the person’s immune system acts to “wall off” the bacteria.

The organisation states that symptoms of active TB are coughing, sometimes with blood, chest pains, weakness, weight loss, fever and night sweats.

The WHO Representative to the Maldives, Dr Akjemal Magtymova, Health Minister Dr Ahmed Jamsheed Mohamed and the Health Ministry were not responding to calls at time of press.


Criminal court employees screened amid tuberculosis scare

Public health workers screened Criminal Court staff for tuberculosis (TB) and conducted awareness sessions about the disease on Thursday after an employee tested positive for the infectious disease.

A court employee told Minivan News today that staff were relieved health officials were now working to put a stop to the potential spread of tuberculosis at the court.  However, the member of staff said their colleagues were  “seriously concerned after one employee was tested positive”.

The employee speculated that the disease may have been transmitted to the court employee from a TB patient, who was brought to the court two months ago for a police custody extension.

Local media has reported that three court employees are thought to have tested positive for the disease so far.  These reports were today dismissed by court workers.

The staff member observed that the local media had picked up on the TB case because of the awareness session being held at the court today, while claiming that reports of multiple confirmed cases was misleading.

“It was just one confirmed but everyone was very scared.  All the employees have been screened now and nobody else was tested positive. But since there was widespread scare, doctors came to the court today and gave us information on TB,” the employee noted on condition of anonymity. “There was some concerns but everything is normal at the court now,” he added.

The potentially serious disease spreads from person-to-person through the air, for example, if someone coughs or sneezes.  It primarily attacks the lungs.

Despite, the TB scare at the Criminal Court, the Maldives has achieved notable success in TB control since the establishment of a National TB control programme (NTP) by the Department of Public Health in 1976. Maldives has an estimated incidence of 47 per 100,000 population of all forms of TB and has sustained the global targets for TB control since 1996, according to the World Health Organisation (WHO’s) communicable disease department for South East Asia.

Tuberculosis, which had a prevalence in the Maldives of 35 cases per thousand people in 1974, had declined in 1996 to about 0.66 per 1000. Childhood TB (under 5 years) is almost nil for the past three years due to the high rate of BCG vaccination, the report added.

The WHO also observed that upon adopting the recommended Directly Observed Treatment Short-course (DOTS)  in 1997, the TB patients in the Maldives continues to receive effective treatment.

However, the Health Ministry has recently raised concerns over a growing number of multidrug-resistant tuberculosis (MDR-TB) in Maldives. The rate of TB prevalence among the country’s  expatriate population is also reportedly on the rise as well.

“Large migrant workforce from high TB-burden countries,” is identified by the WHO as major challenge for local health bodies. However, the WHO has claimed that “MDR-TB and TB-HIV are not major problems in Maldives.”

Meanwhile, a growing diagnoses of multi drug-resistant tuberculosis (MDR-TB) and treatment sites are being established in the region. In 2010, almost 4000 MDR-TB patients were put on treatment.  There are currently 105,000 MDR-TB cases estimated of affecting the region.  These figures were taken from the WHO annual report on tuberculosis titled “Tuberculosis Control in the South-East Asia Region 2012”.

The South-East Asia Region registered an estimated five million prevalent, and about 3.5 million incident TB cases in 2010.  Though the death rates in the region have declined due to successful implementation of the DOTS (directly observed treatment, short course), the disease still claims about half a million lives a year in the Region, the report read.