The number of people infected with HIV/AIDS has been growing, especially among the high-risk groups, officials said here on Wednesday. Without a concerted and coherent response, Nepal is confronting the real possibility of devastating social and economic effects of the kind of full-blown HIV/AIDS epidemic seen in other countries

The National Centre for AIDS and STD Control said as of April 30, the cumulative figure of HIV/AIDS infected people in Nepal stood at 2,262. This included 1,636 males and 626 females.

The centre said 591 people out of the total HIV positive people were found to have AIDS virus. The number of people who have died of HIV/AIDS, according to official figures, is 153.

Nepal has a concentrated epidemic, characterised by a low prevalence rate among the general population but significantly higher rates among high-risk behaviour groups such as injecting drug users and sex workers.

Of the total number of people confirmed to have contracted HIV virus, almost 62 per cent constitute of clients of workers 19 per cent sex workers themselves and 11 per cent of injecting drug users.

The NCASC was established in 1987 under the Department of Health. It was only in 1995 that the Health Ministry adopted a National Policy on HIV/AIDS/STDs, establishing a multi-sector approach involving 12 government ministries.

However, only few of the activities specified in the 1997 National HIV/AIDS Strategy were implemented and intra-sector coordination has remained elusive.

The political environment-denial and lack of commitment-has impeded coherent prevention and control efforts. Moreover, lack of ownership among the affected people had been a major challenge for NCASC.

“We have tried to identify the problems and address it considering the perspectives of the affected people, to not repeat the same mistakes we made in previous years,” said Dr Naresh Pratap KC, deputy director of NCASC. “We are finalising on the strategic plans against HIV/AIDS for next five years, which will be completed by mid-June.”

The first case of AIDS in Nepal was reported in 1988. As of September 2000, it was estimated that 30,000 people in the country were living with HIV/AIDS, and in 1999 alone, 2,500 AIDS-related deaths had occurred according to UNAIDS estimates.

Only in Kathmandu Valley, HIV prevalence rate among IDUs in the early 1990s was about 2 per cent. It now exceeds 50 per cent. It is estimated that one-third of HIV infections nationwide are among injecting drug users.

The prevalence among female sex workers also increased from less than 2 per cent in 1990 to current rate of 20 per cent. Female sex workers, who inject drugs, have a higher HIV prevalence of 70 per cent.

At the end of 1997, an estimated 10,000 women and 580 children under the age of 15 were living with HIV/AIDS.

The trend of increasing HIV infections, combined with heightened social and economic vulnerabilities fueled by extensive commercial sex, injecting drug use, low condom use/access, and population movements highlights the need to act quickly and effectively.

HIV/AIDS is no more solely a health issue. Responding to HIV/AIDS now would cost only a fraction of what will be required at a later stage when the disease is allowed to become more widespread.