UNAIDS estimates that there are 297,052 persons living with HIV in Pakistan (according to Spectrum (v6.36) 2023), amongst which only 46991 are currently registered in government health facilities (June 2024) for treatment. In Pakistan like many places around the world, the communities most affected by HIV also suffer from high levels of marginalization, stigmatization and discrimination including people who use drugs, sex workers, sexual minorities, and transgender communities. Although HIV is a treatable condition whereby free medicine is available in Pakistan through a partnership between the Government of Pakistan, the Global Fund to Fight AIDS, TB and Malaria and UNDP, not enough people living with HIV are diagnosed and on treatment.

Despite notable advancements, Pakistan faces persistent challenges in ensuring widespread access to HIV care and support. UNDP has been working closely with partners to implement a prevention, treatment and care response in Pakistan that reduces communities’ risk to HIV, links people who are HIV positive to HIV treatment, and supports people to stay on their treatment. 

The grant aligns with the goals outlined in the Pakistan AIDS Strategy IV - PAS-IV, focusing on addressing the low coverage of prevention and testing among key populations. The strategic approach includes scaling up community-based interventions including HIV prevention commodities and testing, HIV information and counselling, medical services for sexually transmitted infections, and safe spaces for community mobilization. UNDP has linked with partners such as the Aurat Foundation for the provision of access to justice services so that communities know their rights and how to access legal services if necessary. Trainings on HIV awareness are provided to key stakeholders including police, parliamentarians, religious leaders, and media to reduce stigma and discrimination faced by people living with or affected by HIV. 

UNDP, in partnership with the Pakistan AIDS control programs at national and provincial levels, is working to expand treatment access and initiation through a phased introduction of treatment for all. This includes expanding the ART centers across the country and improving the quality of care with healthcare worker trainings and enhancing systems using data for decision making. For the first time ever, UNDP has introduced community-led monitoring for prevention services so that communities can play an active role in holding care providers accountable for quality. 

UNDP has commissioned the Health Services Academy to support the Government of Pakistan in the implementation of the 6^th round of the Integrated Biological and Behavioural Surveillance (IBBS) which will provide comprehensive data for key populations affected by HIV as well as for hepatitis B, C, and syphilis. This is a real opportunity for Pakistan’s health policy makers and programme managers to respond with programs and policies that address the lived realities of the men, women, girls, boys, and transgender communities most affected by and at-risk to HIV. 

Project Achievements:

1. Under the Global Fund HIV Project, Poverty Reduction & Inclusion Unit-PRIU expanded the community-based HIV prevention activities in Pakistan which benefitted 193713 Men who have Sex with Men (MSMs), 51144 Transgender Persons (TGs), and 67402 Female Sex Workers (FSWs); these services were delivered through 14 community-based organizations in 19 cities with 52 sites across Pakistan. 

2. To inform the HIV response with latest data and evidence on HIV & AIDS, for the Integrated Biological behavioral Surveillance was conducted to provide data  on the prevalence of HIV, Hepatitis B and C, and syphilis, prevalence,  and recommendations on how to adapt and evolve the response to meet the changing needs of communities.

3. National HIV&AIDS Advocacy and Communications Strategy – to take a holistic approach for HIV awareness, communications, and advocacy from communities to decision maker’s level.

4. UNDP developed an online digital health platform by introducing an application which is designed on Human Centered approach access to hard-to-reach communities and provide multi-dimensional services to key populations including information, awareness, access to healthcare centers and facilities at both public and community level, and the possibility to order HIV self-testing kits to residence.

5. More than 400 CBO staff from communities have been trained to provide quality, relevant prevention services resulting significant results in terms of outreach coverage and higher targets achievement reflected in National data base.

6. The quantity of food packages distributed to People Living with HIV (PLHIVs) from April to June 2021 amounted to 3,316, witnessing a substantial escalation to 27,000 by April to June 2024 during the implementation period under UNDP's auspices.

7. Number of MSM who received HIV test during the reporting period has been increased from 14,169 to 66,399 (368.622 % increase) Jan-June 2024

8. Number of PLHIV Children received treatment from ART by June 2021 was 2,227, which was increased by June 2024 to 3,434 (54% increase).

9. Establishment of Legal Aid desks to provide access to justice for Key Population in all four Provinces of Pakistan

10. Introduction of Prep & HIV Self-Testing for the first time in Pakistan

11. Community Led Monitoring for prevention launched for first-time in Pakistan.

12. IBBS round 6 Data collection has been completed.

13. Total Number of Condoms Distributed by June 2021 was 427,360, which was increased by June 2024 to 10,120,610 (2268% increase)

14. Training & Capacity Building support for CBO’s & ART for all cadres of staff is completed with the support of Provincial Aids Control Program on (comprehensive treatment & prevention services, (Outreach workers, Prevention strategy, M & E, DEO, STI, PreP, HTS & Self testing, PSEAH) in four provinces of Pakistan. 
     

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