HIV/AIDS in Pakistan - Future of HIV and Pakistan's National Response

Future of HIV and Pakistan's National Response

Going forward the Government of Pakistan has approved a new ambitious 5 year plan that will be worth almost PKR 8 billion. However, a number of challenges will have to be met during this phase. The most immediate perhaps will be developing the methodology of measuring the impact of program interventions. A National M&E Framework has been developed but implementation on it has yet to start. Lack of the ability to measure the outcomes or impact of interventions in real time (so that this knowledge can inform program direction) was likely the most important factor in the low performance of the first Enhanced Program. Other challenges that must be overcome include establishment of a transparent financial management and a smooth logistical and procurement system. Much of the Enhanced Program services are contracted out and delays in procurement of these services meant that many of the cities went without services for months to years. More complex (and longer term) challenges will include determining how to integrate many of HIV activities within other health activities, improve planning to anticipate future direction of the epidemic and its response and to enhance efficiency and effectiveness of the interventions. For these research must become part of the interventions to guide their implementation using local context and to involve epidemiological tools such as routine analysis of available data and even mathematical modeling to guide program planning.