In 2000, the 189 member states of the United Nations agreed to a broad set of goals setting international development priorities for the coming years. The Millennium Development Goals (MDGs) build on a number of international conferences held in the 1990s, including the International Conference on Population and Development (ICPD) in 1994. Most of the goals of MDGs will be globally achieved by the year of 2015. The sixth goal of MDGs is to combat HIV/AIDS, malaria and other diseases.

The target (target seven of the MDGs) of this goal is to halt and begin to reverse the speed of HIV/AIDS and the incidence of malaria and other major diseases by 2015. Whether to achieve the target of this goal, the only one indicator for HIV/AIDS is to increase condom use rate.

In the context of a conservative society such as Bangladesh, the issues surrounding sexuality and STDs are stifled, stigmatized and hence hidden. The first HIV-positive case in Bangladesh was detected in 1998. Bangladesh, with a population of 136 million, had about 13,000 adults and children living with HIV infection at the end 2002, according to UNAIDS estimates. It is estimated that the prevalence rate of HIV/AIDS infection among adults (15-49 years) is less than 0.1 percent. As of end November 2003, the Ministry of Health and Family Welfare reported a total of 363 cases. Bangladesh is classified as a low HIV prevalence country. Nevertheless, latest surveys indicate a rapid increase of HIV positivity among injecting drug users (IDUs) from 1.7 percent in 2000 to 4 percent in 2002. Such concentrated HIV epidemic can have far reaching implications on HIV transmission to other vulnerable populations in the community. There are some internal and external factors that make Bangladesh more vulnerable to HIV/AIDS.

Only 37 percent of unmarried adolescent boys and 29 percent of unmarried adolescent girls know about HIV/AIDS. There are around 100,000 commercial sex workers in the country, most of whom are highly infected, who entertain five times as many clients, mostly with unsafe sex. In addition there are unsafe blood transfusion services and over 250,000 truckers plying all over the country. Bangladesh is surrounded by a country with high prevalence of HIV and has highly permeable international borders. Around 75,000 job seekers, unaware of HIV/AIDS, go abroad every year as migrant workers and many of them come back after being infected.

Before the situation worsens, the government, NGOs, members of civil society, and the development partners should join hands and act in a concerted manner to combat HIV/AIDS epidemic and prevent its spread. To achieve the goal, Bangladesh should meet the challenges. First challenge, socio-economic and cultural factors that can only be addressed effectively through a multi-sectoral and multi-dimensional approach. Second challenge, essential policy review and legal/law reform to enhance enabling environment and the impetus for HIV/AIDS prevention. Third challenge, since HIV/AIDS is a development concern, all development and health programs such as PRSP and HNPSP are expected to address HIV/AIDS.

A National AIDS Committee was already formed in 1995 to suggest ways and means for preventing HIV/AIDS. The GoB also developed a strategic plan for the National AIDS program (NAP) of Bangladesh in 1997. Several policy guidelines, such as surveillance and reporting of AIDS cases, testing guidelines, behaviour communication change, national blood transfusion services, counseling of HIV/AIDS patients, human rights, HIV/AIDS education in and out of school have been incorporated in NAP. These guidelines should be implemented properly and quickly. All out efforts need to be taken to mobilize the community and raise awareness with regard to the danger of HIV/AIDS epidemic and take preventive steps, otherwise, Bangladesh will become a high prevalence HIV/AIDS country.

A H M Kishowar Hossain is an Assistant Professor, Department of Population Sciences, University of Dhaka.