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STIs and HIV in Pakistan: from analysis to action

> Medicine is a social science, and politics is nothing else but medicine on a large scale. Medicine, as a social science—as the science of human beings—has the obligation to point out problems and to attempt their theoretical solution. The politician, the practical anthropologist, must find the means for their actual solution.1

More than a century ago Rudolf Virchow, pathologist, physician and politician, argued that progress in public health—while dependent on knowledge generated within specific disciplines—requires, principally, integrated and interdisciplinary approaches, especially if we are to move from the theoretical to the practical.

Heeding this principle, a diverse group of researchers and practitioners sought to understand the drivers of sexually transmitted infections (STIs), including HIV, in Pakistan. The results of the research, presented in this supplement, suggest three central messages. First, a window—which is likely closing—exists to prevent a more widespread HIV epidemic in the country. Second, the need for massively scaled-up interventions is pressing: awareness and knowledge are low, measures to reduce risk are low and levels of vulnerability are high. Third, efforts to ramp up service delivery will need to be matched by deliberate yet ingenious and sensitive work from civil society. Such work will need to confront the social and cultural factors which are at the root of many of the vulnerabilities which will fuel a potential epidemic—from the position of women to the values which drive homosexuality underground to the regulations concerning human rights and the manner in which they are enforced.

The multidisciplinary research presented here was commissioned by the National AIDS Control Programme in Pakistan and funded by …