Last June, 51-year-old Jalu Nepali, a resident of Triveni Municipality in Bajura, died after five years of being infected with the human immunodeficiency virus (HIV). In May, a 54-year-old HIV-positive woman named Paulya Sarki, also from Triveni Municipality, breathed her last.

The government has set up anti-retroviral therapy (ART) centres in select medical facilities to distribute free medicines to HIV patients. In Sudurpaschim Province, there are 17 ART centres to dole out medicines to HIV-positive people in its nine districts. Almost all districts of the province have more than one ART centre, but Bajura, one of the remotest and with difficult topography, has just one.

According to data from the provincial health directorate, 66 HIV-positive people in the province died in the course of treatment in the fiscal year 2022-2023. Similarly, over the past three years, 226 HIV-infected people have died, of whom 72 were women and 154 men. This data on the deceased represents the records of only those who have come in contact with health institutions and were getting treatment, and the actual number could be much higher, said officials of the directorate.

Manoj Ojha, public health officer of the directorate, said that Kailali saw the highest number of HIV-related deaths, which was 32 in the fiscal year 2022–23; 38 in the fiscal year 2021–22; and 22 in the fiscal year 2020–21.

“In every district of the province, many HIV-positive people die every year, but the government agencies do not have that data as HIV and sexually transmitted diseases are still considered taboo in our society,” said Mina BK, an HIV-positive patient, activist, and president of Bajura Plus, a social organisation working to make people aware of HIV. “Some HIV-positive people, especially in remote areas, die by suicide, go out of contact, and don’t come forward but choose to suffer in silence because they feel ashamed.”

In the last fiscal year, 173 new HIV cases were discovered in tests conducted on 7,103 people by several government health institutions, and 81 new cases in tests carried out by various organisations.

Currently, 3,626 HIV-infected people and their children are taking medicines from the 17 ART centres in the province, said Ojha, public health officer of the directorate. “Reports of different agencies at the local and district levels show that most of the 226 HIV patients who died in the past three years were from working-class families with poor economic backgrounds or were unemployed.”

According to Dr Sher Bahadur Kamar, superintendent of Seti Province Hospital, one of the ART centres in Kailali, it is important for HIV patients to maintain a healthy and nutritious diet alongside medication.

“Due to poor economic conditions, mental illness, and societal pressure, patients fail to maintain a good diet and sometimes even discontinue the medicines that are provided free of charge,” said Kamar.

The National AIDS Strategy 2016–2021 commits to cutting the number of new infections by 50 percent, new infections among children by 90 percent, and the AIDS-related mortality rate by 25 percent. It says HIV/AIDS will be eradicated by 2030, but the number of infected people and the mortality rate are still on the rise.

“Poverty is the main obstacle to fighting HIV infection in our conservative society, where HIV-positive people are treated like untouchables, leaving them unemployed. The infection would be easier to control if the government helped them get good jobs and shelter and conducted more effective awareness programmes,” said BK.

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Mina BK, the president of Bajura Plus, and others speaking at an interaction on HIV/AIDS in Bajura in this recent photo. POST PHOTO: ARJUN SHAH