Wednesday, August 17, 2022

𝙏𝙃𝙄𝙈𝙋𝙃𝙐-𝘽𝙃𝙐𝙏𝘼𝙉: In the last six months from 𝗝𝗮𝗻𝘂𝗮𝗿𝘆 𝘁𝗼 𝗝𝘂𝗻𝗲 𝟮𝟬𝟮𝟮, the Ministry of Health has detected 𝟰𝟬 𝗻𝗲𝘄 𝗛𝗜𝗩 𝗰𝗮𝘀𝗲𝘀 (19 male and 21 female). This is one of the highest cases detected in the six-monthly reports until now. Out of 40 newly diagnosed cases, the majority (70%, n=28) are between the ages of 25-49 years old and 20% (n=8) of them are above fifty years old while 5% are between the ages of 20-24 years and another 5% are below 5 years. Among the new cases, 13 are diagnosed through medical screening, 12 through contact tracing, 10 through Voluntary Counseling and Testing (VCT), and 5 through screening of pregnant mothers attending the Antenatal Care (ANC) services. Out of 40 new cases, 38 of them have contracted HIV through unsafe heterosexual practices and 2 from Mother to Child Transmission (MTCT). Regarding the two MTCT cases, it was learned that both the mothers were found HIV negative during the first ANC visit in 2016 and 2017 respectively. However, these two pregnant mothers may have been exposed to HIV infection after the first HIV test and during the latter stage of their pregnancy (after the first ANC visit, before delivery, or during breastfeeding) and then transmitted it to their children. These mothers went undetected during the later stages of their pregnancy checkups because back then there was no policy of mandatory two-time HIV testing for pregnant mothers. The policy of two-time HIV testing (first visit and before delivery) was introduced in 2018 to prevent such risk of mother-to-child transmission. 

The cumulative number of cases reported 𝗳𝗿𝗼𝗺 𝟭𝟵𝟵𝟯 𝘂𝗻𝘁𝗶𝗹 𝗝𝘂𝗻𝗲 𝟮𝟬𝟮𝟮 𝗶𝘀 𝟴𝟯𝟱 (433 male and 402 female). Sporadic cases appeared between 1993 and 2000. From 2000 to 2013, the number of new HIV diagnoses rose from 9 to 51. Since 2013, the case detection has plateaued, fluctuating between 49 and 58 annually. At present, about 628 people are living with HIV (PLHIV) in the country. Out of 628 PLHIV, 608 are on antiretroviral treatment (ART) resulting in 97% treatment coverage among the living cases. Despite the low prevalence of HIV in Bhutan, the need to intensify HIV Counseling and Testing is being accorded high priority by the Royal Government to bridge the current case detection gap of 35.8% of the estimated 1300 HIV cases in the country. The Ministry of Health updates the HIV epidemic in the country every six months and informs the nation through appropriate media channels.  

𝐶𝑜𝑛𝑐𝑒𝑟𝑛𝑖𝑛𝑔 𝑡ℎ𝑒 𝑐𝑢𝑟𝑟𝑒𝑛𝑡 𝐻𝐼𝑉 𝑐𝑎𝑠𝑒 𝑑𝑒𝑡𝑒𝑐𝑡𝑖𝑜𝑛 𝑔𝑎𝑝, 𝑡ℎ𝑒 𝐻𝑜𝑛’𝑏𝑙𝑒 𝐻𝑒𝑎𝑙𝑡ℎ 𝑀𝑖𝑛𝑖𝑠𝑡𝑒𝑟 𝐷𝑎𝑠ℎ𝑜 𝐷𝑒𝑐ℎ𝑒𝑛 𝑊𝑎𝑛𝑔𝑚𝑜 𝑠𝑎𝑖𝑑; “𝐴𝑙𝑡ℎ𝑜𝑢𝑔ℎ 𝑤𝑒 𝑎𝑟𝑒 𝑠𝑡𝑟𝑢𝑔𝑔𝑙𝑖𝑛𝑔 𝑡𝑜 𝑓𝑖𝑛𝑑 𝑡ℎ𝑜𝑠𝑒 𝑢𝑛𝑡𝑒𝑠𝑡𝑒𝑑 𝑎𝑛𝑑 𝑢𝑛𝑑𝑖𝑎𝑔𝑛𝑜𝑠𝑒𝑑 𝑠𝑒𝑥𝑢𝑎𝑙 𝑎𝑛𝑑 𝑑𝑟𝑢𝑔-𝑖𝑛𝑗𝑒𝑐𝑡𝑖𝑛𝑔 𝑝𝑎𝑟𝑡𝑛𝑒𝑟𝑠 𝑜𝑓 𝑝𝑒𝑜𝑝𝑙𝑒 𝑙𝑖𝑣𝑖𝑛𝑔 𝑤𝑖𝑡ℎ 𝐻𝐼𝑉 𝑜𝑤𝑖𝑛𝑔 𝑡𝑜 𝑒𝑥𝑖𝑠𝑡𝑖𝑛𝑔 𝑠𝑡𝑖𝑔𝑚𝑎 𝑎𝑛𝑑 𝑑𝑖𝑠𝑐𝑟𝑖𝑚𝑖𝑛𝑎𝑡𝑖𝑜𝑛, 𝑤𝑒 𝑎𝑟𝑒 𝑚𝑎𝑘𝑖𝑛𝑔 𝑔𝑟𝑒𝑎𝑡 𝑠𝑡𝑟𝑖𝑑𝑒𝑠 𝑡𝑜 𝑏𝑟𝑖𝑑𝑔𝑖𝑛𝑔 𝑡ℎ𝑒 𝑐𝑢𝑟𝑟𝑒𝑛𝑡 𝑐𝑎𝑠𝑒 𝑑𝑒𝑡𝑒𝑐𝑡𝑖𝑜𝑛 𝑔𝑎𝑝 𝑜𝑓 35.8% 𝑜𝑓 𝑡ℎ𝑒 𝑒𝑠𝑡𝑖𝑚𝑎𝑡𝑒𝑑 1300 𝐻𝐼𝑉 𝑐𝑎𝑠𝑒𝑠 𝑖𝑛 𝑡ℎ𝑒 𝑐𝑜𝑢𝑛𝑡𝑟𝑦.” 𝐻𝑜𝑛’𝑏𝑙𝑒 𝐿𝑦𝑜𝑛𝑝𝑜 𝑎𝑑𝑑𝑒𝑑, “𝐶𝑎𝑠𝑒 𝑑𝑒𝑡𝑒𝑐𝑡𝑖𝑜𝑛 𝑔𝑎𝑝 ℎ𝑎𝑠 𝑏𝑒𝑒𝑛 𝑟𝑒𝑑𝑢𝑐𝑒𝑑 𝑓𝑟𝑜𝑚 47.6% 𝑖𝑛 2019 𝑡𝑜 35.8% 𝑖𝑛 𝐽𝑢𝑛𝑒 2022 𝑟𝑒𝑠𝑢𝑙𝑡𝑖𝑛𝑔 𝑖𝑛 𝑜𝑣𝑒𝑟𝑎𝑙𝑙 𝑟𝑒𝑑𝑢𝑐𝑡𝑖𝑜𝑛 𝑏𝑦 11.8% 𝑖𝑛 𝑙𝑎𝑠𝑡 𝑓𝑜𝑢𝑟 𝑦𝑒𝑎𝑟𝑠 𝑏𝑢𝑡 𝑖𝑡 𝑖𝑠 𝑛𝑜𝑡 𝑒𝑛𝑜𝑢𝑔ℎ 𝑡𝑜 𝑚𝑒𝑒𝑡 𝑡ℎ𝑒 𝑛𝑎𝑡𝑖𝑜𝑛𝑎𝑙 𝑎𝑛𝑑 𝑔𝑙𝑜𝑏𝑎𝑙 𝑡𝑎𝑟𝑔𝑒𝑡 𝑡𝑜 𝑒𝑛𝑑 𝑡ℎ𝑒 𝐴𝐼𝐷𝑆 𝑒𝑝𝑖𝑑𝑒𝑚𝑖𝑐 𝑏𝑦 2030”. 𝐻𝑜𝑛’𝑏𝑙𝑒 𝐿𝑦𝑜𝑛𝑝𝑜 𝑎𝑙𝑠𝑜 𝑚𝑒𝑛𝑡𝑖𝑜𝑛𝑒𝑑 𝑡ℎ𝑎𝑡 𝑖𝑛 𝑎𝑑𝑑𝑖𝑡𝑖𝑜𝑛 𝑡𝑜 𝑡ℎ𝑒 𝑒𝑥𝑖𝑠𝑡𝑖𝑛𝑔 𝑓𝑎𝑐𝑖𝑙𝑖𝑡𝑦-𝑏𝑎𝑠𝑒𝑑 𝑎𝑛𝑑 𝑚𝑜𝑏𝑖𝑙𝑒 𝐻𝐼𝑉 𝑡𝑒𝑠𝑡𝑖𝑛𝑔 𝑠𝑒𝑟𝑣𝑖𝑐𝑒𝑠, 𝑡ℎ𝑒 𝐻𝑒𝑎𝑙𝑡ℎ 𝑀𝑖𝑛𝑖𝑠𝑡𝑟𝑦 ℎ𝑎𝑠 𝑎𝑙𝑠𝑜 𝑖𝑛𝑡𝑟𝑜𝑑𝑢𝑐𝑒𝑑 𝐻𝐼𝑉 𝑆𝑒𝑙𝑓-𝑇𝑒𝑠𝑡𝑖𝑛𝑔 (𝐻𝐼𝑉𝑆𝑇) 𝑖𝑛 𝑠𝑖𝑥 ℎ𝑖𝑔ℎ-𝑟𝑖𝑠𝑘 𝑑𝑖𝑠𝑡𝑟𝑖𝑐𝑡𝑠 𝑡𝑜 𝑒𝑛𝑠𝑢𝑟𝑒 𝑒𝑛ℎ𝑎𝑛𝑐𝑒𝑑 𝑎𝑐𝑐𝑒𝑠𝑠 𝑡𝑜 𝐻𝐼𝑉 𝑡𝑒𝑠𝑡𝑖𝑛𝑔 𝑠𝑒𝑟𝑣𝑖𝑐𝑒𝑠 𝑓𝑜𝑟 𝑒𝑎𝑟𝑙𝑦 𝑑𝑖𝑎𝑔𝑛𝑜𝑠𝑖𝑠 𝑎𝑛𝑑 𝑡𝑟𝑒𝑎𝑡𝑚𝑒𝑛𝑡. 𝐶𝑜𝑛𝑐𝑒𝑟𝑛𝑖𝑛𝑔 𝑚𝑜𝑡ℎ𝑒𝑟-𝑡𝑜-𝑐ℎ𝑖𝑙𝑑 𝑡𝑟𝑎𝑛𝑠𝑚𝑖𝑠𝑠𝑖𝑜𝑛 𝑜𝑓 𝐻𝐼𝑉, 𝐻𝑜𝑛’𝑏𝑙𝑒 𝐿𝑦𝑜𝑛𝑝𝑜 𝑒𝑥𝑝𝑙𝑎𝑖𝑛𝑒𝑑 𝑡ℎ𝑎𝑡 𝑡𝑜 𝑎𝑐ℎ𝑖𝑒𝑣𝑒 𝑎𝑛 𝐴𝐼𝐷𝑆-𝑓𝑟𝑒𝑒 𝑔𝑒𝑛𝑒𝑟𝑎𝑡𝑖𝑜𝑛 𝑎𝑙𝑙 𝑜𝑢𝑟 𝑝𝑟𝑒𝑔𝑛𝑎𝑛𝑡 𝑚𝑜𝑡ℎ𝑒𝑟𝑠 𝑚𝑢𝑠𝑡 𝑎𝑣𝑎𝑖𝑙 𝑜𝑓 𝑡𝑤𝑜-𝑡𝑖𝑚𝑒 𝐻𝐼𝑉 𝑡𝑒𝑠𝑡𝑖𝑛𝑔 𝑑𝑢𝑟𝑖𝑛𝑔 𝑡ℎ𝑒𝑖𝑟 𝑒𝑛𝑡𝑖𝑟𝑒 𝑝𝑟𝑒𝑔𝑛𝑎𝑛𝑐𝑦 𝑝𝑒𝑟𝑖𝑜𝑑 𝑎𝑛𝑑 𝑎𝑣𝑜𝑖𝑑 𝑎𝑛𝑦 𝑟𝑖𝑠𝑘𝑦 𝑏𝑒ℎ𝑎𝑣𝑖𝑜𝑢𝑟 𝑑𝑢𝑟𝑖𝑛𝑔 𝑏𝑟𝑒𝑎𝑠𝑡-𝑓𝑒𝑒𝑑𝑖𝑛𝑔 𝑡𝑜 𝑝𝑟𝑒𝑣𝑒𝑛𝑡 𝑚𝑜𝑡ℎ𝑒𝑟-𝑡𝑜-𝑐ℎ𝑖𝑙𝑑 𝑡𝑟𝑎𝑛𝑠𝑚𝑖𝑠𝑠𝑖𝑜𝑛 𝑜𝑓 𝐻𝐼𝑉. 𝐻𝑜𝑛’𝑏𝑙𝑒 𝐿𝑦𝑜𝑛𝑝𝑜 𝑎𝑙𝑠𝑜 𝑢𝑟𝑔𝑒𝑑 𝑎𝑙𝑙 𝑒𝑥𝑝𝑒𝑐𝑡𝑖𝑛𝑔 𝑝𝑎𝑟𝑒𝑛𝑡𝑠 𝑡𝑜 𝑡𝑎𝑘𝑒 𝑎𝑑𝑑𝑖𝑡𝑖𝑜𝑛𝑎𝑙 𝑟𝑒𝑠𝑝𝑜𝑛𝑠𝑖𝑏𝑖𝑙𝑖𝑡𝑦 𝑓𝑜𝑟 𝑡ℎ𝑒 𝑝𝑟𝑒𝑣𝑒𝑛𝑡𝑖𝑜𝑛 𝑜𝑓 𝑚𝑜𝑡ℎ𝑒𝑟-𝑡𝑜-𝑐ℎ𝑖𝑙𝑑 𝑡𝑟𝑎𝑛𝑠𝑚𝑖𝑠𝑠𝑖𝑜𝑛 𝑜𝑓 𝐻𝐼𝑉 𝑡𝑜 𝑒𝑛𝑠𝑢𝑟𝑒 𝑡ℎ𝑎𝑡 𝑒𝑣𝑒𝑟𝑦 𝑐ℎ𝑖𝑙𝑑 ℎ𝑎𝑠 𝑎 𝑟𝑖𝑔ℎ𝑡 𝑡𝑜 𝑏𝑒 𝑏𝑜𝑟𝑛 𝑓𝑟𝑒𝑒 𝑓𝑟𝑜𝑚 𝐻𝐼𝑉.       

The Ministry of Health is currently in the process of carrying out the pre-validation assessment to check Bhutan’s readiness for the triple elimination of Mother-to-Child Transmission of HIV, syphilis and hepatitis B by 2025. 

𝑂𝑛 𝑡ℎ𝑒 𝑐𝑜𝑣𝑒𝑟𝑎𝑔𝑒 𝑎𝑛𝑑 𝑎𝑐𝑐𝑒𝑠𝑠𝑖𝑏𝑖𝑙𝑖𝑡𝑦 𝑜𝑓 𝐻𝐼𝑉 𝑡𝑒𝑠𝑡𝑖𝑛𝑔 𝑠𝑒𝑟𝑣𝑖𝑐𝑒𝑠 𝑖𝑛 𝐵ℎ𝑢𝑡𝑎𝑛, 𝑡ℎ𝑒 𝑂𝑓𝑓𝑖𝑐𝑖𝑎𝑡𝑖𝑛𝑔 𝐷𝑖𝑟𝑒𝑐𝑡𝑜𝑟 𝑓𝑜𝑟 𝑡ℎ𝑒 𝐷𝑒𝑝𝑎𝑟𝑡𝑚𝑒𝑛𝑡 𝑜𝑓 𝑃𝑢𝑏𝑙𝑖𝑐 𝐻𝑒𝑎𝑙𝑡ℎ, 𝑀𝑟 𝑅𝑖𝑥𝑖𝑛 𝐽𝑎𝑚𝑡𝑠ℎ𝑜 𝑠𝑎𝑖𝑑: “𝑇ℎ𝑒 𝑀𝑖𝑛𝑖𝑠𝑡𝑟𝑦 𝑜𝑓 𝐻𝑒𝑎𝑙𝑡ℎ ℎ𝑎𝑠 𝑒𝑥𝑝𝑎𝑛𝑑𝑒𝑑 𝑖𝑡𝑠 𝐻𝐼𝑉 𝑡𝑒𝑠𝑡𝑖𝑛𝑔 𝑝𝑟𝑜𝑔𝑟𝑎𝑚 𝑙𝑖𝑘𝑒 𝑛𝑒𝑣𝑒𝑟 𝑏𝑒𝑓𝑜𝑟𝑒 𝑎𝑛𝑑 𝑖𝑡 𝑖𝑠 𝑎𝑣𝑎𝑖𝑙𝑎𝑏𝑙𝑒 𝑖𝑛 𝑎𝑙𝑙 𝑡ℎ𝑒 ℎ𝑒𝑎𝑙𝑡ℎ 𝑐𝑎𝑟𝑒 𝑓𝑎𝑐𝑖𝑙𝑖𝑡𝑖𝑒𝑠 𝑎𝑐𝑟𝑜𝑠𝑠 𝑡ℎ𝑒 𝑐𝑜𝑢𝑛𝑡𝑟𝑦, 𝑠𝑡𝑎𝑛𝑑𝑎𝑙𝑜𝑛𝑒 𝑐𝑜𝑚𝑚𝑢𝑛𝑖𝑡𝑦 𝑡𝑒𝑠𝑡𝑖𝑛𝑔 𝑐𝑒𝑛𝑡𝑟𝑒 𝑐𝑎𝑙𝑙𝑒𝑑 ℎ𝑒𝑎𝑙𝑡ℎ 𝑖𝑛𝑓𝑜𝑟𝑚𝑎𝑡𝑖𝑜𝑛 𝑎𝑛𝑑 𝑠𝑒𝑟𝑣𝑖𝑐𝑒 𝑐𝑒𝑛𝑡𝑟𝑒 (𝐻𝐼𝑆𝐶) 𝑖𝑛 𝑠𝑖𝑥 𝑚𝑎𝑗𝑜𝑟 𝑢𝑟𝑏𝑎𝑛 𝑎𝑟𝑒𝑎𝑠, 𝑛𝑎𝑚𝑒𝑙𝑦, 𝑇ℎ𝑖𝑚𝑝ℎ𝑢, 𝑃ℎ𝑢𝑒𝑛𝑡𝑠ℎ𝑜𝑙𝑖𝑛𝑔, 𝐺𝑒𝑙𝑒𝑝ℎ𝑢, 𝑆/𝐽𝑜𝑛𝑔𝑘ℎ𝑎𝑟, 𝐿𝑜𝑏𝑒𝑠𝑎 𝑎𝑛𝑑 𝑇𝑟𝑜𝑛𝑔𝑠𝑎 𝑖𝑛𝑐𝑙𝑢𝑑𝑖𝑛𝑔 𝑡ℎ𝑒 𝑝𝑟𝑖𝑣𝑎𝑡𝑒 𝑑𝑖𝑎𝑔𝑛𝑜𝑠𝑡𝑖𝑐 𝑐𝑒𝑛𝑡𝑟𝑒𝑠”. 𝑇ℎ𝑒 𝑂𝑓𝑓𝑖𝑐𝑖𝑎𝑡𝑖𝑛𝑔 𝐷𝑖𝑟𝑒𝑐𝑡𝑜𝑟 𝑎𝑙𝑠𝑜 𝑟𝑒𝑖𝑡𝑒𝑟𝑎𝑡𝑒𝑑 𝑡ℎ𝑒 𝑖𝑚𝑝𝑜𝑟𝑡𝑎𝑛𝑐𝑒 𝑜𝑓 𝑐𝑜𝑚𝑖𝑛𝑔 𝑓𝑜𝑟𝑤𝑎𝑟𝑑 𝑓𝑜𝑟 𝐻𝐼𝑉 𝑡𝑒𝑠𝑡𝑖𝑛𝑔 𝑡𝑜 𝑘𝑛𝑜𝑤 𝑦𝑜𝑢𝑟 𝐻𝐼𝑉 𝑠𝑡𝑎𝑡𝑢𝑠 𝑓𝑜𝑟 𝑡𝑖𝑚𝑒𝑙𝑦 𝑐𝑎𝑟𝑒 𝑎𝑛𝑑 𝑡𝑟𝑒𝑎𝑡𝑚𝑒𝑛𝑡. 𝐻𝑒 𝑒𝑥𝑝𝑙𝑎𝑖𝑛𝑒𝑑 𝑡ℎ𝑎𝑡 𝑢𝑛𝑙𝑖𝑘𝑒 𝑖𝑛 𝑡ℎ𝑒 𝑝𝑎𝑠𝑡, 𝑛𝑜𝑤 𝑡ℎ𝑒𝑟𝑒 𝑎𝑟𝑒 𝑠𝑐𝑖𝑒𝑛𝑡𝑖𝑓𝑖𝑐𝑎𝑙𝑙𝑦 𝑝𝑟𝑜𝑣𝑒𝑛 𝑒𝑓𝑓𝑒𝑐𝑡𝑖𝑣𝑒 𝐻𝐼𝑉 𝑚𝑒𝑑𝑖𝑐𝑖𝑛𝑒𝑠 𝑡ℎ𝑎𝑡 𝑐𝑎𝑛 𝑟𝑒𝑑𝑢𝑐𝑒 𝑡ℎ𝑒 𝑣𝑖𝑟𝑎𝑙 𝑙𝑜𝑎𝑑 𝑖𝑛 𝑡ℎ𝑒 𝑏𝑜𝑑𝑦 𝑎𝑛𝑑 𝑖𝑚𝑝𝑟𝑜𝑣𝑒 𝑡ℎ𝑒 𝑖𝑚𝑚𝑢𝑛𝑒 𝑠𝑦𝑠𝑡𝑒𝑚 𝑜𝑓 𝑡ℎ𝑒 𝑃𝐿𝐻𝐼𝑉. 𝐻𝑜𝑤𝑒𝑣𝑒𝑟, ℎ𝑒 𝑐𝑎𝑢𝑡𝑖𝑜𝑛𝑒𝑑 𝑖𝑡 𝑖𝑠 𝑖𝑚𝑝𝑜𝑟𝑡𝑎𝑛𝑡 𝑡𝑜 𝑘𝑛𝑜𝑤 𝑡ℎ𝑎𝑡 𝑡𝑖𝑚𝑒𝑙𝑦 𝑡𝑒𝑠𝑡𝑖𝑛𝑔 𝑖𝑠 𝑡ℎ𝑒 𝑜𝑛𝑙𝑦 𝑚𝑒𝑎𝑛𝑠 𝑡𝑜 𝑘𝑛𝑜𝑤 𝑦𝑜𝑢𝑟 𝐻𝐼𝑉 𝑠𝑡𝑎𝑡𝑢𝑠 𝑡𝑜 𝑖𝑛𝑖𝑡𝑖𝑎𝑡𝑒 𝑒𝑎𝑟𝑙𝑦 𝑡𝑟𝑒𝑎𝑡𝑚𝑒𝑛𝑡 𝑎𝑛𝑑 𝑡ℎ𝑎𝑡 𝑔𝑜𝑜𝑑 𝑎𝑑ℎ𝑒𝑟𝑒𝑛𝑐𝑒 𝑡𝑜 𝑡ℎ𝑒 𝑡𝑟𝑒𝑎𝑡𝑚𝑒𝑛𝑡 𝑖𝑠 𝑖𝑛𝑑𝑖𝑠𝑝𝑒𝑛𝑠𝑎𝑏𝑙𝑒 𝑓𝑜𝑟 𝑎𝑐ℎ𝑖𝑒𝑣𝑖𝑛𝑔 𝑎𝑛 𝑒𝑓𝑓𝑒𝑐𝑡𝑖𝑣𝑒 𝑡𝑟𝑒𝑎𝑡𝑚𝑒𝑛𝑡 𝑜𝑢𝑡𝑐𝑜𝑚𝑒.   

As a part of the national HIV and AIDS response, the Ministry of Health will continue to strive hard to bridge the current case detection gap to achieve sustainable development goals to end the AIDS epidemic by 2030. Four key strategies will be implemented to enhance the case diagnosis; 

i) phase-wise scaling up of the HIV self-testing and counselling services across the country

ii) implementing the targeted index testing (contact tracing) and partner notification services as a core intervention to efficiently and effectively identify HIV-positive individuals 

iii) provider-initiated HIV counselling and testing services will be streamlined and strengthened across the health facilities to enable healthcare providers to provide HIV testing to any persons attending health care facilities as a standard component of medical care

iv) strengthen the routine surveillance systems in the hospitals across the country to meet the requirement of the elimination of Mother to Child Transmission of HIV, Syphilis and Hepatitis B by 2025.  

In terms of care and treatment, the Ministry of Health will further decentralize the provision of antiretroviral therapy (ART) drugs for the people living with HIV from the district hospital to the primary health centres and other community testing centres for enhanced accessibility. The MoH will also decentralize the viral load testing services from the national referral hospital to eight more district hospitals (Gelephu RRH, Mongar RRH, Phuentsholing, Trashigang, Nganglam, S/Jongkhar, Samtse and Wangdue Phodrang). Viral load tests are used to diagnose acute HIV infection, guide treatment choices, and monitor response to ART. Similarly, CD4 testing services will be scaled up from the existing five districts (Thimphu, Phuentsholing, Gelephu, Mongar and S/Jongkhar) to three more districts (Wangdue Phodrang, Trashigang, and Samtse). CD4 count testing helps assess the progress of the infection and enables health care providers to know whether the infection is under control or at risk of complications. Most importantly, the HIV confirmatory test will be also decentralized from the Royal Center for Disease Control (RCDC) to the regional referral hospitals for timely provision of the HIV confirmation result.   

𝐹𝑜𝑟 𝑎𝑛𝑦 𝑐𝑙𝑎𝑟𝑖𝑓𝑖𝑐𝑎𝑡𝑖𝑜𝑛𝑠, 𝑘𝑖𝑛𝑑𝑙𝑦 𝑐𝑜𝑛𝑡𝑎𝑐𝑡 𝑀𝑟. 𝐿𝑒𝑘𝑒𝑦 𝐾ℎ𝑎𝑛𝑑𝑢, 𝑃𝑟𝑜𝑔𝑟𝑎𝑚 𝑀𝑎𝑛𝑎𝑔𝑒𝑟, 𝑁𝑎𝑡𝑖𝑜𝑛𝑎𝑙 𝐻𝐼𝑉, 𝐴𝐼𝐷𝑆 & 𝑆𝑇𝐼𝑠 𝐶𝑜𝑛𝑡𝑟𝑜𝑙 𝑃𝑟𝑜𝑔𝑟𝑎𝑚, 𝐷𝑜𝑃𝐻, 𝑀𝑜𝐻 at +975-17425548/ lkhandu@health.gov.bt