Fighting HIV/AIDS remains a formidable challenge. Positive cases have been rising over the years.

Forty new HIV cases (19 male and 21 female) were detected between January and June. This is the highest number of cases detected in a period of six months.

We now know enough about HIV/AIDS and the modes through which the disease can be transmitted. Despite relentless awareness programmes, however, unprotected sex remains the principal mode of transmission in Bhutan.

According to a press release from the health ministry, 13 were diagnosed through medical screening, 12 through contract tracing, 10 through voluntary counselling and testing, and five through screening of pregnant mothers availing antenatal care services.

Since the disease was detected in Bhutan for the first time in 1993, the number of recorded until now stands at 835. Currently, some 628 people are living with HIV in the country; 608 are on antiretroviral treatment resulting in 97 percent treatment coverage among the living cases.

As positive cases grow, perhaps we need to rethink our strategies and approach. If awareness and education is not working, does it mean that we aren’t doing enough? Are we not reaching out to the right target groups? Where are we falling short?

These are important questions. But, more important, answers must be found and effective interventions put in place.

Awareness and education continues to be our approach in tackling the disease. However, as the health ministry said, there is a need to intensify HIV counselling and testing to bridge the current case detection gap of 35.8 percent.

In what could be considered a significant development, the health ministry has begun carrying out pre-validation assessments to check Bhutan’s readiness for the triple elimination of mother-to-child transmission of HIV, syphilis and hepatitis B by 2025.

Sowai Lyonpo Dechen Wangcmo said that if Bhutan is to achieve an AIDS-free generation, “pregnant mothers must avail two-time HIV testing during their entire pregnancy period and avoid any risky behaviour during breast-feeding to prevent mother-to-child transmission.”

For that, expanding HIV testing programmes to all healthcare facilities, and standalone community testing centre, especially in urban centres, will be a very useful intervention.

What we also know is that close to 70 percent of HIV cases in Bhutan are among the economically productive age group—25 to 49. This, in the long term, could have an adverse impact on the health and economy of the country.

Creative promotion of safe sex and condom use must receive renewed drive. Destroying stigma remains our biggest challenge still. Fighting HIV/AIDS needs renewed and sustained focus.