Malika Zafar, Executive Director, Nai Zindagi, leads a team that expanded HIV treatment and prevention to 62 districts, launched services in prisons, implemented point of care viral load testing, initiated Hepatitis C testing and treatment, and established mobile ARV delivery, enhancing care for people who inject drugs and their partners.

Background
; Nai Zindagi (NZ) is leading efforts to tackle the healthcare challenges faced by People Who Inject Drugs (PWID) and their partners in Pakistan, particularly in relation to HIV and Hepatitis C (HCV) infections. Historical barriers like insufficient screening, disjointed healthcare systems, and deep-rooted stigma have made access to treatment difficult. In response, NZ has developed a comprehensive approach, integrating HCV care within its harm reduction services to reach those most in need.

Innovative Approach
Screening: In 2024, NZ incorporated HCV testing into its harm reduction services to ensure that high-risk individuals are routinely screened. To date, 23,974 HCV tests have been conducted, identifying 8,753 positive cases, including 1,056 with both HIV and HCV. This proactive screening process has enabled quicker identification and intervention.

Treatment: In collaboration with Agha Khan Hospital And Medical College Foundation, NZ has rolled out a holistic care model across 11 high-priority districts. This model covers the entire treatment process, from diagnostics and medical consultations to medicine provision and post-treatment monitoring. Out of 822 individuals referred, 626 were positive on the PCR resulting in a 97% treatment uptake and a 77% cure rate of those due for post-PCR.

Prison Intervention: NZ has also extended its testing and treatment services to prisons. Among 3,811 inmates tested, 350 were diagnosed with HCV, and 30 were co-infected with HIV. This intervention ensures healthcare access for those typically left behind.

Conclusion;
 NZ's forward-thinking model has effectively addressed critical healthcare gaps for PWID, offering a comprehensive solution to the interconnected epidemics of HIV and HCV. By incorporating these services into its harm reduction efforts, NZ has not only improved health outcomes but also created a model that can be adapted for similar communities anywhere.