prevalence rate overall may be taken as a window of opportunity, still available and actions to curb any further disease spread should be roboust. However, it is worth mentioning that data is reported mainly from the public sector health facilities. While, the current health seeking behaviours and health system forces majority of the population to the private sector. The table above shows the sample distribution of high risk group done by the NACP. Disease transmission by inappropriate use of therapeutic injections A major factor that must be accounted for in the overall HIV transmission scenario is the rampant use of therapeutic injections, often with non-sterile injection equipment. There are an estimated 800 million therapeutic injections given annually in Pakistan or approximately 4.5 per capita. This is among the highest in the World. A small but significant proportion of these are reused. This has led to the prevalence of Hepatitis C infection (which is nearly exclusively transmitted via blood exposures) to become >5% nationwide, although this seems to have stabilized at a national level. Conservatively this suggests around 150,000 new HCV infections annually, leading to the conclusion that HIV can also potentially spread via this route as well. Indeed, recent community based outbreaks in Punjab suggest that the process may have already started. National response to HIV epidemic Pakistan's response to HIV/AIDS began in 1987 with the establishment of a Federal Committee on AIDS by the Ministry of Health. The national AIDS control Program was then established. Its objectives are the prevention of HIV transmission among specific population sub-groups, safe blood transfusions, reduced STI transmission, establishment of surveillance, training of health staff, research and behavioral studies, and development of program management. The prevention efforts received a major boost since 2004 when a World Bank loan/grant allowed the Ministry of Health (and the provincial Departments of Health) to start a program which seeks to provide HIV prevention services to IDUs, sex workers and truckers; perform advocacy and communication for the general public and covers significant proportion of the national blood supply for HIV, HBV and HCV screening. This "Enhanced HIV/AIDS Control Program" has been able to establish these services using NGOs to perform the interventions in most large cities although the quality of the services as well as the completeness of their "coverage" remains low. Overall the IDU programs in Punjab are performing the best with over 70% coverage of target populations