Dubai, 29 June 2010 - At a high-level policy dialogue organized by the Joint United Nations Programme on HIV/AIDS (UNAIDS), the World Health Organization (WHO) and the World Bank, senior officials from government, donor agencies, development partners and civil society today launched a consensus statement calling for an accelerated regional response to the HIV epidemic in the Middle East and North Africa.
The statement reaffirmed the goal of universal access to HIV prevention, treatment care and support—a commitment enshrined in the 2006 Political Declaration on HIV/AIDS. While recognizing recent gains, the statement outlined a number of key recommendations to bolster the HIV response in the region. These include:
- wider access to HIV prevention;
- free and equal access to antiretroviral treatment and care for all in need;
- improved data and surveillance on the HIV epidemic, particularly for populations at high risk of HIV infection;
- increased domestic and external funding for the AIDS response;
- the elimination of stigma and discrimination against people living with HIV;
- the removal of political and legal barriers that block an effective AIDS response; and
- the involvement of civil society and people living with HIV in the AIDS response.
The two-day policy dialogue, held under the patronage of HH Sheikh Maktoum Bin Mohammed Bin Rashid Al Maktoum, Deputy Ruler of Dubai, in collaboration with Dubai Police, cast a rare spotlight on an epidemic that is seldom highlighted in the region.
Addressing conference participants, Lt General Dhahi Khalfan Tamim, Commander-in-Chief of Dubai Police, emphasized the importance of a coordinated HIV response. “AIDS knows no boundaries or limits, and has no nationality,” he said. “Unifying the efforts of all stakeholders involved is crucial to halt the spread of AIDS in the region.”
HIV remains a highly stigmatized health condition in the region. In many settings, stigma and discrimination are preventing affected communities from accessing the HIV services they need. “I am here today to ensure that the voices of all those affected by HIV are heard,” said Egyptian actor Mr Amr Waked, a UNAIDS Regional Goodwill Ambassador who attended the meeting. “Social stigma and discrimination in this region must be urgently addressed.”
In his opening remarks, Mr Tim Martineau, UNAIDS Director of Programme Effectiveness and Country Support, noted that focusing resources on key populations—such as injecting drug users, men who have sex with men and sex workers—can change the course of the epidemic in the region. “Universal access goals are achievable if we want them to be,” he said. “We can break the trajectory of the epidemic in this region through strong leadership, a focus on human rights and effective health systems.”
Based on UNAIDS estimates, about 412 000 people were living with HIV in the region at the end of 2008, up from about 270 000 in 2001. However, to date, a lack of reliable data has hindered a clear understanding of HIV dynamics and trends in the region. “The Middle East and North Africa stands as the only region where knowledge of the epidemic continues to be very limited, inaccessible, and subject to much controversy,” said Akiko Maeda, Manager for Health, Nutrition and the Population Sector in the Human Development Department at the World Bank.
According to a new report developed by the World Bank, WHO and UNAIDS, the region has low HIV prevalence in the general population, with the exception of Djibouti, Somalia, and southern Sudan. Most HIV infections occur in key populations at high risk of infection. The report, entitled “Characterizing the HIV Epidemic in the Middle East and North Africa,” is the most comprehensive scientific synthesis of HIV spread in the region since the beginning of the epidemic.
Though all countries in the region are providing antiretroviral medications free of charge, most are falling far short of the goal of universal access to treatment. At the end of 2008, only 14% of the estimated 68 000 in need of treatment were accessing it. “Most people living with HIV do not know their HIV status,” said Dr Jaouad Mahjour, Director of the Division of Communicable Disease Control in WHO’s Eastern Mediterranean Region. “This remains the biggest challenge to expanding antiretroviral therapy in the region. Wider access to voluntary and confidential HIV testing and counselling tailored to the needs of most-at-risk populations is critical.”
