Increasing access to HIV prevention, treatment, care and support services for drug users and their partners is crucial to addressing the issue of growing HIV infections related to injecting drug use in the Middle East and North Africa region.

This was the overwhelming conclusion reached by regional representatives from law enforcement agencies, national AIDS programmes, NGOs, researchers, community representatives, people living with HIV and UN organizations who joined at a regional workshop on the issue of HIV and drug use in the region, held in Cairo, Egypt from 5 – 8 November.

Throughout the 3-day discussions, participants from the Arab countries, Afghanistan, Iran and Pakistan affirmed that drug use is an important risk factor in facilitating spread of HIV that calls for immediate action. Joint efforts of police, national AIDS actors, NGOs, drug users and of people living with HIV were recognized as fundamental elements in the prevention of HIV among drug users and their partners.

While significant efforts are being undertaken in a number of countries to reach out with HIV preventive services to drug users communities, limited capacities coupled with discrimination against drug users hamper implementation of wider-scale programmes.

“From my personal experience and my field work on reducing harm related to drug use, I suggest training more drug users and ex-drug users –to build their skills in order to promote and implement [HIV preventive] programs in the region,” an ex-drug user and outreach worker said in the workshop.

New initiatives for building capacities of civil society actors on implementing harm reduction measures and networking in the region were discussed and examined.

“Participation in this workshop has allowed an exchange of international experiences among NGOs and governments, and a discussion of the strategic approaches to planning at the national level to protect against the harms and risks of drugs and related HIV. It has created cooperation between [national stakeholders]…and encouraged civil society actors to assist and support alternative programs for drug users,” police participants from one of the Gulf countries said.

As part of the workshop, UNAIDS and UNODC launched the finalized Rapid Situation Assessment on Drug Use and HIV in Algeria and Morocco, as well as facilitate consensus on programmatic follow up for all participating countries. WHO and the International Harm Reduction Association launched a project on strengthening the role of civil society in harm reduction for injecting drug users in the Middle East and North Africa.

Although the main mode of HIV transmission in the Middle East and North Africa remains unprotected sexual contact, injecting drug use is an increasingly important factor in the region’s epidemics.

Although the main mode of HIV transmission in the Middle East and North Africa remains unprotected sexual contact, injecting drug use is an increasingly important factor in the region’s epidemics.

The spread of HIV among drug users appears to be closely related to evolving patterns of drug use in the region in recent decades. Evidence suggests increase in number of drug users, decrease in the age at first use of drugs and some indication of an increased percentage of women using drugs in several countries.

The United Nations Office of Drugs and Crime (UNODC) estimates there are 400,000 injecting drug users in Arab countries and approximately 200,000 in Iran. These figures do not include a recent increase in numbers in Afghanistan which have been observed.

The sharing of contaminated injecting equipment among injecting drug users has become the predominant route of HIV infection in at least two countries since the mid to late 1990s – Iran and Libya –where a concentrated epidemic now appears to be well established.

“This is a real and growing issue for countries in the Middle East and North Africa. And although we are seeing increasing willingness to introduce HIV prevention and treatment programmes for drug users, focused efforts are needed urgently to ensure access to services for all drug users and their partners,” said Oussama Tawil, Director of UNAIDS’ Regional Support Team, Middle East and North Africa.

Over the last years, UNAIDS and UNODC have supported assessments on drug use and HIV-related risks in Algeria, Egypt, Libya, Morocco, as well as in Oman and Syria, as part of efforts to better understand trends and dynamics of the epidemics in the region and to increase HIV prevention efforts.

Main findings ensued suggest that needle sharing, ranging from 40 to 60%, coupled with low knowledge on AIDS, limited access to health and HIV-related services, stigma and discrimination, and other associated risk factors, are among some of the challenges faced by the region to reduce HIV risks and vulnerability among injecting drug users.

Within the assessments, researchers spoke to drug users about their thoughts and fears: “If I enter [a treatment center] I'll be marked, and my future is over. I will not be able to do anything, neither work nor life," said one of the participant.

“Drug use and other risk behaviors remain stigmatized in the region, which is why we must forge strong partnerships with different sectors, such as the national AIDS programmes, non-governmental organizations, drug users, people living with HIV and law enforcement agencies, to be able to better understand the epidemic and implement concrete solutions,” said Mr Tawil.

Foundations for an increased response to address HIV risks and vulnerability among drug users have been established in some countries and are underway in others. In Iran – considered a global best practice model – HIV-related initiatives for injecting drug users inside and outside prisons are now being scaled up beyond the pilot levels.

In an example of a bold movement to better tackle the issue of HIV and drug use in the region, representatives from law enforcement agencies, national AIDS programmes, NGOs, researchers, community representatives, people living with HIV, UN organizations and other partners will join at a regional workshop to be held in Cairo, Egypt from 5 – 8 November.

The workshop— “Towards Implementation of a Comprehensive HIV response and AIDS Response Among Drug Users in the Middle East and North Africa”— convened by UNAIDS and its cosponsors UNODC and the World Health Organization (WHO) as well as the German Technical Coorperation (GTZ), will welcome participants from 16 countries and aims to build capacities on programming and implementing HIV prevention, treatment and care interventions among drug users.

As part of the workshop, UNAIDS and UNODC will launch the finalized Rapid Situation Assessment on Drug Use and HIV in Algeria and Morocco, as well as facilitate consensus on programmatic follow up for all participating countries. WHO and the International Harm Reduction Association will also launch the project on strengthening the role of civil society in harm reduction for injecting drug users in the Middle East and North Africa.

“This gathering bringing together wide diversity of partners is unique for the region and a turning point for action on drug use and HIV in the region” Mr. Tawil said.

Caravanning in Morocco has taken a whole new meaning with a special summer caravan travelling around the country in a quest to raise awareness about HIV prevention among young people.

Parking at some of Morocco’s most popular resorts from the Atlantic and Mediterranean coasts to the remote Atlas Mountains sites, the caravan has visited 19 youth campsites where more than 7000 young men and women have stayed during their holidays.

The SIDAmobile initiative’s caravan is run by the Moroccan-based organization ‘Association de Lutte Contre le SIDA’ in Morocco (ALCS) and the Ministry of State for Youth.

“In Morocco, we are very sensitized to the importance of intensifying prevention efforts towards young people because they are particularly vulnerable to HIV infection and also because they represent the future,” said President of the ALCS, Hakima Himmich.

At each stopover, the facilitators –all doctors who have been specially trained to work with young people on the issue of HIV— initiated open and frank discussions about sex and sexually transmitted diseases (STDs). In less than a month, the caravan distributed some 35 000 flyers on HIV and 15 000 condoms were given to young people at their request. Also more than 700 people asked for, and received, a confidential HIV test with counselling.

“It’s the first time I have done an HIV test”, said a participant of the summer camp Assilah Corniche. “There is nothing wrong about it but it’s not very common in my neighborhood to be open about sex, especially for girls.”

“It’s good to learn about HIV and how it spreads,” added another young woman in the same campsite. “Now I know how people become infected with HIV and I learned how to protect myself,” she added.

In Morocco, only an estimated 12% of women aged 15 to 24 are able to identify ways to prevent HIV. “We are trying to create an environment that enables people, especially the younger ones, overcome some of the taboo associated with sex and give them an opportunity to talk about their concerns and ask questions,” said My Ahmed Douraidi from ALCS and coordinator of the SIDAmobile initiative. “This is the first step for any HIV prevention work,” he added.

Praising this grass root prevention initiative and recognizing the importance of high level leadership and commitment, Kamal Alami from UNAIDS office in Morocco said that “HIV prevention on the ground is far more effective when programmes are tailored to audiences”.

“In Morocco, the high level support we receive creates many opportunities, such as music festivals, popular celebrations etc. that we can seize to disseminate prevention messages among young people,” he added.

The summer caravan stems from a collaborative effort between ALCS, the State Secretary for Youth and the United Nations Population Fund (UNFPA)

Related links
United Nations Population Fund (UNFPA) 
Association de Lutte Contre le SIDA (ALCS)

 

The Joint United Nations Programme on HIV/AIDS urges all parties concerned, including the media, to understand that HIV infection is a condition that requires appropriate treatment and care.

The Joint United Nations Programme on HIV/AIDS (UNAIDS) joined other UN agencies and the Secretary General in stating its shock at the tragic bombing of the UN offices in Algiers, and great sadness at the loss of life.

The Joint United Nations Programme on HIV/AIDS (UNAIDS) expresses serious concern over the verdict delivered by the Libyan Supreme Court to uphold the death sentences imposed on six health care professionals.

The Joint United Nations Programme

Significant progress is being made

GINEBRA, 2 de agosto de 2013—Ban Ki-Moon, secretario general de las Naciones Unidas, ha designado a Speciosa Wandira-Kazibwe de Uganda como su enviada especial para VIH/sida en África.

La Sra. Wandira-Kazibwe es actualmente Asesora Principal del Presidente de Uganda sobre Población y Salud y coordina el desarrollo de las reformas del sistema de salud de Uganda.

Desde 1994 hasta 2003, se desempeñó como vicepresidenta de Uganda, la primera mujer en África en ocupar dicho cargo. La Sra. Wandira-Kazibwe, cirujana con doctorado en ciencias en salud mundial y población de la Escuela de Salud Pública de Harvard, también se desempeña como miembro de la iniciativa Champions for an HIV-Free Generation (Campeones para una generación libre de VIH).

Como enviada especial para VIH/sida en África, la Sra. Wandira-Kazibwe ayudará en el avance de la respuesta al sida en África fomentando el compromiso proactivo y la participación de todos los sectores de la sociedad.

“Es un honor y me complace mucho asumir este papel nuevo y desafiante en este momento crucial de la respuesta al sida”, dijo la Sra. Wandira-Kazibwe.

“Esperamos trabajar estrechamente con una líder tan experimentada como la Sra. Wandira-Kazibwe”, dijo Michel Sidibé, director ejecutivo de ONUSIDA. “Estoy convencido de que su empeño y dedicación infatigables ayudarán a que se haga realidad el cambio en toda África”.

África sigue siendo la región más afectada por el VIH, en mayor medida que otras regiones del mundo, con un 69% de personas que viven con el VIH a nivel mundial. Aunque existen tendencias positivas, en 2011 hubo 1,8 millones de nuevas infecciones por el VIH en todo el continente, y 1,2 millones de personas murieron debido a enfermedades relacionadas con el sida.

ONUSIDA

El Programa Conjunto de las Naciones Unidas sobre el VIH/Sida (ONUSIDA) lidera e inspira al mundo para conseguir su visión compartida de cero nuevas infecciones por el VIH, cero discriminación y cero muertes relacionadas con el sida. El ONUSIDA reúne los esfuerzos de 11 organizaciones de las Naciones Unidas (ACNUR, UNICEF, PMA, PNUD, UNFPA, UNODC, ONU Mujeres, OIT, UNESCO, OMS y Banco Mundial) y trabaja en estrecha colaboración con asociados globales y nacionales para maximizar los resultados de la respuesta al sida. Acceda a más información en unaids.org y conecte con nosotros a través de Facebook y Twitter.

La Unión Africana y la Agencia de la NEPAD lideran la transformación de las respuestas sanitarias en África

ADDIS ABEBA, 16 de julio de 2012 — Los jefes de estado y de gobierno africanos han aprobado hoy una hoja de ruta que traza el nuevo rumbo de las respuestas del continente en materia de sida, tuberculosis y malaria. La Comisión de la Unión Africana (AUC) y la Agencia de Planificación y coordinación de la NEPAD desarrollaron, con el apoyo de ONUSIDA, la Hoja de ruta sobre responsabilidad social y solidaridad mundial, que fue aprobada en la 19ª Cumbre de la Unión Africana en Addis Abeba (Etiopía).

"Esta hoja de ruta implica un paso adelante importante en nuestras respuestas al sida, la tuberculosis y la malaria", afirmó el Dr. Thomas Yayi Boni, presidente de la Unión Africana y también presidente de Benín. "A través de ella, buscaremos soluciones africanas que reflejan el dinamismo y el potencial de nuestro continente, como por ejemplo, la producción farmacéutica local. Juntos, invertiremos en el futuro".

Estructurada en torno a tres pilares estratégicos (gestión sanitaria, financiación diversificada y acceso a los medicamentos), la Hoja de ruta ofrece un conjunto de soluciones prácticas y basadas en los recursos africanos para favorecer respuestas sostenibles al sida, la tuberculosis y la malaria. En el documento se definen los objetivos, los resultados esperados, los papeles y las responsabilidades necesarias que deben seguir las partes interesadas durante un periodo de tiempo de tres años, hasta 2015.

"Esta hoja de ruta servirá de motor para el desarrollo de soluciones propias de África", declaró el Dr. Ibrahim Mayaki, director ejecutivo de la Agencia de la NEPAD. "Juntos, debemos apoyar a los líderes africanos para que lo pongan en práctica; y ello implica la creación de nuevas asociaciones, nuevos acuerdos financieros y nuevas medidas para fortalecer las instituciones africanas sostenibles".

Gestión sanitaria

La hoja de ruta hace especial hincapié en la importancia de conseguir marcos de política, supervisión y responsabilidad robustos para las inversiones en materia de sida, tuberculosis y malaria. AIDS Watch Africa, una iniciativa africana para la concienciación y la responsabilidad de la respuesta al sida en África, desempeñará un papel crucial a la hora de calcular los avances logrados, así como de conseguir que las partes interesadas a escala nacional, regional, continental y mundial sean responsables de los compromisos establecidos en materia de sida, tuberculosis y malaria.

"La visión de responsabilidad compartida y solidaridad mundial de AIDS Watch Africa marca un distanciamiento radical del enfoque adoptado hasta ahora", afirmó el director ejecutivo de ONUSIDA Michel Sidibé. "Insto a todos los líderes africanos a que pongan en marcha urgentemente la Hoja de ruta, así como a todos los asociados para el desarrollo, a fin de que apoyen los esfuerzos realizados por el continente africano, basándose en el espíritu de la solidaridad y responsabilidad mutuas".

Financiación diversificada

Según los datos recogidos por ONUSIDA, África necesitará una inversión anual de 11.000 – 12.000 millones de dólares estadounidenses para la respuesta al sida en 2015. Ese mismo año, se calcula que habrá un déficit de financiación de 3 000 - 4 000 millones de dólares estadounidenses. De la misma manera, los recursos disponibles para las respuestas a la tuberculosis y a la malaria en el continente se encuentran lejos de ser suficientes.

Por medio de la Hoja de ruta, se hace un llamamiento a los gobiernos africanos y a los asociados para el desarrollo, con el objetivo de que, juntos, trabajen para cubrir esas deficiencias, apostando por una "participación justa" basada en sus competencias y sus compromisos previos. Se anima a los países a que desarrollen planes nacionales viables desde el punto de vista financiero, con unos objetivos claros. Por otra parte, a los asociados para el desarrollo se les solicita que ofrezcan recursos predecibles a largo plazo, y que pongan en consonancia sus compromisos y las prioridades africanas.

"Lograr una movilización y un desembolso de fondos de una manera efectiva es fundamental para nuestra respuesta al sida" declaró el Sr. Idriss Déby Itno, presidente de la República del Chad. "Cada jefe de Estado debería seguir esta Hoja de ruta. Debemos considerarlo como una oportunidad para cambiar nuestro enfoque, no solo con respecto al sida, sino también al desarrollo de nuestro continente".

Acceso a los medicamentos

Numerosos países africanos dependen de recursos externos para suministrar medicamentos que pueden salvar la vida de su población. En el caso del sida, se importa más del 80% de los fármacos para el VIH que se ofrecen en África. La gran mayoría de los medicamentos contra el VIH que mantienen con vida a los africanos se pagan gracias a la ayuda externa recibida.

Así, la Hoja de ruta establece un conjunto de acciones prioritarias para acelerar el acceso a medicamentos asequibles y con garantía de calidad en África. Entre dichas acciones, se encuentran las siguientes: reforzar los sistemas reguladores de medicamentos africanos; garantizar, a través de la cooperación Sur-Sur, que los países africanos tienen acceso a tecnología y artículos sanitarios básicos; y eliminar los obstáculos al comercio existentes, a fin de permitir que se desarrollen centros de producción farmacéutica en África que puedan abastecer los mercados regionales.

El presidente de la Unión Africana hace un llamamiento para celebrar un evento paralelo sobre el sida y la responsabilidad compartida

Durante la Cumbre de la Unión Africana, el Dr. Yayi Boni hizo un llamamiento a los líderes Africanos, a fin de celebrar un evento paralelo de alto nivel en la Asamblea General de las Naciones Unidas de 2012 que se centre en el sida y la responsabilidad compartida. Este acontecimiento ofrecería una oportunidad única para presentar la Hoja de ruta a la comunidad mundial, declaró el Dr. Yayi Boni.