Now Is the Time To Avoid a Full-Blown Regional AIDS Epidemic

The number of cases of HIV/AIDS in the Middle East and North Africa (MENA) region, although small compared to other regions in the world, is significant and is a cause for concern. Although the MENA region has just 2% of the world’s HIV caseload, it is one of the two regions in the world with the fastest growing HIV/AIDS infection rate.

According to United Nations’ statistics, there are 500,000 adults and children living with the virus in the region. Unfortunately, AIDS-related mortality has almost doubled in the past decade among both adults and children, while it has diminished or stayed the same in the rest of the world.

The predominance of the infection among some groups of people in the MENA region reflects the diversity of the countries’ populations and the differing attitudes, culture and political commitment, as well as the availability and access to HIV services.

Thus, while in some countries it affects mainly people who inject drugs, in other countries it affects men who have sex with men or sex workers.

The existence of a large population of male migrant workers in the region explains the spread of the infection upon their return to their home countries. The assumption is that a large proportion of women living with HIV in the region acquired the infection from spouses who engaged in high-risk behaviors when away from them.

Socio-economic factors behind the spread of AIDS

Several factors explain the sharp increase in HIV-infected people in the Middle East and North Africa. Among those factors are a lack of awareness, denial of reality and misinterpretation of facts.

Other important issues are income inequalities, labor migration, unemployment – particularly among the young – gender inequality and a number of social and cultural values and prejudices in the sundry societies.

The economic costs of a large HIV/AIDS epidemic can be substantial. A World Bank study estimates that a full-blown HIV/AIDS epidemic could reduce the average growth rate in the MENA region by 1.5 per year for the period 2000-25.

Cumulatively, this would represent a potential loss in production of about 35% of the current gross domestic product value by 2025.

In addition, several studies show that poverty and income and gender inequality facilitate the spread of HIV epidemics. While abject poverty in the MENA region is relatively low, a significant proportion of the population lives on less than $2 per day, which makes it extremely vulnerable to the effects of the epidemic should anybody in the household be affected by the infection.

The overall response to the infection is still inadequate, despite the innovative interventions of some Non Governmental Organizations (NGOs). Stigma against the infection is still widespread and hinders the implementation of effective policies.

Stigmatized HIV-infected people suffer from low self-esteem and are more likely to engage in high-risk behavior. Others go underground, which makes it harder to conduct epidemiological surveillance to keep track of the infection.

Target the young people

Because a significant proportion of the general population is under 24 years of age, special programs and messages should be targeted at this age group.

By 2035, the MENA region will have an estimated 100 million youths whose needs and aspirations must be addressed. Street children should be included in education and prevention efforts. A World Bank report estimates that over 70% of male street children in Egypt are engaged in commercial sex.

To keep prevalence rates low, there are four levels of intervention: advocacy, information/education, prevention and timely treatment. It is widely known that HIV/AIDS demands the collaboration of different sectors and actors to implement adequate policies.

The relatively low rates of infection have made the governments in the region complacent in their approach to HIV/AIDS, which is precisely the wrong way to deal with this situation.

It is now up to the governments in the region to provide adequate resources, increase efforts at mass education and put the emphasis on prevention strategies and early treatment. There is now a window of opportunity to control the spread of the infection and avoid a catastrophic epidemic in the future.