AIDS Conference in Washington, DC: AIDS Not a Myth in #MENA Region

PITAPOLICY kicks off August with the theme: Socially Responsible Organizing and Investing.  Our first post is by a new contributor, Zena F. Itani, who attended AIDS Conference Week in Washington, DC.  Itani has a Masters in Public Health and wants to address the myth that AIDS/HIV is a non-issue in the pita-consuming region.  If you would like to add to the discussion, or address another subtheme within socially responsible organizing or SRI (Socially Responsible Investments), ping 

AIDS 2012: Turning the Tide on a Fast Growing Epidemic in the MENA Region

By: Zena F. Itani

Advocates from the Middle East and North Africa were among the 23,000 attendees at the 19th Biennial International AIDS Conference (AIDS 2012) held in Washington, DC from July 22 to 27. AIDS 2012 marked the return of the conference to the United States after 22 years as President Barack Obama lifted the country’s entry restriction on HIV positive visitors. MENA representatives, including people living with HIV/AIDS (PLWHA), were the face of the region with the second fastest growing epidemic in the world. HIV positive delegates from Lebanon, Jordan, Sudan, Egypt and other MENA countries discussed struggles and progress in a region where new cases of HIV have increased 79% over the last decade, according to a comprehensive 2011 report issued by UNAIDS, the Joint United Nations Programme on HIV/AIDS.

Zero New Infections. Zero AIDS-related Deaths. Zero Discrimination.

While the vision of UNAIDS is being realized in some parts of the world, “getting to zero” is very much an uphill battle in the Middle East. Regionally, high risk groups include men who have sex with men (MSM), injection drug users (IDUs), sex workers, and male migrant workers. Different at-risk groups drive infection rates at the country level. For example, data from Morocco show that MSM are most at risk in one city, while IDUs drive infections in other cities. In port areas on the Red Sea and the Gulf of Aden, sex workers, male migrant workers, and other migrant groups are at highest risk. A rising number of women are contracting HIV from their husbands, a trend that also fuels the mother-to-child transmission rate.

Beyond the startling upward trend in new HIV cases, close to 500,000 men, women, and children in the region are currently living with HIV/AIDS. UNAIDS estimates that only 8% of those infected get the treatment and care they need. AIDS-related deaths among adults and children have doubled in the last decade, even as they have leveled off in other countries, or come close to zero in the case of pediatric AIDS deaths.

Stigma and Access

The main topics of discussion at the MENA Networking Zone and the conference Regional Session were the effects of stigma and discrimination on everything from HIV testing and treatment, to data collection and civil rights. Stigma and related lack of access to HIV testing, counseling, and treatment are key drivers of the MENA epidemic. According to UNAIDS, stigma and misinformation about the disease contribute to governments and civil society organizations providing few services, at-risk groups being less able or willing to get testing, counseling and treatment, and thus, less data to inform prevention and treatment planning.

All MENA heads of state have endorsed the UN Political Declaration on HIV/AIDS, and many have committed in regional forums to universal access to treatment, but UNAIDS reports that implementation varies widely. Government declarations often do not translated into widespread voluntary testing and counseling, or adequate prevention and treatment services.

MENA advocates are mobilizing. During the conference, thousands converged on the White House for the “We Can End AIDS March,” according to the Kaiser Daily Global Health Policy Report. Protesters included members of Think Positive, a Lebanese association that provides voluntary HIV counseling and testing, capacity building for PLWHA, and campaigns to fight “HIV + Phobia” in Lebanon and the region.

Filmmakers are also taking up the battle against stigma and discrimination. In 2011, acclaimed young Egyptian director Amr Salama released Asmaa, a film based on the true story of an HIV positive woman denied a lifesaving operation by doctors. Screened in the conference’s Global Village, the film epitomizes the struggle of PLWHA, particularly women, against stigma and discrimination in their communities, the medical system, and in their own families.

The title character is a feisty young woman from an Egyptian village who contracts HIV from her husband when he returns from serving a prison sentence. Her husband dies, and Asmaa and her infant daughter are exiled by villagers. Asmaa moves to Cairo, where she becomes part of an association of AIDS patients, a band of men and women who support each other through daily incidents of discrimination, fear, and hate. She needs a gall bladder operation, but doctors refuse to operate on her because of her status. With nothing to lose, Asmaa goes on a popular TV show to air her story and give a face to HIV/AIDS. She insists on her rights, and refuses to divulge how she contracted the virus, despite pressure from doctors and the TV producer. “I don’t have to defend my virtue to anyone,” Asmaa says, defiantly.

Asmaa’s courage and that of the filmmaker were applauded at the screening, and HIV positive conference-goers from the region came forward to say they face the same challenges every day. Many thanked the director for telling Asmaa’s story, and their own. Norhan Salama, Egyptian Training Coordinator of the International Federation of Medical Students Association, said that she uses the film in Egyptian medical schools to promote awareness and dialogue about HIV/AIDS among students who would otherwise learn next to nothing about the disease, or speak to people and families infected and affected by HIV.

The Future of HIV/AIDS in a Changing Region
Asmaa represents the direction of the epidemic in the region. More and more women are living with HIV, often exposed by male sexual partners. HIV compounds the lack of rights many women face in the Middle East. But more and more women, men who have sex with men, and others at risk are mobilizing, demanding their rights, and building capacity to provide voluntary testing, counseling, and prevention education in their communities. In an effort to organize and give voice to the increasing number of women living with HIV and AIDS, activists have started MENA Rosa, a networking group for HIV positive women that provides support and advocates to raise awareness and funds for prevention and treatment. MENA Rosa and its members know that at the root of the dearth of treatment, education, and HIV testing and counseling services in the region are stigma, gender inequities, and ignorance. As Asmaa says without faltering as she reveals her face to television audience, “I will not die of my disease, but I will die from yours.”



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Filed under Analysis, Interests, PIDE (Policy, International Development & Economics)

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