DUBAI // Most countries in the Middle East and North Africa are falling "well short" of providing universal Aids treatment, according to a UN report released yesterday. There is also a "chronic" lack of reliable data and a shortage of financial and technical resources dedicated to reducing the impact of the condition.
The report by UNAids, the Joint United Nations Programme on HIV/Aids, warns countries not to underestimate the damage caused by stigmatising and discriminating against people with the virus. The extent of the problem was revealed at a two-day meeting in Dubai, in collaboration with Dubai Police, which ended yesterday. It is estimated that of the 68,000 people in the region who need anti-retroviral treatment, only 14 per cent are receiving it. Most of the rest do not even know they are HIV-positive. The World Health Organisation said confidential and voluntary testing was "critical" in increasing the number of patients treated.
According to UNAids, "the impact of stigma and discrimination on care-seeking behaviour appears to be a major obstacle to treatment access in all countries of the region". Hind Khatib, the regional director of UNAids, said reducing this stigma and discrimination was the most achievable and effective action. "Allow people who even fear being tested to come forward without being discriminated," she said. "If the governments can't give that sort of support and care, bring in others who can."
Some countries, such as Iran, have introduced measures to target at-risk groups not publicly acknowledged by their governments. Condoms are provided in prisons and needle-exchange programmes have been set up and managed by non-governmental organisations (NGOs). The Lebanese health ministry plans to start treating heroin addicts with methadone within the public health system after a successful pilot programme by an NGO.
Another major criticism is the lack of good data in the region. The shortage of "accurate and comprehensive information" is described by UNAids as a chronic problem. Dr Nada al Marzouqi, the head of the UAE's National Aids Programme, who was present on the last day of the conference, conceded that the country had a lot of work ahead. However, she said the commitment was there. She was one of the key driving forces behind the law approved recently by the Council of Ministers to better integrate HIV-positive Emiratis into society. It also provides for voluntary testing and counselling centres to be set up. The release of the UAE's UN General Assembly Special Session progress report in March was an important step, she said, but did not include all the data relevant to the country's fight against the disease. The UAE failed to provide any data on its most at-risk populations in the progress report. It also admitted there was no unified national strategy on HIV, or any programmes in place to "reduce HIV stigma and discrimination". Dr Tim Martineau, director of programme effectiveness and country support at UNAids, said these were "fundamental constraints" to service provision. A final review of National Aids Committees, also released by UNAids, called on countries to strengthen and better utilise their aids programmes or committees. It said they often had limited authority and autonomy, and therefore unclear goals, which hampers their efforts. In a regional consensus statement agreed at the closing of the conference yesterday, countries vowed to develop evidence-informed multisectoral strategic plans and strengthen all their coordination, planning, implementation and monitoring of any Aids strategies. They also agreed to improve services available to at-risk groups and anyone with HIV/Aids by offering "free and equal access to treatment, care and support for all those in need". Lt Gen Dahi Khalfan Tamim, Chief of Dubai Police, spoke to conference delegates about the UAE's commitment to fighting the epidemic. "Aids knows no boundaries or limits and no nationality," he said. "Unifying the efforts of all stakeholders involved is crucial to halt the spread of Aids in the region." @Email:munderwood@thenational.ae
