Publication: Characterizing the HIV/AIDS Epidemic
in the Middle East and North Africa : Time for Strategic Action
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Date
2010
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2010
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Abstract
Despite a fair amount of progress on understanding human immunodeficiency virus (HIV) epidemiology globally, the Middle East and North Africa (MENA) region is the only region where knowledge of the epidemic continues to be very limited, and subject to much controversy. It has been more than 25 years since the discovery of HIV, but no scientific study has provided a comprehensive data-driven synthesis of HIV/AIDS (acquired immunodeficiency syndrome) infectious spread in this region. The current report provides the first comprehensive scientific assessment and data-driven epidemiological synthesis of HIV spread in MENA since the beginning of the epidemic. It is based on a literature review and analysis of thousands of widely unrecognized publications, reports, and data sources extracted from scientific literature or collected from sources at the local, national, and regional levels. The recommendations provided here focus on key strategies related to the scope of this report and its emphasis on understanding HIV epidemiology in MENA as a whole. The recommendations are based on identifying the status of the HIV epidemic in MENA, through this synthesis, as a low HIV prevalence setting with rising concentrated epidemics among priority populations. General directions for prevention interventions as warranted by the outcome of this synthesis are also discussed briefly, but are not delineated because they are beyond the scope of this report. This report was not intended to provide intervention recommendations for each MENA country.
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“Abu-Raddad, Laith J.; Akala, Francisca Ayodeji; Semini, Iris; Riedner, Gabriele; Wilson, David; Tawil, Ousama. 2010. Characterizing the HIV/AIDS Epidemic
in the Middle East and North Africa : Time for Strategic Action. © World Bank. http://hdl.handle.net/10986/2457 License: CC BY 3.0 IGO.”
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The book summarizes the results from several recent reviews of studies related to the effectiveness of the four key interventions in reducing risky behaviors in the context of transmitting or acquiring HIV infection. Overall, the four key interventions have strong effects on the risk of HIV infection among PWID via different pathways, and this determination is included in the documents proposing the comprehensive package of interventions. In order to attain the greatest effect from these interventions, structural issues must be addressed, especially the removal of punitive policies targeting PWID in many countries. The scientific evidence presented here, the public health rationale, and the human rights imperatives are all in accord: we can and must do better for PWID. The available tools are evidence-based, right affirming, and cost effective. 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It is an instrument to guide the World Bank's role in the global development agenda, which includes the Declaration of Commitment at a Special Session of the U.N. General Assembly in June 2001. That declaration reaffirmed a pledge made by world leaders to have halted and begun to reverse the spread of HIV/AIDS by 2015. The document provides a unifying framework for the World Bank's work on HIV/AIDS in Eastern Europe and Central Asia. It identifies the potential costs of inaction, the constraints on an effective response, priority actions to resolve such constraints, and the Bank's plans for helping countries do so as part of a multi-institutional effort. HIV/AIDS is fast becoming a threat to health and economic development in parts of Eastern Europe and Central Asia. Despite the dangers, country responses to the epidemic have been patchy and limited by widespread denial. Where actions have been taken to contain the epidemic, they have tended to be pilot efforts on a scale that is too small to make a dent in the overall course of the epidemic. Governments and civil society have started to address the problem, but they need to do much more to avert HIV/AIDS crises in the region.
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