On the HIV/AIDS Epidemic in the Middle East and North Africa: A human rights approach

One patient wrote in the Egypt Health Ministry’s AIDS awareness bulletin “When you die, you find someone to mourn you. But when you get infected with the AIDS virus, even the closest person runs away.” What these words meant was very true for the 35-year old Egyptian man who was kicked out of his house by his brothers and lost his job as a janitor at a Cairo hotel when he caught the AIDS virus after having sex with a foreign woman. He lived on streets with his mother, after his brothers refused to let him stay in the house. For fear of being despised by a mostly conservative society where strict cultural taboos deny the practice of premarital sex, he declined to reveal his name. A 38-year old Iranian father, Mohammed, suffered similar discrimination problems as a result of the stigma attached to the HIV. He refrained from telling even his wife about his HIV status. It is this kind of stigma that most holds back the combat against the disease in many of the Arab countries.

While less is known about the HIV infection in North Africa and the Middle East than in other parts of the world, there is still a growing concern on the rapid spread of the disease in this region. The spread of the disease means more than the deterioration of the health conditions of thousands of people. Unfortunately, due to socio-cultural constraints of the societies of this region among many other factors, the epidemic tragically reveals how societies discriminate against people, against homosexuals, against sexual intercourse, against one’s right to employment, right to migrate, right to health care and most importantly right to live as one desires. Thus, there is a strong relation between human rights and the HIV/AIDS epidemic.

According to the UNFPA, the HIV/AIDS epidemic started in the late 1980’s in the Middle East and North Africa. Few new country estimates of HIV infection were produced for this region between 1994 and 1999. Recent evidence, however, suggests that new infections are on the rise. With an estimated 80,000 new infections in the region during 2001 the number of adults and children living with HIV/AIDS had reached 500,000. 46% of the infected population was women. The main modes of transmission for those living with AIDS in the year 2000 were heterosexual relationships and infected drug users.

Compared to the other parts of the world, the HIV/AIDS epidemic in the Middle East and North Africa region has not yet constituted a vitally serious problem. However, due to insufficient surveillance systems and pervasive fear and stigma attached to the virus, many of the cases remain unreported. As far as the human rights related issues are concerned, HIV/AIDS-related social discrimination and hate crimes, women’s rights and HIV/AIDS, rights of HIV/AIDS-affected children, lack of sufficient medical care and treatment for HIV/AIDS patients, handling of HIV/AIDS in prisons and the legal aspects of the HIV/AIDS-related immigration and employment procedures are of immediate concern. While systematic analysis of the factors giving rise to the epidemic is lacking in many countries in the region, socioeconomic disparities, high unemployment, population mobility, and political instability are the main factors leading to the spread of the disease in the Middle East and North Africa. Furthermore, the countries of this region are lacking sufficient educational systems to introduce the facts about the HIV/AIDS to their populations, the necessary surveillance systems for keeping record of the spread of the disease and its demographic dimensions and the government led programs to reduce the stigma around the people living with AIDS and around those who constitute high-risk vulnerability. Discussion of sexual behavior, including extramarital and homosexual sex may also be difficult in the conservative settings.

Some countries such as Iran and Lebanon have undertaken initiatives to introduce prevention policies and anti-discrimination programs. However, the HIV/AIDS epidemic is still a serious human rights concern in the Middle East and North Africa region and much work remains to be done. Within this scope, federal response to the HIV/AIDS epidemic must be comprehensive in nature - including appropriate resources for prevention, research, and care and treatment. Anti-discrimination campaigns and educational programs must be promoted to reduce the stigma around the patients living with HIV/AIDS. Government spending must be regulated in order to provide better surveillance systems and research programs. Other governmental and non-governmental initiatives must respond to the psychological, financial and medical needs of the HIV/AIDS patients. Governments must respect the rights of these individuals by enforcing human rights laws. Equal opportunity programs must be promoted to protect the employment and immigration rights of the people living with the epidemic. Both national and international agencies must be devoted to undertake the necessary actions to reduce the human rights abuses with respect to the HIV/AIDS epidemic in this region.

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[1]Reuters, Sept 6, http://www.aegis.com/news/re/1998/RE980902.html
[2] IRIN
[3] UNAIDS, AIDS Epidemic Update, Dec. 2001.

Written by Zeynep Basak 2002. All rights reserved. This material may not be published, broadcast, rewritten or redistributed without the author's permission.