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Regional Session on Middle East and North Africa - MENA |
THSY09 |
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| Venue: |
SR 8 (450) |
| Interpretation: |
None |
| Time: |
16:30 - 18:00, 07.08.2008 |
| Code: |
THSY09 |
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Chairpersons: |
Abdullah Abdillahi Miguil, Djibouti
Hafedh Chekir, United States (Co-Chair)
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The focus will be on achieving Universal Access in MENA. There is no single HIV epidemic in the region. Diversity of political commitment, policies, attitudes and access to services shape national AIDS responses. Most countries report low prevalence, while data suggests higher prevalence coupled with risks and vulnerability factors among specific populations and locations.
The first presentation will set the stage on epidemic dynamics and key drivers that spread HIV in MENA. Facts coupled with political commitment and resources provide solid ground to focus where impact can be reached.
A comprehensive response addressing risk factors, gender, socio-economic marginalization, can be reached only through synergy of partnerships with sectors, religious leaders, media, and civil society. The voice of people living with HIV from MENA will advocate and suggest concrete actions to become ?part of the solution? and fight stigma.
Examples of programmes for those at risk (IDU, sex work and MSM) will illustrate that HIV prevention services can reach those in need even in a context of socially or culturally sensitive issues.
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Presentations in this session:
16:30
THSY0901 | Opening and Welcome by the Minister of Health of Djibouti
| 16:35
THSY0902
Powerpoint (2.19 MB) | There is no single HIV Epidemic in MENA - learning from facts to shape the AIDS response in the region
Oussama Tawil, Switzerland
| 16:45
THSY0903
Powerpoint (1.39 MB) | Keeping the focus: HIV prevention services for those most in need - perspectives from the field
Amal Karaouaoui, Morocco
| 16:55
THSY0904 | Forging social partnerships across society: Who are the key partners that can enable a novel HIV response?
Eltayeb Mansour, Sudan
| 17:05
THSY0905 | 'Part of the Solution' - people living with HIV engaged as key actors to achieve Universal Access in MENA
Nawel Lahouel, Algeria
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Rapporteur report
Leadership report by Richard McKay
Hafedh Chekir opened the panel by welcoming the audience and the speakers, and noting the importance of the HIV epidemic to this region.
Oussama Tawil, a representative of UNAIDS, spoke first, highlighting the fact that there is no single HIV epidemic in MENA and that this knowledge ought to shape the region’s response. He focused on the socio-political context, trends and patterns, a snapshot of the regional response, and main challenges and opportunities. Out of the 22 countries making up this region, 11 have been represented at this conference. 1/3 of its population is below 15 years of age. He acknowledged that the region’s surveillance for populations most at risk was not as good as it needed to be, and expressed concern about the recently recognised increasing prevalence among MSM and sex workers, a situation for which more data was needed. He divided the region’s response into three slightly overlapping categories: comprehensive (Algeria, Djibouti, Morocco, Somalia, Sudan, Iran), adaptive and potentially effective (Jordan, Lebanon, Oman, Tunisia, Yemen), and those limited by “political constraints” (Egypt, Gulf Countries, Libya). One other category included countries whose response was limited by war or post-war contexts. Tawil closed by noting the challenges of overcoming stigma and scaling up the response that the region will face.
Amal Karaouaoui of Morocco addressed the need to keep the focus on HIV prevention in the region on the populations that need it most. She commenced her talk by emphasising that homosexuality and sex workers form part of the “forbidden zone”, but hoped that the challenge of HIV will permit an opportunity to break the silence on these topics. Karaouaoui illuminated the excluded plight of female sex workers in Oman, who had limited access to information and to social, judicial, and health services. MSM, hidden by a “thick” silence, were stigmatised and marginalised, and faced barriers to accessing health care. Karaouaoui emphasised that a successful response in these communities would need to be highly tailored. In Algeria, community outreach programmes involving these groups had been initiated. In the Sudan, outreach workers had been able to achieve some success in dispensing information, and Karaouiaoui felt that, in fact, outreach workers held the “keys to the region” and made an appeal to other countries in the region to follow their lead in reaching out to the affected communities. It is difficult, she said, but it is possible and feasible.
Nawel Lahouel of Algeria finished the session with an emphasis on the importance of involving PLWHA as key actors to achieve universal access in MENA. She highlighted the Algerian Declaration, formulated during a regional meeting of PLWHAs in 2005, as an important reference point for regional PLWHAs, bringing them together despite different languages, cultures and religions. She emphasised the need for PLWHAs to be included in every level of the national response to HIV. She finished by saying that she hoped that things would change in her region, and that PLWHAs there wanted to be able to live like PLWHAs did elsewhere.
One audience member applauded the panelists for their work, but questioned how, if 7 of the region’s countries maintain the death penalty for MSM, they could expect to achieve a successful response to HIV with this population. Another audience member pointed out that none of the presentations mentioned youth as a vulnerable population, or sought to involve them in the response – a point which other audience members re-emphasised. Tawil answered that the very good questions that the audience had raised should be answered by the region’s governments, with NGOs and international organisations like the UN providing a platform for discussion. He acknowledged that the situation facing MSM in such a repressive environment was probably the most serious and the most difficult to resolve. He suggested that a policy dialogue needed to happen with governments, but that “we are at the beginning of the road”. Karaouaoui reiterated that she felt that community outreach work with multi-sectorial support was the best solution in reaching marginalised populations in repressive regimes. She went further by saying that outreach work would only work well if it was linked to good testing and health care services.
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