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Providing HIV services to key affected populations in MENA: outreach workers under threat

International AIDS Conference Washington 22-27 July 2012. Providing HIV services to key affected populations in MENA: outreach workers under threat . Presented by Dr. Wessam El Beih , country coordinator, Egypt. Syria. Tunisia. Iran. Lebanon. Iraq. Palestine. Morocco. Jordan.

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Providing HIV services to key affected populations in MENA: outreach workers under threat

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  1. International AIDS Conference Washington 22-27 July 2012 Providing HIV services to key affected populations in MENA: outreach workers under threat Presented by Dr. Wessam El Beih, country coordinator, Egypt

  2. Syria Tunisia Iran Lebanon Iraq Palestine Morocco Jordan Algeria Kuwait Libya Egypt United Arab Emirates Bahrain Qatar Saudi Arabia Oman Sudan Yemen Djibouti Somalia Prevalence (adult population) > 1.0 0.3 – 1.0 0.15 – 0.3 0.03 – 0.15 Middle East and North Africa: Countries < 0.03

  3. Estimated HIV prevalence (adults and children)

  4. Estimated New Infections (adults and children)

  5. Estimated deaths due to AIDS

  6. HIV prevalence among key populations

  7. Laws, regulations or policies that present obstacles to effective AIDS programmes

  8. Hindering Laws and Policies for an effective response in MENA MENA countries reporting having legal/policy obstacles to an effective response for populations at higher risk of HIV infection * Data from Country UNGASS 2010 reports submitted to UNAIDS

  9. Countries in MENA with Sodomy Laws (Homosexual Activity is Illegal) Capital Punishment Sodomy Laws Controversial info No laws N/A or no data

  10. HIV Travel Restrictions on entry or stay

  11. Implications of such policies Compromise to the ability of governments and civil society to provide services; and the ability of key populations to access services that are available Nearly 60% of the diagnostic HIV tests carried out between 1995 and 2008 were for migrant workers, while only 4% of tests were for the key populations Although individual countries have improved access to antiretroviral therapy (ART) (nearly a 25% increase, between 2009 and 2010), the estimated regional coverage remains low at 8%.

  12. Universal Access to HIV prevention, care, support and treatment by 2015 ZERO NEW HIV INFECTIONS. ZERO DISCRIMNINATION. ZERO AIDS-RELATED DEATHS.

  13. Prevention Programs for Key populations and PLHIV • Integrated in all National Strategic Plans with varying level of practical commitment • Civil society based programs- with varying government support in various countries • Several models of outreach and service delivery to FSW, MSM, IDU and others

  14. In most cases rely on external resources (global fund or bilateral donors) • Excellent results in enrolling individuals, providing services and evidence of behavior change. (sustainable?) • Often face significant and persistent stigma and discrimination within their local communities, and outreach work can come with considerable personal risk

  15. Risks • Civil society organizations • Very successful pilot models • Local advocacy with law enforcement authorities • Sustainability and safety of facility- based service delivery models • Means to ensure government backing up • Challenge is to scale up • ADVOCACY • Mainstream service delivery models

  16. BREAD. FREEEDOM. SOCIAL JUSTICE

  17. Way forward • Accountability and shared responsibility • National Strategic Plans based on human rights • Advocacy for multisector response • Targeted interventions with high impact and lower financial resources • Non traditional interventions ZERO NEW HIV INFECTIONS. ZERO DISCRIMNINATION. ZERO AIDS-RELATED DEATHS.

  18. Zero New Infections. Zero Discrimination. Zero AIDS- Related Deaths • Political declaration and targets set forth • The Arab convention • Alazhar declaration on personal freedoms • Spirit of the Arab uprising- youth

  19. Thank you شكراًelbeihw@unaids.org

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