CAIRO: While Egypt is categorized as a low-prevalence country when it comes to HIV/AIDS, the virus should be atop the country's health agenda before it becomes an epidemic, Dr Nafis Saddiq, Special Envoy for the UN Secretary-General on HIV/AIDS, said in an interview with Daily News Egypt. "What we're saying about the Middle East and Asia is that these are epidemics waiting to happen, she said. "A lesson we learned from Africa is that the time to address the epidemic aggressively is when it's at the low prevalence state, she added. Saddiq, who is currently on a visit to Egypt, warned that "otherwise it's not inconceivable that it will become a high prevalence country if you let the high risk groups go unprotected and have no access to health care. The UN official noted that in Egypt, as in all other countries, the epidemic at the moment is driven by sex workers, men who have sex with men (MSMs) and injecting drug users, stressing that all these groups can easily transfer it to the general population. Egypt is a low prevalence country with around 0.02 percent who has HIV/AIDS, however there has been a dramatic increase over the last 10 years, around 250-300 percent, with around 11,000 cases, according to UNAIDS. "I've noticed that the government is trying to take it more seriously, there is a national AIDS program, a national AIDS commission which perhaps is not as active as it could be but it is [relatively] active, said Saddiq. Saddiq said that a major problem in Egypt is that while all ministries are represented in the central body coordinating the national AIDS program, they are not taking the epidemic as seriously as they should be. She also cited the fact that civil society groups are not represented as a concern. "[However] I have to say that there is progress from my last visit two years ago, there is a lot more advocacy and a lot more understanding, people are not so reluctant to talk about HIV and all the high risk groups as they were before, she said. Saddiq explains that Egypt is in dire need for a consistent policy regarding HIV/AIDS by all ministries. She pointed out that, for example, when the Ministry of Health gives money to NGOs working with the high risk groups, the law enforcement agencies, or the police, then arrest them. "There needs to be consistency in the policy approach, she asserted. Removing the stigma A challenge facing UNAIDS is the stigma associated with HIV, which is "not an easy issue to get rid of, according to the UN official. Saddiq said that getting rid of the stigma associated with the virus "requires the participation of everybody, starting with the leaders at the highest levels, pointing out that in some countries, presidents can be seen shaking hands with HIV patients and encouraging them to take part in everyday activities and professions. Secondly, Saddiq notes that the health ministry and the health services are "a big problem in propagating the stigma and discrimination. "Health workers [look at] people with AIDS as somebody that should be avoided so they don't treat them and they isolate them, and that increases the stigma so we need to work with the health workers in institutions and outside so they [are not] part of the problem, they should be part of the solution, she explained. Saddiq also finds it crucial that religious and societal leaders speak out and set an example with HIV positive patients by showing that you can sit, eat and live with them. With regards to HIV/AIDS statistics, many argue that there is an underestimation of the number of patients. "It's not underestimated but the problem is you don't know who has HIV/AIDS because most people don't come forward to be tested, said Saddiq, explaining that the UNAIDS and the World Health Organization (WHO) have developed a surveillance methodology through which they can make estimates of the number of cases and most governments are on board. HIV/AIDS in the Arab World Arab countries are generally low prevalence with 380,000 infections, the number of at 20,000 and the number of new infections at 35,000 every year. "The number of new infections is increasing in this region, noted Saddiq. "Awareness is definitely increasing but some of the governments still think that it's a disease brought in from the outside and not by their own citizens and the point is if it's in the country it doesn't matter anymore, it's in the country and has to addressed, she said. Saddiq explained that the majority of countries in the Arab world are starting to realize the necessity of addressing HIV/AIDS through different programs, some of which are very active like Morocco and Tunisia, and other areas where they are not so active like the Gulf. "Egypt is in between, it's actually increasing its activity each year and starting to take the epidemic seriously and the fact that it could become an epidemic, that's a positive thing happening here, she said. UNAIDS's Agenda There are success stories of UNIADS in several countries, such as Kenya, Botswana and Zambia where the number of new infections is decreasing. Also in Asia, the prevalence level in some countries such as Thailand and Cambodia has gone down. "But the number of new infections globally is still high, said Saddiq. This year UNAIDS is giving high priority to the prevention of mother-child transmission program, which has proven to be very successful. However, Egypt is lagging behind so "hopefully they will move up that program, she said. Another issue given high priority is the protection of women and girls against HIV/AIDS, who are very susceptible to the virus, including married women, because of the lack of knowledge and the lack of protection. Also an area given priority, especially in the Middle East, is lifting the travel ban on HIV positive people. "It's not helpful in protecting the population, it just discriminates against [the patients], said Saddiq. There is also the question of advocacy and sustained support for the AIDS programs, which is particularly challenging in the low prevalence countries and in countries where officials think the virus is under control. Another challenge is the international community and resources. "A lot of resources are available but still not enough to cope with the epidemic, said Saddiq, adding, "Once you start to see a decline in several countries, the international community thinks 'now it's over' when it's not and the programs need to continue until it's at very low prevalence everywhere in the world.
