The HIV/AIDS epidemic could cost the Middle East and North Africa (MENA) region approximately one-third of today's gross domestic product (GDP) by 2025 according to a recently published World Bank report.
With an estimated 0.3 percent of adults infected with the HIV/AIDS virus, MENA's level of infection is relatively low compared with Africa, South Asia and the Caribbean regions.
The report cautions, however, that low prevalence does not mean low risk. In 2002 alone, 83,000 people were newly infected with HIV in the region and the total number of AIDS deaths has increased almost six fold since the early 1990s.
"Low HIV/AIDS prevalence today does not guarantee low prevalence tomorrow," said Chief Economist for the MENA, Mustapha Nabli. " Even by conservative estimates, future accumulated losses could reach 35 percent of today's GDP as rising mortality leads to a decline in productivity, capital investments and size of labor force if governments postpone investing in HIV revention."
Many countries in MENA have enough evidence of risk factors to warrant immediate investments in stepping up their efforts in prevention, particularly as the spread of HIV is vulnerable to migrations, wars, economic downturns and other developments that affect social stability.
"We know from international experience that HIV/AIDS prevalence rates grow exponentially, so the MENA region is well poised to capitalize on this knowledge by investing early on in monitoring and prevention," said World Bank Vice President for MENA, Christiaan Poortman, "Good prevention programs are a bargain compared with the costs of the epidemic."
To date, no country in the region systematically screens high-risk groups such as intravenous drug users, sex workers and migrants, crucial to generating clear information on the pattern of the epidemic. According to the report, the combination of poor screening, poor behavioral data and overconfidence in social and cultural conservatism has led to a continued perception of low risk and low priority on the national development agenda, resulting in inadequate levels of protection against HIV/AIDS.
The hardest hit country in MENA is Djibouti, where 339 persons for every 100,000 are afflicted with HIV/AIDS. The next most affected countries include Gulf states like Oman, Qatar, Bahrain and Kuwait, followed by Tunisia and Morocco. However, the report points out that the actual number of HIV/AIDS cases are higher than the reported cases due to weak surveillance and reporting systems in the countries.
Drawing on the global experience of fighting HIV/AIDS, the report calls for the highest level of political commitment to invest in prevention, in partnership with civil society groups and donors. The report prescribes a multi-sectoral approach in tackling HIV/AIDS, stressing the epidemic cannot be managed with a typical public health approach, and health services alone cannot eliminate the factors that produce vulnerabilities. Societies have coped best where governments are open, provide information and services and join forces with local community groups.
"Clearly, in most countries, governments budgets are under strain and face competing demands from other sectors,” stated senior economist and co-author of the report, David Robalino. "However, because prevalence rate are still low, initial expenditures on HIV/AIDS prevention can be modest, focusing for instance on proactive surveillance systems. Failing to commit to this minimum over the short-term, on the other hand, can be very costly, as shown in our report."
Few countries in the region have begun to develop an HIV/AIDS policy or national plan involving various stakeholders. Tunisia has piloted a project for youth, which offers education, counseling and testing.
In response to the rising HIV rates among intravenous drug users, Iran has set in motion a needle exchange program as well as voluntary counseling and testing. Morocco has introduced a large-scale plan to upgrade services against sexually transmitted diseases. Djibouti is adopting similar initiatives, but with the epidemic at a relatively advanced stage, considerable resources will be needed to reduce the impact of HIV/AIDS on citizens. — (menareport.com)
© 2003 Mena Report (www.menareport.com)
