HIV/AIDS
UNICEF provides support for the National AIDS Program led by the Ministry of Health with a focus on policy development, advocacy, system strengthening, improve the quality of service provision, and evidence generation.
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Challenges
Egypt remains a low HIV prevalence country with evidence of a concentrated epidemic among people who inject drugs and men who have sex with men in Cairo and Alexandria[1].
Some HIV professionals presume that vulnerable populations may include prisoners, migrants, and children in street. This hypothesis is not evidenced by any serological studies conducted among these populations but self-reported behaviour hints that some members of these populations may be vulnerable.
While the estimated number of people living with HIV in Egypt remains relatively low (11,000 by the end of 2016) compared to the total population, Egypt is reported to have the fastest growing epidemic in the Middle East and North Africa Region (MENA) by a 76% increase in number of cases between 2010 and 2016.
This, coupled with the witnessed alarming trend in number of new confirmed cases by 25-30% annually is seen as worrying signs that point into a dire need for increasing investments to avoid further epidemic growth and a failure in controlling the epidemic.
It is very challenging to provide prevention services to the key vulnerable populations who are at highest risk foremost because their behaviors are considered as crimes under Egyptian law. When it comes to providing testing, care, support and treatment services for people living with HIV, most of the affected people are not tested early enough. Furthermore, there is a high treatment drop out in the first year of treatment due to several personal and structural reasons including lack of treatment knowledge and support. All these factors lead to increased mortality rates. In 2016, the estimate number of deaths due to AIDS among children aged 0 to 14 is less than 100 and number of orphans due to AIDS aged 0 to 17 are 2200.
A robust national strategic plan was developed to cover the period 2015-2020 with ambitious targets aligned to global targets of 90-90-90 (90% of those living with HIV knowing their status, 90% of those knowing their status are enrolled to treatment and 90% of those on treatment sustained on treatment to reach viral suppression) set and endorsed globally through the 2016 political declaration for Ending AIDS by 2030.
The strategy implementation has faced several challenges. While Egypt’s government has pledged national resources to support the procurement of treatment, several gaps in areas of prevention, care, support and the enabling environment persist.
[1] BIOLOGICAL & BEHAVIORAL SURVEILLANCE SURVEY (BioBSS 2010).
Solutions
- Through UNICEF’s technical guidance and advocacy efforts, mother and children needs in relation to HIV/AIDS prevention, treatment, care and support have been included in the National Strategic Plan for 2016-2020.
- Through UNICEF’s support to the procurement and supply management of anti-retroviral treatments (ARVs). Around 4000 people living with HIV receive high-quality medicines for HIV treatment on monthly basis including pregnant women, infants and adolescents, both Egyptians and refugees.
- With regards to evidence generation, UNICEF has supported the NAP to conduct the ‘Stigma Index’ research study to document HIV stigma experienced by people living with HIV in their communities. The findings informed the design of programmatic interventions and provided baselines to measure changes in stigma and discrimination over time aiming to create enabling environment that strengthen the access of people living with HIV to various services and fulfill their health and other human rights.
In 2018 - 2019, UNICEF will collaborate with the Ministry of Health and Population (MOHP) and National AIDS Programme (NAP) in the following areas:
- Support MOHP to formulate a national policy and operational plan for elimination of mother to child transmission (e-MTCT) through generating and reviewing evidence and developing a national consensus on strategic priorities;
- Support the implementation and quality improvement of e-MTCT model interventions in 10-15 MCH centers in 4 governorates through staff capacity development, strengthening of PSM (Procurement and Supply Chain Management) system and referral mechanisms and update HIV training package & IEC (Information, education and communication) materials;
- Provide technical and financial support to Civil Society organizations (CSOs) to actively collaborate with MOHP in fostering mothers and children’s retention in care, mitigate the impact of HIV/AIDS on the lives of children and adolescents, and addressing risks of MTCT (mother to child transmission) among vulnerable women and female partner of most at risk populations;
- Support MOHP to formulate a national policy and operational plan for elimination of mother to child transmission (e-MTCT) through generating and reviewing evidence and developing a national consensus on strategic priorities;
- Support the implementation and quality improvement of e-MTCT model interventions in 10-15 MCH centers in 4 governorates through staff capacity development, strengthening of PSM (Procurement and Supply Chain Management) system and referral mechanisms and update HIV training package & IEC (Information, education and communication) materials;
- Provide technical and financial support to Civil Society organizations (CSOs) to actively collaborate with MOHP in fostering mothers and children’s retention in care, mitigate the impact of HIV/AIDS on the lives of children and adolescents, and addressing risks of MTCT (mother to child transmission) among vulnerable women and female partner of most at risk populations;