30 May 2024

Ending the aids epidemic among young people

The Middle East and North Africa (MENA) is one of only two regions in the world with rising numbers of people acquiring HIV. The Joint United Nations Programme on HIV/AIDS (UNAIDS) estimates that about 20,000 people acquired HIV in the MENA region in 2022, a 54 percent increase since 2010. This is the steepest rise in annual new HIV infections in the world. Almost 20 percent of new infections were in young people, aged 15–24 years.These trends are occurring against a backdrop of instability, including armed conflict and forced displacement, which is undermining governance, damaging public infrastructure, and disrupting public health and other essential services.Yet, with an overall HIV burden that is still comparatively low, MENA also has a big opportunity to become the first region to end AIDS as a public health threat. Doing so will require HIV strategies that actually reach the people who are most affected by the epidemic. At the moment, across most of the region, services that can prevent new HIV infections are either lacking or are missing most of the people who are most at risk. Many of them are young people who are struggling with multiple challenges and hardships.Vulnerable, marginalized populations bear the brunt of the HIV epidemic in the MENA region and account for the majority of new HIV infections. Not only are most countries in the region failing to prevent rising numbers of new HIV infections, but about half the people living with HIV are not getting the treatment and support they need to stay alive and healthy. United Nations Member States have committed to ensuring that at least 95 percent of people diagnosed with HIV receive treatment and that 95 percent of those on treatment reduce their HIV viral loads to levels that make it impossible for them to transmit the virus to others. The MENA region is a long way from achieving those targets. In 2022, only 67 percent of people aged 15 years and older with HIV knew that they had acquired the virus, 50 percent were receiving life-saving treatment, and 45 percent were able to reduce their viral loads to levels that no longer pose a threat to their health. As a result, there has been a comparatively slow decline in AIDS-related deaths among people aged 15 years and older: a 19 percent decrease in MENA between 2010 and 2022, compared with 46 percent globally.Very little attention is being paid to the young people affected by this epidemic, who, in the absence of support and services, risk acquiring HIV and transmitting it to others. Consequently, the region’s HIV programmes keep losing ground against the epidemic – at a time when almost all other regions are markedly reducing the numbers of people acquiring HIV and succumbing to AIDS-related illnesses each year.
16 May 2024

UNICEF Middle East and North Africa Regional Office 2023 Annual Report

The Middle East and North Africa (MENA) is a region of contrasts. It is home to a culturally diverse group of low, middle-, and high-income countries. Child poverty remains high in most countries, ranging from 16 percent in Egypt to 76 percent in Yemen. Less than half of the children have access to social protection, hindered by low public financing for such programs. Inequalities between and within countries are substantial, and this gap is widening.In 2023, some MENA countries flourished while others experienced complex humanitarian crises that took a terrible toll on the lives of children and families. There were devastating earthquakes in Syria and Morocco, floods in Libya, the large-scale conflict across all of Sudan, creating the world’s largest child internal displacement crisis, and the ongoing tragic situation in Israel and the State of Palestine.Country offices and the regional office in Amman had to respond to the needs of children in very varied contexts. This required a high degree of program flexibility, solid contingency planning and preparedness, and a high level of attention to the duty of care for staff. The scope of such crises has inevitably impacted UNICEF’s work and the region’s progress toward child-related Sustainable Development Goals (SDGs).Through it all, the UNICEF MENA Regional Office (MENARO) and 16 country offices continued to deliver results for children. In 2023, UNICEF, along with its partners, met most of the immediate needs of the most vulnerable children while delivering programmes, advocacy, and support to defend the rights of children and young people in varying circumstances and help them fulfill their potential. The dedication of country and regional office staff was outstanding, with teams delivering results in unimaginably challenging conditions, more particularly in Sudan, the State of Palestine, and Yemen, involving the loss of family members, multiple relocations, and evacuations. For MENARO, protecting staff security and well-being was a significant focus and achievement.
13 May 2024

Gender-related Barriers to Immunization: Zero-dose Children

A total of 25 million children were un-or under-vaccinated in 2021 and the number of children missing out on any vaccination, or “zero-dose children”, increased by 5 million in 2021 compared with 2019, rising from 13 to an estimated 18 million. Almost half of all zero-dose children live in three key geographic contexts: urban areas, remote communities and populations in conflict settings. Communities with zero-dose children face multiple deprivations, including high levels of poverty, lack of access to quality healthcare, nutrition, clean water, sanitation and other basic services, high levels of illiteracy and pervasive gender inequality.Gender norms, roles and relations affect people’s access to health services, health-related information and their health-seeking behaviours, including for immunization. This report explores gender-related barriers to immunization in Egypt, Iraq, Sudan, Syria and Yemen, with a focus on zero-dose and under-immunized children. Promising and innovative practices from these five countries to overcome gender-related barriers to immunization are highlighted, along with recommended approaches and entry points for addressing these demand and supply-side barriers at the individual, household, community, social and institutional levels in order to increase immunization reach and coverage.The report draws on a desk review of existing literature related to gender and immunization in the UNICEF MENARO region as well a gender and zero-dose questionnaire completed by UNICEF Country Offices, complemented by interviews with key informants. Representing Phase I of UNICEF MENARO’s efforts to identify and address gender-related barriers to immunization, this report provides a snapshot overview of some of the challenges and barriers in zero-dose communities, with a recommendation to conduct in-depth research at the community level through interviews and focus group discussions with caregivers and service providers during the second phase.Zero-dose children are geographically dispersed within each of the five countries, with each area facing specific vulnerabilities and challenges related to conflict, insecurity, poverty, lack of basic health infrastructure and displacement, characterized by entrenched gender inequality. Marginalized communities such as nomadic populations, internally displaced persons (IDPs), ethnic minorities and persons living with disabilities face compounded discrimination and disadvantage. Gender-related barriers to immunization are therefore manifested in several ways on different levels, ranging from women’s restricted mobility, lack of access to transportation, money, time, information and other critical resources, the prevalence of gender-based violence as well as women’s limited agency in household decision-making dynamics to men’s low engagement and participation in children’s health and caretaking. The lack of gender-responsive health systems create additional barriers on the institutional level for the health workforce and caregivers.This report is divided into five main sections for the MENA countries included in this review, with each country section further divided into the following sub-sections: gender roles and responsibilities; access to and control over resources; beliefs, norms and perceptions; needs, preferences and challenges; enabling factors and partnerships, with recommended approaches and entry points for addressing gender-related barriers outlined at the end of each section. The report concludes with summary recommendations for addressing gender-related barriers to immunization at the individual and household level, community and social level as well as at the institutional and structural level.