Middle East and North Africa

Mrs Hind Khatib Othman, Director of UNAIDS Regional Support Team for Middle East and North Africa participating in the Saudi initiative “Combating AIDS in GCC countries”. 16-18 April 2011. Riyadh, Kingdom of Saudi Arabia.

A new initiative “Combating AIDS in GCC countries” was hosted by the Minister of Health of Saudi Arabia, Dr Abdullah bin Abdul Aziz Al Rabeeah and the Gulf Cooperation Council (GCC) on 16 April in Riyadh.

The initiative is a call for collaborative approach to keep HIV prevalence low in the GCC countries and re-affirms the political commitment of the council to respond effectively to AIDS. The GCC is a political and economic union between the Persian Gulf States of the United Arab Emirates, Bahrain, Saudi Arabia, Oman, Qatar and Kuwait.

Dr Abdullah Al Rabeeah stressed that AIDS is not only a health issue but also a development one that poses a ‘real threat to the long-term growth of the region.’ “The GCC countries will work closely to produce recommendations that will help prepare a roadmap to respond to AIDS,” said Dr Al Rabeeah.

The participants agreed on the need to join efforts to better understand and know their countries’ epidemics. During the meeting, they shared global and regional experiences, identified obstacles hindering an effective response and agreed to enhance national AIDS strategies that are focused, results-oriented, evidence-informed and embedded in human rights. Stigma and discrimination towards people living with HIV, weak surveillance system, travel restrictions and mandatory HIV testing along with gender inequalities were identified as critical issues that are hindering an effective AIDS response in the region. 

Mrs Hind Khatib Othman, Director of UNAIDS Regional Support Team for Middle East and North Africa noted that a large number of people in the region are migrants seeking work, particularly in the GCC Countries. Migrant workers have often little or no right to legal or social protection in their host country and generally lack access to HIV services and information.

Mrs Khatib Othman stressed on the importance of including migrant and mobile populations in the national AIDS strategies. As part of the entry visa process in some countries, people migrating for work must undergo a health test, including a test for HIV, from a certified clinic. However, there is little or no referral to treatment or support services for people who test positive for HIV. If found HIV positive, most countries in the region will deport a migrant worker without explanation, with little compensation, and no consideration for the migrant’s rights or dignity.

People living with HIV participated openly at the event and provided inputs to shape the final recommendations. They welcomed the Saudi Arabian government’s decision of providing free HIV treatment and care services and for their protective policies regarding job applications and maintenance. However, they called on the private sector to follow in the government footsteps. “I am healthy, I want and need to work, I do not want to live on donations and sympathies of others,” said a representative of a network for people living with HIV.

The GCC initiative also highlights the role that civil society can play in enhancing the response to HIV in the GCC countries. “Religious leaders and the media can play an important role in breaking the silence and mobilizing other sectors of society,” said Dr Mongia Souahi, professor of Islamic science at Ez-zitouna University in Tunisia. She also stressed the important role women can play—including female religious leaders—in HIV prevention efforts and in addressing stigma and discrimination.

The meeting concluded with the writing of the draft Riyadh Charter. The document was agreed upon by GCC health delegates and was endorsed by the Deputy Minister of Health of Saudi Arabia, Dr Ziad Memish on the behalf of the Ministry. The Charter includes ten recommendations for GCC countries to act upon. These recommendations are:

• Conduct research in the GCC countries to identify the main modes of transmission, recent HIV infections, and the nature and background of key populations.

• Increase collaboration and coordination among ministries, health, religious and social authorities in terms of training and HIV awareness raising programs.

• The Gulf Committee to work with relevant authorities in developing a Media Charter to tackle HIV issues in the Media.

• Support availability of services to prevent mother-to-child transmission of HIV.

• Scale up HIV treatment, care and support programs for people living with HIV.

• Review and enact laws and legislations that preserve the human rights of people living with HIV.

• Scale up HIV counseling and testing programs.

• Enhance involvement of civil society and the private sector in the AIDS response.

• Develop HIV prevention programs focusing on adolescents and young people.

• Develop a strategy and adopt mechanisms to ensure the implementation of the Riyadh Charter.

The draft Riyadh Charter will be further discussed by the individual countries with the hope of being endorsed by the GCC Health Ministers at a side event during the World Health Assembly. UNAIDS pledged their support to ensure that the Riyadh Charter be translated into an operational plan of action.

The next phase of the story is around the corner as the film will be launched later this year after touring several world film festivals.

“I am keeping my HIV status a secret from my family and friends. I am burdened by the disease and by my secret. I feel guilty, but I fear if I were to tell, that I would be rejected,” says Ali, a 25 year old man living with HIV.

This sense of isolation and low self esteem is all too common for many people living with HIV in Egypt. To date, not a single person living with HIV in the country has publically disclosed their status. So for the majority of Egyptians AIDS remains without a personal face which contributes to misconceptions and fear about the disease.

The world over, media plays a huge role in shaping public opinion about social issues and bringing to life the human impact and complexities of difficult themes. According to UNAIDS Country Officer in Egypt, Wessam El Beih, Egyptian media, especially the film industry, has propagated misinformation and portrayed biased views about people living with HIV, “leading to prejudice and discrimination.”

Over the past several years, UNAIDS in Egypt has advocated with scriptwriters and film producers to create feature films that could bring a human face to HIV by creating characters that people could identify with. The inspiration behind this idea came from people living with HIV who hoped that social views would be more compassionate if their real experiences were shown in a drama.

In 2007, a young scriptwriter and director Amr Salama accepted the challenge after attending a meeting convened by UNAIDS with a group of people living with HIV. He listened to their stories and was touched by their experiences. Salama spent a full year, collaborating with UNAIDS, on several versions of a script featuring the true story of a woman who lived with HIV and died of injustice. He was anxious to convey the same emotional intensity that he had experienced when he heard people’s stories.

“This film was a tremendous journey of exploration. I wanted it to reflect the anger I felt for the injustices I have seen,” said Mr Salama. “I was angry, not just for the people I met who lived with HIV, but rather at the silence and injustice that were close to becoming norms in our society.” Mr Salama’s movie script is entitled Asmaa—a woman’s name which means “names” in Arabic.

Overcoming fear to speak out

The next big challenge for the project was grabbing the interest of a producer. Mohamed Hefzy, a young producer who had worked on social issues such as street children and autism, took an interest in bringing the film to life. Mr Hefzy’s conviction of the role of media in addressing human rights issues led him to believe this project was worth investing in.

“It's ironic that this film, about a woman who decides to break the fear barrier to demand her basic rights for health care, was made before the Egyptian revolution. After all, the revolution was only made possible by Egyptians overcoming their fear to speak out. I hope that the film, like the revolution, will empower people living with HIV to do the same and that society's perception will change irreversibly as a result," says Mr Hefzy.

People living with HIV have been involved in many of the steps in creating this movie, some even acted on screen, and their experiences have inspired and informed the views of the cast.

The film has been given star endorsement. Tunisian celebrity actress Hind Sabry, who lives in Egypt, plays the leading role in the film of the character Asmaa. This is the story of a woman who bravely overcomes her own fears as well as social rejection to claim her rights.

Tunisian actress Ms Hind Sabry plays the leading role in the film, the character Asmaa.

Ms Sabry has personally committed to advocating for the rights of people living with HIV for several years. She has participated in TV public service announcements and been a voice for people living with HIV in several forums. To prepare her for this role, UNAIDS facilitated meetings between the actress and women living with HIV.

“I believe the movie may come under criticism because it tackles thorny issues, but Asmaa is an artistic and humanitarian experience,” said Ms Sabry.

The next phase of the project is around the corner as the film will be launched later this year after touring several world film festivals. Many people—in Egypt and further afield—eagerly await the release of the production and carry a lot of hope for positive social change.

Twenty-two students from across sub-Saharan Africa, the Maghreb and Egypt took part in the five-day training which was launched on 17 April 2011. Credit: Senghor University of Alexandria

In 2010 UNAIDS and the Senghor University of Alexandria signed an agreement of cooperation to include a 25 hour module specific to AIDS into the university’s Master’s degree in International Health programme.

The opening session of this new module, co-organized by Senghor University and UNAIDS, was held on 17 April 2011. Twenty-two students from across sub-Saharan Africa, the Maghreb and Egypt took part in the five-day training.

In attendance at the course opening was Jean-Elie Malkin, special advisor to UNAIDS Executive Director, whom he represented on this occasion. He was joined by other senior UNAIDS staff including the Director of UNAIDS Regional Support Team for West and Central Africa Meskerem Grunitzky-Bekele; and Director of UNAIDS Regional Support Team for Middle East and North Africa, Hind Khatib-Othman. Dr Christian MÉsenge who is the Director of the Health Department at Senghor University of Alexandria represented the University’s President Albert Lourde.

A man receiving opioid substitution therapy as part of a harm reduction programme in the Islamic Republic of Iran. Credit: UNAIDS/P.Virot

Injecting drug use and the growing HIV epidemic in the Middle East and North Africa were the focus of the Harm Reduction 2011 conference that took place in Beirut, Lebanon from 3-7 April 2011

Some 1000 scientists, researchers, drug users, doctors and politicians from 80 countries participated in the first international drugs-related conference to be held in the Middle East and North African (MENA) region.

Discussions during the conference centred around the existence of legislation in the region that hinders the implementation of harm reduction programmes. Nearly one million people in the Middle East and North Africa (MENA) inject drugs. Injecting drug use is already the major mode of HIV transmission in Afghanistan, Pakistan, the Islamic Republic of Iran (more than 67% of registered cases) and Libya (up to 90% of cases). It is also significant in Oman and Bahrain and has growing incidence in Morocco and Egypt.

The region is slowly increasing availability of harm reduction programmes although countries are at different stages of introducing the different components of the harm reduction package. The Islamic Republic of Iran is a model—with a rapidly scaled-up plan to make available needles and syringes, opioid substitution therapy (OST), HIV testing and counseling, and sexually transmitted infection services. Morocco also has integrated harm reduction policies into its national AIDS strategic plan. Pilot drop-in centres with needle and syringe exchange are in place, and preparations for introducing OST are underway.

The Lebanese Minister of Health announced during the conference the launch of a pilot programme consisting of the first ever legal sale of Buprenorphine in government hospitals for people who inject drugs. “The government’s support for harm reduction measures such as the provision of Buprenorphine is based on our belief that the evidence for such a public health measure is irrefutable—its implementation has helped to contain HIV and Hepatitis infections amongst injecting drug use communities in every country it has been introduced,” said Dr Walid Ammar, Director General of the Lebanese Ministry of Public Health.

Despite positive changes occurring in some countries, repressive measures and criminalization of drug users are still predominant in the region. This discourages people at higher risk of transmission from accessing HIV services.

Funding harm reduction

The uptake of harm reduction in most of the region has been slow mainly due to governments and civil society organizations lack of awareness as well as capacity to implement effective harm reduction activities.

To try reverse this situation, the Global Fund to fight AIDS, Tuberculosis and Malaria has granted $US 8.3 million to a multi-country project. Its aim is to raise awareness, advocate and build capacity of civil society organizations to scale up the provision of harm reduction services in 12 countries over the next three years. The 12 countries included in the project are Iran, Pakistan, Libya, Lebanon, Syria, Jordan, Bahrain, Morocco, Egypt, Afghanistan, Oman and West Bank and Gaza.

The project will begin in July 2011 and will be coordinated by the Middle East and North Africa Harm Reduction Association (MENAHRA), based in Beirut.  

Credit: The World Bank

Information about the spread of HIV in the Middle East and North Africa region has been extremely limited, with no real picture of the epidemic emerging. As a major contribution to increasing knowledge of AIDS in the region, the World Bank recently convened a discussion to highlight the first ever comprehensive scientific analysis of the epidemic.

A groundbreaking report, a joint effort involving the World Bank, UNAIDS and the World Health Organization, was the focus of the event at the Bank’s Washington Headquarters. The event on 15 February brought together policy makers from the region, politicians, researchers, civil society actors, and partners. They discussed the findings and implications for prioritizing resources amid the fundamental social and political changes currently affecting the region.

HIV in North Africa and the Middle East

HIV infection has already reached all corners of North Africa and the Middle East. There are substantial differences in the way the virus is spread across the region and various risk contexts are present. The epidemic has become generalized in Djibouti and Sudan, though prevalence in the general population in most other countries is low. The nearly one million people  who inject drugs (0.2% of the population), men who have sex with men and their sexual partners, and commercial sex networks are the most impacted by HIV. A significant number of individuals have also contracted the virus while living and working abroad.

Levels of risk behaviour, such as using non-sterile injecting equipment, are high in a number of countries in the region. This confirms the potential for further HIV spread among the key populations.

A number of social challenges, including pervasive stigma, are also facilitating the spread of the virus.

The way forward

Laith J. Abu-Raddad, the report’s main author, who participated in the World Bank discussion, believes that with today’s greater understanding of the epidemic, time is of the essence in building a more meaningful response. “We are no longer groping in the dark on HIV in the region. The data are now available and we have a good understanding of what’s happening with regard to HIV transmission and the populations affected.” He added, “The priorities are clear to address the problem of the rising epidemics in the region and it is time for policy makers and partners to take action.”

Participants at meeting agreed that the current political climate presents a window of opportunity for sustained change. They called on policy makers to focus investment on evidence-informed prevention efforts for key populations to yield long term health and social benefits.

Stigma and discrimination must also be challenged and access to testing, care, and treatment services expanded substantially.

A partnership with civil society, concerned populations and people living with HIV will be the cornerstone of effective implementation. Strengthening grassroots organizations is considered essential for cementing progress made and reaching the most stigmatized and vulnerable.

The report includes data on Afghanistan, Algeria, Bahrain, Djibouti, the Arab Republic of Egypt, the Islamic Republic of Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Qatar, Saudi Arabia, Somalia, Sudan, the Syrian Arab Republic, Tunisia, the United Arab Emirates, West Bank and Gaza (Occupied Palestinian Territories), and the Republic of Yemen.

(From left to right): Zoheira Merah, an HIV activist and member of Al Hayat Association for People Living with HIV; UNAIDS Goodwill Ambassador Amr Waked; Hind Khatib, Director of the UNAIDS Regional Team for the Middle East and North Africa; Dr Walid Ammar, Director General of the Ministry of Public Health in Lebanon; Mr Elie Aaraj, President of the Regional/Arab Network Against AIDS; and Mr Moradi, a member of the Regional Resource Group for non-governmental organizations in the Middle East and North Africa. Credit: UNAIDS

HIV prevalence throughout most of the Middle East and North Africa remains low in the general population. In many settings, the epidemic is concentrated among key populations at high risk of infection, such as injecting drug users, men who have sex with men and sex workers. Exceptions to the general rule are evident in Djibouti, southern Sudan and parts of Somalia, where HIV prevalence now exceeds 1% among pregnant women in the general population.

Sixty participants from 18 countries across the Middle East and North Africa—including people living with HIV and UNAIDS Cosponsor organizations—gathered last week in Broumana, Lebanon, for a regional meeting focused on the empowerment of people living with HIV.

Supported by UNAIDS in collaboration with the Regional/Arab Network Against AIDS (RANAA), UNICEF, UNDP and USAID, the meeting focused on developing the leadership skills of people living with HIV with a view to advancing the vision of Zero new infections, Zero stigma and discrimination and Zero AIDS-related deaths. The participants pledged to strengthen coordination and partnerships with key actors, including government, civil society and faith-based organizations and the private sector.

Amireza Moradi, an HIV activist and participant in the meeting, applauded the efforts of people living with HIV in the region. “By our involvement as people living with HIV, we aspire to build a tolerant society,” he said.

A number of factors continue to hamper the HIV response in the Middle East and North Africa which can make people reluctant to access HIV services. These include stigma and discrimination, mandatory HIV testing, HIV-specific travel restrictions, human rights violations and gender inequalities. Although all countries in the region have established HIV treatment and care services, and provide treatment free of charge, the estimated coverage of treatment services is just 14%.

Despite challenges, there has been increasing commitment towards the HIV response in the region, as expressed through the Algiers’ declaration of people living with HIV in 2005, recommendations of a Tunisia regional meeting of people living with HIV in 2008 and a Dubai consensus statement on AIDS in 2010. In recent years, people living with HIV have made significant progress in organizing associations and advancing their rights.

Hind Khatib, Director of UNAIDS Regional Team for the Middle East and North Africa, reinforced the need to involve people living with HIV and key populations when developing HIV-related policies, strategies, and programmes as well as during implementation and monitoring and evaluation. “We are proud to be part of this positive movement in the region, and we will continue to support people living with HIV to have a louder voice,” she said.   

UNAIDS Executive Director, Michel Sidibé and Dr Christian MÉsenge Director of the Health Department at Senghor University of Alexandria. Credit: UNAIDS/Chironi

UNAIDS and the Senghor University of Alexandria signed an agreement of cooperation to include a 25 hour module specific to AIDS in the university’s curriculum of their Master’s degree on Health.

The memorandum of understanding was signed in Geneva on 21 October 2010 by UNAIDS Executive Director, Michel Sidibé and Mr Albert Lourde, Rector of the Senghor University.

The agreement also established that a selected group of students cursing the second year of the master’s degree will have the opportunity to undertake their mandatory 3 months internship in several UNAIDS country offices located in West and Central Africa as well as the Middle East and North Africa regions.

UNAIDS will also certify the continuing education courses organized by the University throughout the francophone Africa when such courses are related to AIDS.

This initiative is a consequence of the broader cooperation agreement between UNAIDS and the International Organisation of La Francophonie (IOF) signed in December 2009 focusing on institutional dialogue between governments, partners, stakeholders in the field and civil society. The IOF and UNAIDS strengthened their collaboration for the benefit of the peoples of the French-speaking world, specifically the most vulnerable.

The main areas of cooperation, which were identified with the Operating agencies of La Francophonie, could thus be embodied in new tailor-made agreements built around the themes of democracy and human rights, including legislative aspects of HIV, and education and research, in conjunction with the University Agency of La Francophonie (AUF) and the Senghor University of Alexandria.

This new agreement signed with Senghor University embodies the ties between UNAIDS and La Francophonie by building the capacity of the francophone countries in terms of human resources as well as raising awareness of the AIDS epidemic and UNAIDS work.

H.E. Ismail Omar Guelleh, President of the Republic of Djibouti together with Mr Michel Sidibé, UNAIDS Executive Director. Credit: UNAIDS/P.Virot

Each year, there are more than 200 million people on the move. The UN estimates that between 20 and 30 million are migrants in irregular situations and that wars and conflicts have caused the displacement of 16 million refugees. 

Many countries around the Red Sea and Gulf of Aden are affected by intense poverty and violent internal conflicts. This has resulted in large numbers of migrants living in and around the ports. There is also a large community of mobile populations, including truck drivers, dock workers, port staff, security staff, ships crews and sex workers who can be at higher risk of exposure to HIV.

Poverty, social exclusion; separation from families and communities, loneliness, fear and marginalization can make mobile populations and migrants particularly vulnerable to HIV. The situation can also be aggravated by lack of access to HIV prevention, treatment and care services.

“It is essential that mobile and migrant populations living in and transiting through ports have access to HIV services and are included in national HIV plans,” said Michel Sidibé, Executive Director, of the Joint United Nations Programme on HIV/AIDS (UNAIDS). “Achieving universal access goals means making sure all sectors of society are reached, particularly people most vulnerable to infection.”

The Government of Djibouti, in close collaboration with UNAIDS, the International Organization of Migration, the Inter-Governmental Authority on Development (IGAD), and other partners, convened a meeting from 26-29 September 2010, which brought together leaders from Red Sea countries and other countries across Africa to address the issue of key populations at higher risk of HIV infection along the Red Sea and the Gulf of Aden ports.

“For us, this conference has been extremely instructive, we have learnt a lot from the experts, but particularly from people living with HIV who have come forward to tell us their stories,” said His Excellency Abdallah Abdillihi Miguel, Minister of Health of Djibouti. “This meeting has reinforced my conviction that we have to continue to work towards universal access to HIV prevention, treatment, care and support and make sure that everyone in need, even those most marginalised and vulnerable, has access to services.”

The experts and leaders agreed to take concrete actions to strengthen advocacy and leadership on HIV and mobility; integrate HIV and mobility into national strategic plans; ensure improved planning; enhance the capacity of civil society and partnerships with the private sector; and develop a common communication strategy with particular emphasis on human rights.

To help successfully implement the project and build the capacity of NGO staff and government officials, five days of training in HIV took place in Kabul.
Credit: UNODC

Providing comprehensive HIV services for injecting drug users is critical to an effective HIV response. In recognition of this, the United Nations Office on Drugs and Crime (UNODC) has begun to support the implementation of an initiative to make services accessible to Afghan refugees who inject drugs in Iran and Pakistan, and also to Afghan injecting drug users who have returned home.

The use of non-sterile injecting drug equipment is one of the most efficient modes of HIV transmission and remains one of the critical activities fuelling HIV epidemics among drug users. HIV can also spread from people who inject drugs to their sexual partners and other populations at higher risk of HIV exposure such as sex workers.

The project aims to create an environment that supports a cross-border regional network of HIV services so that Afghan refugees will be able to access HIV services when they go back to their country. UNODC awarded two grants to non-governmental organizations to provide services to Afghan drug users in Herat province, bordering Iran and Nangarhar, which borders Pakistan.

Khatiz Organization for Rehabilitation in Herat and the Health and Social Development Organisation in Nangarhar are using mobile outreach units to offer a wide-ranging set of servcies. These include facilitating specific information and education materials for drug users; distributing clean needles and syringes; promoting and distributing condoms; treating and helping prevent sexually transmitted infections; primary healthcare such as HIV voluntary counseling and testing services and antiretroviral treatment.

Training in HIV and drug use 

To help successfully implement the project and build the capacity of NGO staff and government officials, five days of training in HIV took place in Kabul. Doctors, nurses, social workers, project managers and employees from the women’s prison participated.

During the meeting, also attended by high-level delegations from the government, UN agencies and NGOs, the seriousness of the situation in Afghanistan was discussed. Dr.Mohammad Zafar, Deputy Minister of Counternarcotics, told the gathering that according to a 2005 UNODC survey, the country has one million drug users, including 19 000 – 25 000 who inject drugs, making up 3.8% of the total population.

According to Dr.Ajmal Sabaoon, National AIDS Control Programme Manager, Afghanistan is moving from a low-level HIV epidemic towards a concentrated epidemic. He briefed participants on results of an Integrated Biological and Behavioral Survey conducted by John Hopkins University in 2009, which indicates that HIV prevalence among injecting drug users in three major cities of the country (Kabul, Herat and Mazar) has increased from 3% to 7% from 2007 to 2010.

Knowledge of HIV among IDUs is also very low. According to the study, only 29 % of the IDUs could correctly identify ways of preventing the sexual transmission of HIV and reject major misconceptions about HIV transmission. About 22 % of the IDUs have ever tested and know their HIV status.

The surveyed injecting drug users are known to be mobile, as almost 80% reported that they had changed residence at least once. Much of the mobility appears to be related to various phases of the conflict in the country, with the majority of IDUs relocating to Pakistan or Iran. The UNODC and its partners hope that by providing HIV services to injecting drug users in such bordering locations will help reverse the growing HIV prevalence among IDU in the country as well as within the sub regional area.

Protecting drug users against HIV is one of the nine priority areas in the UNAIDS Outcome Framework 2009-11. This can be aided by making comprehensive, evidence-informed and human-rights-based interventions, such as harm reduction and demand reduction, accessible to all who need them.

Mr Sidibé delivered an address during the closing ceremony of the conference. 31 March 2010.

While a wide range of AIDS epidemics occur across the Francophone world, this week in Casablanca, countries came together to speak with a common voice and with one common goal – stopping AIDS from making further inroads in French-speaking countries. Representatives from around 50 French-speaking countries wrapped up the 5th Francophone conference on HIV/AIDS today.

“I am impressed by the leadership Francophone countries have shown,” said UNAIDS Executive Director Michel Sidibé, “here in Casablanca we have heard about how French-speaking countries are making important contributions to the AIDS response.”

Mr Sidibé delivered an address during the closing ceremony of the conference. In his speech he said, “In partnership with Francophone countries my dream can become a reality: we can stop all new HIV infections.”

During the conference, speaker after speaker highlighted the financial difficulties the AIDS response faced since the global economic crisis. Mr Philippe Douste-Blazy, President of UNITAID, called for a new approach to address funding needs. "We need innovative financing mechanisms to complement classic institutional financing."

It was the first time that the event, which began on 28 March, was held on the African continent. It brought together scientists, policy-makers and health and development experts from more than 40 countries.

"Over the past few days we have had a lot of fruitful exchanges. We have reached some important conclusions, now we must put them into action," said Patrice Debré, French Ambassador in charge of the fight against HIV/AIDS and infectious diseases.

It was also the first Francophone HIV conference in which UNAIDS participated significantly. The Joint United Nations Programme plans to continue this strengthening of cooperation with Francophone countries.

"I see UNAIDS presence here as the start of a new era of deeper collaboration with French-speaking countries," said Mr Sidibé, "We want to give value to their expertise and reinforce experience sharing between nations."

UNAIDS estimates that there were 4.1 million people living with HIV in Francophone countries and 340,000 new infections in 2008. Prevalence rates vary widely: for example Algeria has a rate of 0.1 percent while the Central African Republic has a rate of 6.3 percent.

The next Francophone Conference on HIV/AIDS will take place in Geneva, Switzerland in 2012.