Earlier this month the UN Program on HIV/AIDS (UNAIDS) and the Algerian Ministry of Health announced their cooperation in building a dedicated HIV/AIDS research center in southern Algeria. The center, scheduled to open in 2013, will be the first of its kind in the Middle East and North African region, and the first on the African continent. HIV rates in Sub-Saharan Africa remain high and the Middle East and North African region has the second fastest growing incidence in the world, making the center even more necessary now.
Because of its physical and cultural location, Algeria is a logical choice for the research center. Administratively, Algeria is in the Middle East and North Africa region according to UNAIDS, but is in the African region according to the World Health Organization. Algeria’s dual identity was obvious in press releases for the research center; French press touted the center as African, while the English declared it Middle Eastern. Officials hope the central location will attract experts from Africa, Europe and North America (link in French, translation here), and focus research on the intersection of both African and Middle Eastern HIV/AIDS issues. The Algerian government, which relies on international aid for only seven percent of its HIV expenditures, will provide funds to build the center, and UNAIDS will provide financial support via salaries.
The choice to locate the center in the south, in the regional capital Tamanrasset, presents both opportunities and challenges. Located 400 km north of the Niger border, Tamanrasset was described in a UNAIDS report as “a region… highly characterized by its remoteness, instability, and vulnerability due to its proximity to the African Sahara” (p. 60). The region has one of the highest incidences of HIV in the country. Many immigrants from sub-Saharan Africa pass through Tamanrasset on their way to Europe, though the Tuareg rebellion in the Azawad region of the Sahara has caused dramatic reductions in migrant numbers since January.
However, building the center nearly 2,000 km from the capital Algiers supports a widespread belief often expressed in Arabic media that many diseases, including HIV/AIDS, are primarily problems of immigration (link in Arabic, translation here) from sub-Saharan Africa. While Algeria is one of few Middle Eastern countries that do not restrict entry based on HIV status, its AIDS epidemic is not the product of immigration alone. According to the 2011 UNAIDS report on the region, approximately 13,000-18,000 people are HIV+ in Algeria. While the overall prevalence of HIV is around 0.1 percent in the general population, the epidemic is focused on sex workers, of which four percent are estimated to carry the virus.
The epidemic continues to grow. In 2010, women passed men as the largest HIV+ group in the country. Of the eligible HIV+ people, only 25-43 percent are on anti-retroviral therapy and pharmaceutical stock-outs are common. Also, only 14-33 percent of HIV+ pregnant women receive therapy to prevent viral transmission to their child. While these statistics sound dire, they are some of the best in the Middle Eastern region.
Algeria is at the forefront of social mechanisms to address HIV in the region. In 2005, it held the Middle Eastern region’s first meeting for people living with HIV. Since then, the non-governmental organization El Hayet (meaning “life” in Arabic, Facebook page here in French) was launched to help protect the rights of HIV+ women through reducing their participation in acts that make them vulnerable to HIV transmission by ensuring their social and financial autonomy. The Association for Protection against AIDS (known by its French acronym, APCS, for Association de Protection Contre le Sida) created the first anonymous testing center in the country and also fights for legal protection for HIV+ people who are victims of discrimination, such as those evicted from housing once their status became known.
This research center is a welcome step in a long process to address the HIV epidemic in the region.