Independant On-line, Aids researchers unite for greater exposure, 10 August 2004

New Delhi - A global network of researchers has been set up to study the growing HIV/Aids epidemic in the Middle East and North Africa.

The Global Network of Researchers for HIV/Aids in the Middle East and North Africa (GNR-MENA) was conceived at a meeting of academics at the University of Illinois-Chicago last year and formally launched at the 15th International Aids Conference in Bangkok last month. It will encourage research initiatives, scientific exchanges and debate on HIV in this troubled region.

Sandy Sufian, founder of GNR-MENA and professor at the University of Illinois-Chicago, says one of the major goals of the network is to be "a scientific forum with no political or disciplinary boundaries". It will allow health experts from the region to draw up plans to tackle the HIV epidemic, prioritise research agendas, and collaborate on studies.

GNR-MENA will create a database of names and affiliations of interested researchers around the world, particularly in the Middle East, and will organise meetings for scholars from the MENA region to plan research on HIV/Aids.

According to the Joint United Nations Programme on HIV/Aids (UNAids), the total number of HIV infections in the Middle East and North Africa more than doubled from 210 000 in 1998 to 480 000 in 2003. Despite this, research on HIV and sexually transmitted infections in the region is scarce. Medline, the international index of medical research publications, lists only ten articles published in 2002-03, mostly relating to Israel and Turkey. During this period, fewer than 20 presentations on HIV in the region were given in international conferences.

The prevalence of HIV/Aids in the adult population in the Middle East and North Africa is low compared to sub-Saharan Africa and Asia, at 0.2 percent of the population. But Carol Jenkins of the World Bank warns that the quality of local HIV/Aids surveillance is poor, and that what data exists is from one-off studies, mostly from captive populations, such as prisoners, who do not represent communities. Moreover, she says the studies often do not describe their sampling methods and are not peer-reviewed.

Jenkins says there have been few behavioural studies to help explain who is getting infected and why. Lacking this kind of data is "dangerous", she says, as it is easy to miss the epidemic in its early stages, especially in hidden populations in hard-to-reach groups.

The behavioural data that is available is from specific and limited groups. For example, prevalence rates were established among 291 injecting drug users in Bahrain in 2000 (0.3 percent prevalence), bar girls in Djibouti in 1996-98 (2.8 percent), and among 815 homosexual men in Egypt in 2001 (0.86 percent).

The limited data does, however, indicate that socio-economic conditions and risk behaviours conducive to spreading the epidemic do exist. These include a large number of migrants, slow-growing economies in some countries, high youth unemployment, illicit drug trade and low educational levels.

Some countries have responded to the epidemic by setting up blood screening measures and making antiretroviral treatment available. But Oussama Tawil of UNAids says more needs to be done by offering "psycho-social support and voluntary counselling and testing centres".

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