NEW YORK // The Middle East and North Africa has one of the fastest-growing Aids epidemics in the world because governments across the region are failing to assist those most threatened by the disease, a new UN report says.
The region has about 460,000 people suffering from HIV, the virus that causes Aids, and one of the highest rates of new infections, despite a global trend of the disease being brought under control, the UN says.
The Middle East, North Africa and Eastern Europe now have the world's "fastest-growing epidemics", says the 139-page report, AIDS at 30: Nations at the Crossroads, which marks three decades since the virus was first reported.
Conservative attitudes and behaviour have kept the number of HIV-cases in the region relatively low, but the rate of new infections more than doubled in less than a decade, growing from 36,000 new cases in 2001 to 75,000 in 2009.
Hind Khatib-Othman, regional head of the world body's agency, UNAIDS, said the epidemic is concentrated in marginalised groups: sex workers, injecting drug users and men who have same-sex relations.
"We have a small number of people living with HIV, but now we have evidence that actually the numbers are growing and multiplying very fast among key populations," she said. "We still have so much stigma and discrimination with the wrong policies in place … it's going to become a major problem if we don't turn around the commitment of policymakers and governments."
More than one-fifth of Djibouti's sex workers are infected, along with 14 per cent of Iranian injecting drug users and almost six per cent of Egyptian men who have same-sex relations, the United Nations says. Data are incomplete so the full extent of the epidemic is not known.
The report warns against laws that drive victims underground. Globally, 47 nations restrict the travel of sufferers, 116 countries or regions criminalise aspects of sex work and 79 countries or regions have laws against same-sex relations.
This is particularly true of the Middle East and North Africa, where more than four-fifths of states have anti-homosexuality laws, and only 17 per cent of nations - the lowest figure globally - have schemes to tackle discrimination against sufferers.
The report's release comes ahead of a three-day summit at UN headquarters, starting on Wednesday, in which the UAE health minister, Hanif Hassan Ali al Qassim, is due to join foreign counterparts to renew efforts against the disease.
Delegates are negotiating for new commitments towards achieving universal access to HIV prevention, treatment, care and support by 2015.
Arab diplomats are seeking to dilute language in the text, by avoiding mention of punitive laws against victims and identifying the high-risk groups, said Ms Khatib-Othman.
Sharonann Lynch, an HIV analyst for the aid group Doctors Without Borders, said: "You cannot help people whose very existence you are trying to deny. Unless we get over this hurdle … then we will have a political commitment that is more political than it is a commitment to fight HIV."
The UNAIDS report describes gains this past decade in which some governments have "changed course" and embraced reforms. Egypt, Lebanon, Morocco, Iran, Djibouti and Tunisia now have projects to assist high-risk groups.
Ms Khatib-Othman, who is based in Cairo, described a possible "breakthrough" in talks with Gulf Co-operation Council members that could see an overhaul of the policy of testing migrant workers for HIV and deporting those found to be infected.
"We now have serious discussions with Qatar, who want to change their policies," she said. "If this change comes … we are going to have a snowball effect on other Gulf countries and hopefully, by the end of next year, we will have brokered a better environment for HIV-positive people."
In the wake of political uprisings in Egypt and Tunisia, the report highlights the value of "youth-based social networking" in which a "new generation" of technology users is sharing tips about contraception and sex diseases.
The Egyptian politician Dr Mohamed ElBaradei and the South African cleric Desmond Tutu recently wrote that the use of mobile phones and the internet during Egypt's uprising were "part of the agenda we must harness for an HIV-prevention revolution".
But Ms Khatib-Othman said officials, including the interim leaders of Tunisia and Egypt, are taking a "step backwards" during this period of political upheaval and avoiding such topics as sexual behaviour, condom use and drug addiction.
"We have had the Arab Spring, one revolution after another, which has hindered our efforts," she said. "But we actually see hope in what's happening here in the move to better democracy. That it's going to be a force to bring about changes in policy for better rights and better access to people living with HIV."