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Much progress has taken
place in the level of political commitment in the
Region. However, it has still not reached the level
necessary for a strong and effective response to
HIV/AIDS. Stigma and discrimination may prevent
decision-makers from declaring their commitment.
Also, lack of sufficient and reliable data on the
HIV epidemic in a country, because of weak
surveillance systems, will prevent the strong and
effective advocacy necessary to obtain the
commitment of leaders and senior politicians.
To date,
many countries in the Region are considered to be in the
state of a low-level epidemic. Around 10 countries have
estimated HIV/AIDS cases to be 1000 or below. This situation
has led to HIV/AIDS being placed low down on the list of
priorities of Ministries of Health, especially where other
diseases form greater burdens and therefore are given higher
priority than HIV.
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Access to
prevention, care and treatment services |
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The
health systems in many countries of the Region,
especially those worst affected by HIV/AIDS, are
weak, and face severe shortages of funds and of
trained health personnel. Often there is a shortage
in the number of qualified professional staff
dedicated to programmes on HIV/AIDS and sexually
transmitted infections. Also, there is low coverage
of therapy provided to HIV/AIDS patients in the
Region. An estimated total of 77 500 people living
with HIV/AIDS in the Region are in need of
antiretroviral therapy. Around 4000 are receiving
the
therapy, i.e. a coverage of 5.16% only compared with
a global coverage rate of 12%. The low regional
coverage relates to multiple factors, including lack
of capacities, lack of funds, weak political
commitment and weak health infrastructure.
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Complex emergency
situations |
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Several countries in the Region are suffering from
one form or another of complex emergency situation.
External military occupation, internal civil
conflict, mass population movement, embargo and
political instability are examples of emergencies
existing in the Region. These situations lead to a
variety of risk factors that increase HIV
transmission and hinder prevention, treatment and
care services from taking place.
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Stigma and
discrimination |
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Stigma and discrimination against people living with
HIV/AIDS are faced everywhere: in the family, at
school, in the workplace, in health care settings,
in the community and in travelling. Stigma and
discrimination together constitute one of the
greatest barriers, if not the greatest barrier, for
effective response to the epidemic. Because of
stigma and discrimination, people at risk do not
obtain information about preventive measures, and
people living with HIV/AIDS do not get adequate
care.
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