The Muslim world consists of 1.3 billion people spread mainly across three continents. With such a wide scope, it is perhaps surprising that more attention has not been paid to the spread of HIV/AIDS in the Muslim world. AEI’s Nicholas Eberstadt recently released a report with Laura M. Kelley on the spread of the disease in this overlooked population and discussed their findings at a July 8 AEI conference.
Part of the reason that there has not been more discussion about HIV/AIDS in the Muslim world is that statistics are not always readily available, and many figures are unreliable. The Joint United Nations Program on HIV/AIDS (UNAIDS) puts the number of total infected in North Africa, the Middle East, and Muslim Asia at 1 million. Eberstadt and Kelley called these figures gravely understated and added that no data exists for Afghanistan, Turkey, or Somalia—all countries with large at-risk populations, according to the authors. Poor testing rates of many countries also keep figures inaccurately low.
The first cases of HIV/AIDS in this part of the world were officially recorded in the mid-1980s in Bahrain, Qatar, Iran, and several other Muslim states. Eberstadt and Kelley blamed the inaction following these diagnoses in part on the assumption that “premarital sex, adultery, prostitution, homosexuality, and intravenous drug use” do not occur in the Muslim world because of its strict codes of morality. Examples of such denial by governments include Islamic clergy in Nigeria urging Muslims to boycott a U.S.-backed HIV/AIDS seminar in 2001 for fear that attendance would increase promiscuity and a claim by Pakistan’s National AIDS Control Programme that the country’s low rate of infection was due to its superior “social and Islamic values.”
The absence of democratic governments among some Muslim nations hinders the delivery of treatment and prevention services to at-risk populations, even when governments admit the existence of the disease. Eberstadt and Kelley wrote that while the ideal human society envisioned by the Koran contains neither drug abuse nor prostitution, many Muslim societies lack the required “civic assistance” to fight these existing social ills that facilitate the spread of HIV. Citizens within these societies often cannot count on their governments to provide social services to prevent the spread of disease or to care for the sick.
Some level of success has been achieved, however, in countries that have been willing to face up to the epidemic. Although infection still carries a stigma in Iran, the government has nonetheless made some progress in confronting the disease. Eberstadt and Kelley found that until 2001, HIV-positive workers could be fired from their jobs and that hospitals and doctors could still refuse to treat patients with the virus as late as 2002. Today, HIV education has become part of the curriculum in many public schools, and couples must attend lectures on how to prevent the disease before marrying. Needle-exchange programs have also been implemented, particularly in high-use drug areas of Tehran.
Bangladesh has also made considerable strides in prevention and education among hard-to-reach populations. The Bandhu Social Welfare Society has brought safer-sex education to thousands of gay and bisexual men, and HIV/AIDS awareness programs have even been taught in mosques. Groups such as the Islamic Foundation, the Islamic Medical Mission, and the UN Development Programme have launched programs to educate religious leaders to deliver prevention education to their followers.
While these efforts outpace the efforts of many other Muslim countries, Eberstadt and Kelley contrasted efforts in Thailand and South Africa to demonstrate what can be accomplished in fighting the disease. Despite low official incidence of HIV/AIDS in Thailand, Thai officials launched an aggressive anti-HIV education campaign in the 1990s, spreading education to all sectors, from the school to the brothel. By contrast, South African prevention and education programs have only gotten underway in the last five years. As a result, the infection rate in Thailand has remained at less than 5 percent while 25 percent of the South African population is now infected, according to UNAIDS.
Eberstadt and Kelley remain hopeful that other countries can adopt education and prevention programs like those undertaken in Thailand and currently in use in Iran. They write that “conservative and fundamentalist regimes can find ways to harness their religious piety as a means to help deal with urgent social need,” suggesting that messages can be crafted to show that caring for the sick and at-risk populations is consistent with notions of Muslim virtue. Programs to raise women out of poverty can help prevent more people from becoming commercial sex workers and therefore putting themselves at risk. With the help of Western nations, pharmaceutical care and the public health infrastructure required to deliver this care can be expanded and have a real impact in stopping the spread of the disease in the Muslim world.