IRAN: LACK OF POLITICAL LEADERSHIP IN HIV/AIDS CAMPAIGN

S E C R E T SECTION 01 OF 03 IRAN RPO DUBAI 000005 SIPDIS SIPDIS LONDON FOR GAYLE, BERLIN FOR PAETZOLD; BAKU FOR HAUGEN, ISTANBUL FOR ODLUM; PARIS FOR WALLER E.O. 12958: DECL: 2/4/2018 TAGS: IR PGOV SOCI TBIO SUBJECT: IRAN: LACK OF POLITICAL LEADERSHIP IN HIV/AIDS CAMPAIGN RPO DUBAI 00000005 001.2 OF 003 CLASSIFIED BY: Jillian Burns, Director, Iran Regional Presence Office, DoS. REASON: 1.4 (d) 1.(C) Summary. Despite the growing number of HIV cases in Iran, the country lacks political leadership in its fight against the disease, according to an Iranian epidemiologist. For example, he asserted, the Iranian government did not observe World AIDS Day on December 1, 2007. Although Iran's AIDS-related programs have improved in the past six years according to the doctor, there continues to be tremendous social stigma toward the disease. Religious and cultural restrictions prevent open discussions and information campaigns. Furthermore, he claimed that the government occasionally engages in public disinformation, claiming success and declining prevalence rates which contradict evidence and hinder prevention and treatment efforts. The government does the minimum to absolve itself of responsibility and is not making inroads, according to several Iranian health workers. End summary. Government lacks leadership on HIV/AIDS -------------- 2.(S) According to an Iranian epidemiologist, Iran's leadership made no observance of World AIDS Day on December 1, 2007, and there were no AIDS awareness messages on public television. (Note: According to UNICEF`s website, there was an art exhibit at a major Tehran park to raise awareness on World AIDS Day in December 2007. This program was supported by UNICEF Iran and organized by a major Iranian non-governmental organization as well as other NGOs, UNAIDS, the UN office of Drugs and Crime (UNODC),and the Tehran municipality, and the country's Disease Control office. Endnote.) The epidemiologist, who was in Dubai applying for a visa to attend an HIV/AIDS workshop at a California university, told IRPoff that although Iran's AIDS response has improved in the past six years, public outreach and awareness is sorely lacking. 3.(S) According to the epidemiologist and his wife, a midwife in Tehran, treatment for HIV/AIDS has not yet acquired broad social support in Iran, and advocacy comes mainly from the medical community. He said that Tehran University's Center for AIDS research and Iran's Disease Management Center held a joint conference for medical scientists around AIDS Day. However, most publications and articles regarding HIV/AIDS are limited to the scientific community and do not address the general public. The only public campaign poster the doctor recalled seeing was a large poster in Tehran's Mehrabad airport. He mentioned another smaller ad from about three years ago which he said cautioned physicians about treating HIV-positive patients; he said this ad was quickly removed, leading him to believe it was released without approval. 4.(S) In Iran, most health-related messages come from the minister of health, but the epidemiologist believed that because the current minister of health and his deputy both happen to be gastrointestinal physicians, they are less interested in HIV/AIDS. According to an Iranian psychiatrist who operates a small private drug addiction clinic, the government disregards the country's HIV/AIDS problem and denies the drug problem that is helping the spread of the disease. She said the government does the minimum to absolve itself of responsibility. Several other Iranian health workers also felt that the government was making little progress fighting the spread of HIV/AIDS. According to a recently retired Iranian military nurse and a young orthopedic surgeon, former President Khatami was the only Iranian leader to ever publicly acknowledge that HIV/AIDS is a serious problem in Iran. They indicated there is no mandatory AIDS testing in the military, and testing at marriage is only recommended. According to a psychiatrist with a drug addiction clinic, the government promotes the idea of voluntary HIV testing and counseling for specific groups such as pregnant women. According to the epidemiologist and his wife, hospitals do not test patients for HIV prior to medical operations; doctors can perform consensual HIV testing if suspicious of a patient's status for protection of medical personnel. 5.(S) In contrast, the epidemiologist praised the directors of RPO DUBAI 00000005 002.2 OF 003 Iran's Disease Management Center and Tehran University's AIDS Research Center whose efforts and dedication, he said, have improved the country's HIV/AIDS prevention and treatment programs. AIDS stigma remains -------------- 6.(S) According to the epidemiologist, Iran's leaders do not address the country's HIV/AIDS problem in public to avoid addressing the culturally taboo topics of intravenous drug use (IDU) and sexual transmission that are largely responsible for the spread of the disease in Iran. Separately, a doctor from a charity hospital in southern Tehran said there is a strong social stigma in Iran associated with HIV, even among the medical community who sometimes turn away HIV-positive patients. Although he maintained the government is starting to address the AIDS issue, he agreed with the first source's assessment that cultural limitations are negatively impacting efforts to educate the public. He said that because of religious restrictions, officials do not discuss the disease's details and methods of transmission. Even public service campaigns are vague, for example he described one ad with an image of a woman with the AIDS red ribbon symbol, with the message "I am aware" without naming the disease. According to the retired military nurse and the orthopedic surgeon, Both sources maintained that the current government denies and downplays the problem probably for religious and moral reasons. 7.(S) Iranian officials still deny and sometimes misinform the public about HIV/AIDS, according to the epidemiologist. He said that in a December 2007 speech, Health Minister Lankarani claimed that the number of AIDS cases in Iran is declining due to the country's free AIDS treatment program. The doctor said this claim contradicts evidence of rising prevalence reported by the UN and other sources. Antiretrovial drug therapy -------------- 8.(S) The Iranian government provides AIDS antiretroviral drug therapy for free, but only to a very small number of people. According to the AIDS researcher, centers for behavioral diseases run by the ministry of health provide antiretroviral therapy, and most of the government's AIDS budget goes towards treatment, as it costs 300 thousand Tomans or about 300 dollars to treat one patient. The researcher claimed that there are only about 200 patients under treatment, and the government has supplies for a total of 300 patients. She said they use generic drugs, mainly Nelfinavir from Pfizer, which prevents HIV-infected cells from reproducing, but drug resistance is growing and there are not many drug options. She said that about 70 government outreach clinics operate in Iran. Iran's new AIDS drug -------------- 9.(S) In September 2006, Iran's president announced that Iranian scientists at Tehran University had come up with a new drug that boosts the immune system to better fight the AIDS virus. Two doctors claimed separately to IRPoff that actually Russian scientists developed the drug and then sold the patent to Iran after the Russian ministry of health rejected their product. According to the two Iranian AIDS experts affiliated with Tehran University, the medicine has passed small and large animal testing and is now on trial on human volunteers. The same sources explained that the medicine, an immune cell booster, technically referred to as a CD4 booster, is called IMOD and is a natural selenium-based drug. The AIDS expert said Iran's Fars-Russ company performed animal testing in Iran. She explained that the drug has a low toxicity level and is being administered to volunteer patients. She said the best results have been among those with a CD4 count of 340-200, but patients more advanced in their disease and lower CD4 counts also benefited from it. 10.(C) Comment: As in many countries, HIV/AIDS is a sensitive topic in Iran. The country's efforts in research and treatment areas are positive but lack frank and honest discussions about intravenous drug use and sexual transmission, the primary methods of infection in Iran. Furthermore, government RPO DUBAI 00000005 003.2 OF 003 disinformation about the seriousness of the situation undermines efforts to raise public awareness about the disease. The theme of this past World AIDS Day was "leadership," a factor which appears to be lacking in Iran. BURNS