IRAN: LACK OF POLITICAL LEADERSHIP IN HIV/AIDS CAMPAIGN

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E.O. 12958: DECL: 2/4/2018
TAGS: IR PGOV SOCI TBIO
SUBJECT: IRAN: LACK OF POLITICAL LEADERSHIP IN HIV/AIDS CAMPAIGN

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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

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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

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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

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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

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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

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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

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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