Every day Noor and Rose spend hours educating themselves, largely through the Internet, about the disease and how to get the medicine they need, all while hiding medicine and medical records in their home lest someone discover their secret. They talk about their condition only with other HIV patients, sometimes traveling hours to private seminars where patients reassure one another that they can’t spread the virus to their loved ones through touching or through sharing glasses of water.
HIV infections are climbing in only two regions of the world: Eastern Europe and the Middle East. The United Nations estimates that as many as 570,000 people in the Middle East have HIV or AIDS, 40 percent of them women. According to the United Nations, 70 percent of the men infected are married to women, often to hide their homosexuality. In Egypt, the Ministry of Health says there are 2,700 cases, but the true number is estimated conservatively at more than four times that – and growing.
“The world is talking about the beginning of the end of AIDS. We are not,” said Wessam not el Beih, the U.N.’s AIDS country director for Egypt.
According to one survey, 57 percent of doctors here think that HIV can be transmitted through a mosquito bite, according to a footnote in a U.N. report. Many patients, unaware of the symptoms or risks, learn only by chance that they’ve been infected, when a blood test required for a visa or a medical procedure comes back positive.
The U.N. is leading the AIDS education effort here, and there have been efforts by individuals to bring attention to the issue. Last year, it provided some funding for the $1 million film about the woman who contemplated becoming the first person to admit on television that she was HIV-positive, based on a true story. She never had the chance; she died because she could not find a doctor to perform gallbladder surgery on her.
Ehab Abdel Rahman, the director of the HIV program at the Ministry of Health, balks at the suggestion that Egypt isn’t doing enough. He notes that in a country of nearly 90 million people, the number of cases is small. Patients receive the medicine they need. Any shortage is a shipping problem, not a social one. The blame, he said, lies with patients who try to diagnose and medicate themselves.
“We always ensure there isn’t any defective or shortage of medicine. It has never happened,” Rahman said. “Our goal is to have stigma-free hospitals.”
But Omnia Kamal, a Morsi adviser on women’s issues and a member of the committee that’s charged with drawing up the country’s new constitution, offers a different view. In a nation plagued with economic programs and a litany of social issues, AIDS is not a priority, she said. There are more cases of hepatitis B and C, for example, which also need to be addressed.
“We have to start with economic issues, and then we will deal with social issues,” Kamal said. “For a proper democratic transition, you can’t start by changing everything right away.”
To be sure, there’s a connection between fixing the government and confronting social issues. Rahman said the government spent $8 million a year on AIDS prevention and medicine. But patients said they weren’t seeing the effects, and many think that the system, like most government institutions, is corrupt.