OF HIV/ AIDS SPREAD IN SOMALIA. ACT NOW
BEFORE IT’S TOO LATE!!!
Immunodeficiency Virus (HIV) infection knows no borders, nationalities nor ethnic groups.
Somalia is situated in a geographical hot zone as HIV/AIDS rapidly becomes pandemic. The
improved security and the secession of hostilities in many parts of the country has led to
the return to the repatriation of a large number of Somali refugees. Many of those
returning have been exposed to HIV infection while they were living out of the country. In Somalia, there are many other risk factors that
facilitates the spread of HIV infection. According to the latest UNAIDS report, the rate
of HIV infection in Somalia has risen from an estimated 0.2% in 1987 to 2% in 1997. In
major Somali cities, the HIV infection is spreading rapidly.
only effective method of combating the spread of HIV/AIDS is through education and
awareness. In Somalia, raising public awareness of HIV/AIDS poses an immense yet crucial
challenge. Alarming misconceptions exist – even among the well educated - that the
disease is “foreign” disease that does not exist in Somalia because of the
strong Muslim culture. With Sexually Transmitted Diseases (STDs) not discussed in polite
conversation and HIV often portrayed as a disease of foreigners, it is not surprising that
many Somalis do not think they are at risk of HIV and other STDs. This misperception can
have serious consequences for Somalis and contribute to the spread of these infections.
Though the rate of HIV/AIDS infection is assumed to be much lower in Somalia than in
neighboring countries, studies and surveys conducted in Somaliland (the northwest region
of Somalia) and Puntland (the northeast region of Somalia) indicated that the HIV/AIDS
epidemic may be about to hit Somalia.
the spread of HIV/ AIDS infections depends on influencing people to change their behavior
through health education. Efforts must be
made to provide information to the public about the disease as well as the behavior
conducive to its spread. Influencing
behavioral change is never been easy but the challenge is compounded by the conservative
Muslim culture of Islam that makes discussions around sexual behavior taboo. Prevention
efforts are key at this stage; Somalis must be educated on the risk factors for disease
transmission. Controlling the spread of
disease later will be tremendously more difficult than instituting prevention efforts now. Somalis must have access to the knowledge of a)
what the disease is; b) how it is transmitted (and, in turn, how it is not); c) how likely
they are to become infected; and d) what they can do to avoid infection.
is clearly taking an immense and growing human toll. AIDS is not only a health issue.
Apart from human suffering, the situation in high prevalence countries is characterized by
substantial losses of trained manpower and subsequent reductions in the GNP, disruption of
families and a huge social and economic burden resulting from a growing number of AIDS
widows and orphans. Increasingly, however,
responding to AIDS in Somalia requires efforts going beyond the health sector in order to
mitigate the social and economic consequences of the epidemic.
represent a major public health problem throughout Somalia. STDs are very important
because of their complications and social stigma. An
ongoing yet unpublished study on STD prevalence in Galkayo city
currently indicates that 20% of people attended one of the private clinics in Galkayo
suffer one or more STDs. This figure is
consistent with a recent report on STD prevalence in Somaliland, which indicated that 31%
of women and 12% of men in the study had one or two STD symptoms. Yet, sexual behaviors that facilitate HIV
transmission are the same as those for other STDs. HIV and other STDs share common risk
behaviors and are amenable to common behavioral interventions. In addition, HIV infection
and other STDs are linked by biological mechanisms. Other STDs increase both HIV
infectiousness and susceptibility, yet STD prevention is not usually implemented as a
significant HIV prevention strategy. Several Studies in Sub Saharan Africa on interactions
between STDs and HIV particularly the Mwanza
finding suggest that prevention and control of STDs before or early in this epidemic will
probably reduce STDs in the highly active core population and will have a major impact on
the spread of HIV. As a result, the high
prevalence of STDs in Somalia will only facilitate the spread of HIV/AIDS. Therefore, as
we see the scientific evidence that supports STD control as an intervention that will have
enormous impact in the early phase of the HIV epidemic, we should properly consider
implementing various interventions that proved to be effective on controlling the STDs. There is
consensus among physicians working in Somalia that STDs are increasing among Somalis,
especially women and quite possibly Somalia is on the verge of HIV/AIDS epidemic. However,
timely prevention initiatives may effectively curb this epidemic.
to curb the spread
regional authorities, and any future government in Somalia, will have many pressing issues
to deal with and a limited budget which to implement change. It is unlikely that addressing prevention
activities for HIV/AIDS (and, in turn, STDs) will rank a top priority. Therefore:
professionals, international bodies and organizations must step in and advocate that
regional authorities should include their priority on combating the spread of HIV/AIDS.
information gathering and surveys must be carried out.
Sentinel surveillance and KABP survey will be the most appropriate to gather
comprehensive information about the HIV/AIDS status in the general population in Somalia.
ü The high
prevalence of STD must be reduced throughout the country through primary prevention
including community awareness and continued health promotion.
management through a syndromic approach should be implemented, particularly at primary
authorities have to mobilize and advocate national and international resources for
STD/HIV/AIDS prevention and care.
of health personnel in all relevant aspects of HIV/STD prevention and control, including
communication skills and behavioral aspects.
HIV/AIDS task force must be created. The task force must comprise all the agencies
involved in this issue, as well as regional, local authorities, religious leaders,
community leaders, youth and women’s groups.
ü In order
to mobilize awareness and appropriate and timely responses in concerned sectors, the
HIV/AIDS task force should bring together other agencies dealing with education, social
security, agriculture, small-scale business and infrastructural development.
ü To avoid
overlaps and undeserving in some regions, all the activities and tasks must coordinated by
the task force. Due to lack of cooperation and coordination between UN agencies,
international and local NGO’s, local authorities, and also community members have
resulted in duplication of efforts and wastage of scarce international and national
resources. Therefore, we have to learn from the past experience and share information.
ü A program
of HIV and STD prevention needs to begin working at the community level specifically among
women and youth groups. We have to ensure
that the local community is capable of responding to epidemics.
agencies and International and National NGOs with the local authorities have to develop
and promote national STD treatment guidelines.
and other international agencies have developed many approaches to deal the AIDS
devastation and how the local community or society can respond the HIV epidemic. These
approaches need to be tailored to Somalia.
the past 10 years, important progress has been made towards improving STD management in
order to combat the AIDS devastation in many developed and developing countries. Correct
STD management is one of the few cost effective instrument with proved efficacy to reduce
the transmission of HIV. Therefore, local authorities, the private sector, and donor and
UN agencies need to understand the importance of establishing countrywide, appropriate,
and sustainable STD services and seeks a consensus for long-term collaboration. Developing
effective STD management and prevention programs will require active participation and
strong leadership by both the government and the international and local agencies working
process of preventing STDs must be a collaborative one. No one agency, organization or
sector can effectively do it alone; all members of the Somalia communities and the
international and local organization must do their part. A successful national initiative
to confront and prevent STDs/HIV/AIDS requires widespread public awareness and
participation and bold national leadership from the highest levels.
Medical Association and its members have been very active locally and internationally
and we are committed to help our people wherever they are and what ever it takes. Our
members have the knowledge and the expertise to combat the HIV/AIDS epidemic through not
only clinical side but also prevention. PMA is willing to collaborate anyone who intent to
contribute the HIV/AIDS prevention in Somalia, or any other health problem. Please feel
free to contact PMA by calling 252 543 4808, by fax # 252 543 4501, or sending email to firstname.lastname@example.org. We will be very happy to answer any question that
you may have and provide you more detail information about the status of STD/HIV/AIDS in
Puntland State, and Somalia in general.
you for your quick response or action.
Prof. Mohamed Jama Salad,
Abdinasir M. Abubakar, MD, MPH .