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Country Progress Report 2006 Algeria

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Country Progress Report 2006 Algeria People’s Democratic Republic of Algeria Ministry of Public Health and Hospital Reform Department of Prevention National STI/HIV/AIDS Control Committee Algerian Report on the monitoring of the Declaration of Commitment of the United Nations General Assembly Special Session on HIV/AIDS (UNGASS, 2001) in December 2005 Period covered: January 2003 – December 2005 WITH THE SUPPORT OF Joint United Nations Programme on HIV/AIDS UNAIDS UNHCR-UNICEF-WFP-UNDP-UNFPA-UNODC- ILO-UNESCO-WHO-WORLD BANK TABLE OF CONTENTS People’s Democratic Republic of Algeria........................................................................... 1 Ministry of Public Health and Hospital Reform................................................................ 1 Department of Prevention................................................................................................... 1 National STI/HIV/AIDS Control Committee..................................................................... 1 Algerian Report on the monitoring .................................................................................. 1 Period covered: January 2003 – December 2005 ............................................................ 1 TABLE OF CONTENTS................................................................................................... 2 The health system in Algeria: 5 health regions, 48 wilayas and 185 health sectors ..... 6 Table of indicators used for Algeria’s report on the monitoring of the Declaration of Commitment ....................................................................................................................... 7 of the United Nations General Assembly Special Session on HIV/AIDS (UNGASS, 2001) in December 2005..................................................................................................... 7 2 – Overview of the HIV epidemic.................................................................................. 11 3- National response to the AIDS epidemic ................................................................... 22 5 – Support required from development partners in the country ............................... 32 6 – Monitoring and Evaluation Framework ....................................................................... 37 The Multisectoral Monitoring and Evaluation unit ........................................................ 38 Status of the monitoring and evaluation activities at the end of 2005 ............................ 39 The growing under-reporting of HIV/AIDS in Algeria: the need for a uniform system ................................................................................................................................ 41 Access to computerised databases for epidemiological surveillance and other surveys ............................................................................................................................................ 42 Bibliography....................................................................................................................... 43 TEAM................................................................................................................................ 48 METHODOLOGY........................................................................................................... 49 I – Strategic level................................................................................................................ 69 II – Political support........................................................................................................... 70 III – Prevention................................................................................................................... 70 IV – Treatment and support ............................................................................................... 71 V – Monitoring - evaluation............................................................................................... 72 I – Individual freedoms ...................................................................................................... 81 II – Participation of civil society........................................................................................ 82 III– Prevention.................................................................................................................... 82 IV– Treatment and support ................................................................................................ 82 2 APPENDIX 1: Process of consultation/ preparation for the national monitoring report on the Declaration of Commitment on HIV/AIDS APPENDIX 2: Questionnaire concerning the Composite Index for National Policies APPENDIX 3: National declaration forms for indicators relating to programmes, knowledge, behaviours and impacts 3 1 – Brief assessment of the situation The available information shows that HIV infection in Algeria continues to spread, especially through unprotected sex. Injecting drug use, highlighted by the survey of knowledge and behaviours that was carried out in the north of the country in 2004, also represents a not insignificant method of contamination. The reporting data for HIV/AIDS concerning STI/HIV seroprevalence, in addition to the surveillance of knowledge and behaviour, indicate that Algeria is probably experiencing an epidemic that is concentrated in the highest risk population groups and within certain geographical regions, with the potential for a deterioration of the epidemiological situation unless precisely targeted and rigorous measures are implemented in response to the problems. Furthermore, all of the determinants required for infection to occur exist within the country and could trigger an epidemic process (Sex trade, sexually transmitted infections (STIs), mobility-migration, etc.). A significant number of knowledge and behaviour surveys have been conducted in Algeria. However, very few of them have produced data enabling a comparison of the trends for knowledge and behaviour to be made over time and space, because they have not been conducted using a standardised methodology. Standardisation is also important, both for the serosurveillance of HIV infection via the sentinel network and the actions involved in the monitoring of interventions. The first disbursements from the Global Fund’s HIV Project in 2005 provide the opportunity to bolster the monitoring of the STI/HIV/AIDS control programme. All of the optimised and unified human resources must be used for the programme’s monitoring and evaluation activities. Biological surveillance and “risk surveillance” (STIs and behaviours) on the one hand, and the monitoring of the implementation of the programmes on the other, will not be successfully integrated unless data collection and analysis methods are standardised. The analysis of resource and results indicators gathered from different government sectors and civil society organisations (NGOs) shows that in 2005, there was a significant increase in the speed of implementation of the response to the epidemic, thanks to the arrival of the first payments from the Global Fund. For certain sectors, such as Religious Affairs, Justice, Health, National Defence and Higher Education, along with civil society organisations, the increase observed in 2005 is a result of efforts committed over a period of several years. For other departments, 2005 marked the (new) beginning or the significant intensification of their interventions. The improvements observed can be illustrated by several encouraging figures: - In 2005, 575 patients in advanced stages of the illness had access to an anti-retroviral treatment, in the health sector’s six reference treatment centres set up in 2001 in addition to those of the national defence sector. - Whilst the number of blood donations has continued to grow (from 174,405 donations in 1994 to 299,115 donations in 2003), the percentage of HIV-positive donations has fallen on a yearly basis, reaching the low and stable level of 0.01%. - In 2002, 99% of the 3,268 young, single people between the ages of 15 and 29 that were interviewed recognised that sex was a source of HIV contamination. - In 2005, 183 female sex workers were given prevention kits and 749 such workers in 12 wilayas (provinces) received awareness training to allow them to participate in a behavioural survey. - In 2005, 400 peer educators received awareness training on HIV prevention in prisons. In 2006, in order to improve the impact of the resources used for controlling the illness, it will be necessary to invest in human and material resources, both of which are needed to integrate 4 monitoring and evaluation activities into the planning and implementation of routine interventions. In this way, it will be possible to make strategic decisions concerning the more accurate targeting of interventions in the areas where they will have the greatest possible impact. The future challenges in the fight against STI/HIV/AIDS are underlined by the following data, derived from different surveys: - 41% of injecting drug users have shared injecting equipment, according to a survey carried out in 2004 on the knowledge of problematic drug users (which included 50% of injecting drug users amongst the 285 participants). - In 2004, 65% of drug addicts did not know that the use of condoms can reduce the risk of HIV transmission. - In 2004, 44% of drug addicts acknowledged that they had had remunerated sex. - 15% of the drug addicts interviewed in 2004 had access to HIV counselling and screening. - When interviewed in
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