Eritrea
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According to the 2010 UNAIDS Report on the global epidemic, there were 25,000 people living with HIV at the end of 2009. Of these, 22,000 were adults and 3,100 were children. The overall adult HIV prevelence at the end of 2009 was 0.8%. This denotes a decerease in the national HIV prevalence over the last six years (HIV prevalence was 2.41% in 2003).
According to the country's 2007 national sentinel survey, HIV prevelence is higher among urban residents (3.5%) than among rural residents (less than 1%). The survey also shows that HIV prevalence is higher among 30 to 34 years olds (2.1%), followed by 25-29 year olds (1.88%) and 20-24 years olds (1.26%).
According to the 2010 UNAIDS Report on the AIDS epidemic, there 4,955 people of antiretroviral treatment at the end of 2009, equivalent to 25% coverage of all people in need. The estimated number of women on antiretroviral treatment to prevent mother-to-child transmission of HIV was 34% in the same period.
Key elements of the national response
Since its independence from Ethiopia in 1991 the Eritrean government has shown its strong commitment to controlling the epidemic. In 1992 the National AIDS Control Program Unit (NACP) in the Ministry of Health was launched which became the National HIV/AIDS/STIs and TB Control Division (NATCOD) in 2003.
The HIV/AIDS, Malaria, Sexually Transmitted Diseases and Tuberculosis (HAMSET) project was launched in 2001. This is World Bank-supported multisectoral project involving government, civil society (non governmental organizations, faith based organizations), private sector and people living with HIV.
The government launched its first five-year National Strategic Plan (NSP) on HIV/AIDS/STIs for the period 1997-2002. A second NSP was formulated for the period 2003-2007 and it involved bilateral and multilateral development partners. Currently, the country is in the process of developing its third NSP for 2008-2012.
Eritrea has recently launched a new evidence-based National Strategic Plan for 2008/12 entitled "Geared toward Universal Access" where priority strategies have been re-oriented with a special emphasis on the most at risk populations.
The National HIV and AIDS Policy and Policy Guidelines have also been re-visited in 2009 to reflect progresses made in responding to the epidemic and to redefine the country's vision, priorities and goals in the response to HIV.
To secure appropriated level of funding for the new National Strategic Plan, the Eritrean Country Coordination Mechanism - "The Partnership" - developed a proposal for the Global Fund to fight AIDS, Tuberculosis and Malaria round 8 entitled "Reaching the Un-reached: Accelerating HIV and AIDS Interventions towards Universal Access to Prevention, Treatment, Care and Support". The round 8 submission was approved for an amount of USD 45 million. This grant comes to complement two previous grants for HIV and AIDS and secures funding for the National Strategic Plan 2008/12 priority interventions.
Finally, Eritrea’s national response to the HIV epidemic is based on multisectoral approach and is in line with the principles of the “Three Ones”. Eritrea has also formulated its Millennium Development Goals in 2004 and has set its Universal Access Targets on prevention, treatment, care and support services in 2007 and is expected to be realized by 2010.
Key Achievements
Important milestones in the government's response to the HIV epidemic in the past years include:
- Establishment of the NACP in 1992
- Adoption in 1997 of the first 5-year National Strategic Plan, which emphasized a multisectoral approach and decentralization of HIV prevention and control programmes
- Ratification in 1998 of the HIV and STIs policy guidelines. The key elements of the guidelines include individual and collective responsibility, voluntary counseling and testing, confidentiality, reduction of stigma and discrimination, equity in access to health services;
- Launch of the HAMSET Control Project in 2000
- Approval in 2002 of a Second National Strategic Plan (NSP) for HIV/AIDS/STIs for the period 2003 – 2007
- Adoption of a set of HIV testing guidelines in 2002
- Launch of a national behavior change communication (BCC) strategy in 2002 called "Winning through Caring: The BCC Strategy for prevention of HIV and control of AIDS in Eritrea"
- Restructuring of the Ministry of Health in 2003 and the creation of the National HIV/AIDS/STI and TB Control Division (NATCoD)
- Development of PMTCT guidelines and plan of action in 2003
- Development of Joint UN and Partners Implementation Support Plan to the National Strategic Plan, developed for 2003, 2004 and 2005
- Development and implementation of Joint UN team program of support on AIDS in 2006, 2007
- The formulation of National HIV/AIDS/ST Monitoring and Evaluation Plan in 2005;
- Development of antiretroviral policy and treatment guide lines in 2005
- Launching of antiretroviral therapy in September 2005
- Development of a revised Eritrean HIV/AIDS Care Manual in 2007
- Launch of the third five-year National Strategic Plan for 2008-2012
Key Challenges
While significant progresses have been made in expanding a comprehensive National HIV Response, the situation and response analysis conducted for the preparation of the new national strategic plan 2008/2012 was the opportunity to identify a number of recommendations to address challenges that the NACC will have to be dealing with in 2009.
To inform the response, the need for an in-depth understanding of the evolving epidemiologic situation is required and the present structure needs to be strengthened to allow for a comprehensive analysis of the data collected.
For a fully comprehensive multi-sectoral response, the line ministries and key national partners will embarked in the development of Sectoral Plans within the framework of the newly established National Strategic plan 2008/2012.
In terms of technical prevention strategies, the national behavior change communication strategy is well established in school and in the community but coordination within the different services and sectors will have to be re-assessed to increase availability and access to services.
Development of a communication strategy to promote STI services will be thoroughly explored for an increased use to the available services. The national programme of prevention of mother to child transmission has made some significant progresses but current statistics indicate that only 70-75% of pregnant women do attend ANC clinics. Strengthening the integration of PMTCT services within reproductive health services will improve access to ANC attendees.
In terms of technical care strategies, it is estimated that 58.4% of the need for antiretroviral treatment are available. This implies a further scaling up and decentralization of ARV services. This applies similarly to the Home Care Services to be expanded through the strengthening of community health approaches.
The health system's ability to support UA-driven interventions and provide timely, high-quality and effective treatment, care and support to infected and affected individuals and families are yet another challenges that require attention. Accordingly, the reinforcement of human resources, especially with in-service training of health workers and strengthening the pre-service training institutions for sustainable supply of skills and scaling up of interventions is yet another priority for Eritrea.
Last but not least, coordination mechanisms of the integrated multi-sectoral response and the monitoring and evaluation system need upgrading so to match the scaling up of the National HIV Response.
- NACA - National AIDS Coordinating Agency
- National Strategic Plan
- PMTCT and Paediatric Care and Treatment Fact Sheet
- 2010 UNGASS report
Andrew Kosia
Chair, UN Theme Group on HIV/AIDS
(WHO Representative)
Tel: +291 1 15 1613
Fax: +291 1 15 1322
Email: kosiaa@afro.who.int
Pascal Steiner
UNAIDS Country Coordinator
Tel: +291 1 15 15 99
Fax: +291 1 15 16 00
Postal Address:
5 Warsay Avenue
P.O. Box 5366
Asmara, Eritrea
Email: stenierp@unaids.org
NATCoD for Eritrea (NAC)
Andeberhan Tesfazion
Director, NATCoD
Ministry of Health
P.O. Box 212
Asmara, Eritrea
Tel: +291 1 122129
Fax: +291 1 124265
Email: andatt2005@yahoo.com
Networks of people living with HIV
BIDHO (Association for people living with HIV & AIDS and those affected)
Corp. Hagos Ghirmay
Chairman
P.O. Box 5537
Tel: +291 1 202772
Fax: +291 1 202797
Email: challengehiv@yahoo.com
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