By: Fikrejesus Amahazion
While many countries – both in SSA and around the world – have made significant progress in combating HIV/AIDS, Eritrea’s strong record battling HIV/AIDS stands out positively, although receives less attention. Located in the fractious Horn of Africa, the young, low-income country is on pace to achieve the UN’s Millennium Development Goal related to combating HIV/AIDS, malaria, and other diseases. Further, its HIV-related figures – such as its 0.59% prevalence rate – are distinguished as amongst the best, both within the region and across the continent. With little known about the country or its HIV/AIDS related strategies, this Destination HealthEU post offers important insights.
Additionally, the Ministry of Health has been key in the national response, establishing a national HIV/AIDS policy that, amongst other things, provides guidelines on preventative activities, ensures provisions of treatment and care, and secures the rights and dignity of people living with HIV/AIDS. Part of the latter involves the distribution of ARTs; notably, the estimated total ART coverage in Eritrea has risen to 72%. ART usage is important since it helps to avert HIV/AIDS related deaths, while being a critical factor in driving down the rate of new infections.
National institutional efforts, such as the establishment of Voluntary Counseling and Testing (VCT) and Prevention of Mother to Child Transmission (PMTCT) centers, have also been vital. VCT centers offer rapid testing and pre- and post-test counseling, while PMTCT centers, which focus on pregnant women, offer testing services and support those found HIV positive in preventing the transmission of HIV to their children. Overall, these initiatives have meant that more people have received greater access to better quality care, training, education, and support.
Possibly the most significant feature of Eritrea’s HIV/AIDS response has been the targeting of traditional and patriarchal stereotypes and practices. Focusing on these practices is crucial, since many traditional or patriarchal stereotypes and practices can increase HIV/AIDS risk factors. For example, in several countries throughout the region, child or adolescent marriage is still quite common. In addition to representing a significant child rights issue, the practice is thought to increase HIV/AIDS prevalence via several mechanisms. Importantly, Eritrea has made child and adolescent marriage (under 18) illegal, and remained committed to enforcement, especially within rural areas. Consequently, one potential risk factor for HIV/AIDS has been dramatically reduced.
Last, gender equality has been a central focus in the country, providing the foundation for positive outcomes in battling HIV/AIDS. No less an authority than the WHO has claimed that gender discrimination and violence render females far more vulnerable to infection. Further, the feminization of poverty places women at a tremendous risk for HIV/AIDS since “above all… poverty limits people’s options for protecting themselves and forces them into situations of heightened risk.” Through improving gender equality, a key driver of the HIV/AIDS epidemic may be controlled since women will face fewer barriers in accessing HIV prevention, treatment and care services due to limited decision-making power, lack of control over financial resources, restricted mobility, or unbalanced child-care responsibilities.
Eritrea’s efforts at improving gender equality and decreasing the burden of poverty borne by women include, inter alia: ratifying several relevant international rights instruments, including The Convention on the Elimination of All Forms of Discrimination against Women (CEDAW 1979); making gender equality a fundamental component of the National Education Policy and national poverty reduction strategies; issuing Labour and Land Reform Proclamations to secure the equal status of women in society; and working closely with the National Union of Eritrean Women (NUEW) to coordinate, monitor, and implement gender-equality programs and policies across all sectors of society. Though gender equality is yet to be fully achieved and challenges remain, the efforts represent important steps in the right direction, both for the status of women and in terms of fighting HIV/AIDS.
 Muller, T. 2005. “Responding to HIV/AIDS Epidemic: Lessons from the Case of Eritrea.” Progress in Development Studies. 5: 199-214.
 a) Laga, M., B. Schwartlander, E. Pisani, P. Sow, and M. Carael. 2001. “To Stem HIV in Africa, Prevent Transmission to Young Women.” AIDS. 15: 931-934.
b) Bruce, J. 2007. “Child Marriage in the Context of the HIV Epidemic.” Population Council. September (11): 1-4.
 Coming to a consensus on how to refer to the practice has been a challenge. At various times, the practice has been referred to as: a) female genital cutting; b) female genital circumcision; c) or female genital mutilation. Here I use female genital mutilation as that is the term utilized by the WHO. At different times, Eritrea has referred to the term as female genital mutilation or cutting.
 a) Pre-independence initiatives
b) Recent initiatives
 a) Brady, M. 1999. “Female Genital Mutilation: Complications and Risk of HIV Transmission.” AIDS Patient Care and STDs. 13 (12): 709-716.
b) Yount, K. and B. Abraham. 2007. “Female Genital Cutting and HIV/AIDS among Kenyan Women.” Studies in Family Planning. 38(2): 73-88.
According to the Global Partnership for Education, FGM rates have decreased dramatically; for girls under the age of 15, rates have dropped to under 15%.
 WHO. 2000. “Violence Against Women and HIV/AIDS: Setting the Research Agenda.” Gender and Women’s Health Meeting Report. 23-25 October 2000. Geneva, Switzerland.
 Irwin, A., J. Millen, and D. Fallows. 2001. Global AIDS: Myths and Facts - Tools for Fighting the Global AIDS Epidemic. Cambridge, MA: South End Press.