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Comment
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Much is being written in the international media about the twin elections in Iran, which take place on Friday. Some, like veteran Iranian journalist Amir Taheri, are expecting the "first major political defeat" for Iranian President Mahmud Ahmadinejad.
One election will be for municipalities, the other for the Council of Experts (COE). This congressional body of 86 ayatollahs selects the supreme leader of Iran and supervises his activities. Members have to be experts in Islamic jurisprudence so they can debate
Islamic law, and see that the grand ayatollah does not violate the Holy Koran.
The COE can hire and fire the supreme leader, a post held since 1989 by the strong and all-powerful Ayatollah Ali al-Khamenei. It is currently headed by the old and ailing Ayatollah Ali Meshkini, who has re-nominated himself for office but stands a very slim chance of succeeding since he is supported neither by Ahmadinejad nor by Khamenei.
For this reason, Ahmadinejad has his eyes set on winning elections for the COE, which are by direct votes for an eight-year term. Khamenei, who is 66 and also in frail health, is likely to be ousted - if Ahmadinejad gets his way - before the new council's term expires in 2014.
By all accounts, the president does not like the overpowering influence that Khamenei has on Iranian politics. Some expect that if the president's list wins the elections, they would ask Khamenei to step down on the grounds of ill health.
The man earmarked to replace Khamenei by the president is Ahmadinejad's ideological mentor, Ayatollah Mohammad Taghli Misbah Yazdi. Born in 1934, the radical cleric studied in Qom and was educated in Islam by none other than Ayatollah Ruhollah Khomeini, the founder of the Islamic Republic in 1979. He graduated with honors from the religious seminary in 1960 and worked as editor-in-chief of a anti-Shah journal called "Revenge".
He was also a member of the board of directors at an influential religious school in Iran. In recent years, he has headed the Imam Khomeini Education and Research Institute and is a current member of the outgoing COE. During the 1990s he rose to fame for seriously challenging the reformist president Mohammad Khatami, arguing that contact with the West is un-Islamic and claiming that the reformists were straying from the pure revolutionary ideals of Khomeini.
He encouraged disobedience to Khatami through his writings and sermons on Fridays, prompting the former president to describe him as a "theotrician of violence". Yazdi's day in the sun came when his student Ahmadinejad was voted to power in August 2005. To him, Western culture means "misleading ideas" and it resembles injecting Iran "with the AIDS virus".
If this man becomes the new leader of Iran, all talk about curbing Ahmadinejad's powers and re-engaging Iran in dialogue with the West will come to an abrupt end. But luckily for opponents of the Iranian president, his ambitions face strong obstacles from within Iranian politics. These have been created by the Khamenei-backed Guardian Council.
This body is made up of 12 officials (six being clerics appointed directly by the supreme leader) and has ultimate executive, judiciary and electoral authority. The remaining six members are lawyers appointed by a judicial authority, which in turn is approved or vetoed by Khamenei.
Although Khamenei originally supported Ahmadinejad's rise to power in 2005, the two men have parted on a variety of issues and the president sees Khamenei as an obstacle to his powers at the presidency. He wants - but cannot so long as Khamenei is in power - to clip the wings of the supreme leader. Khamenei, a smart man by all accounts who also served as president in the 1980s, realizes the threat coming from Ahmadinejad. That is why he ordered his supporters - all 12 members of the Guardian Council - to veto most of the 493 candidates running for elections on Friday who are declared supporters of the president.
Among those vetoed are Yazdi's son. They also banned any woman from standing for office at the CEO. All reformists running for office were also rejected because they are trying to pass an amendment in the Iranian constitution allowing non-clerics into the CEO - something that Khamenei curtly refuses as well.
Other candidates turned down include pro-business and modernizing clerics supportive of former presidents Mohammad Khatami and Ali Akbar Hashemi Rafsanjani, who challenged Ahmadinejad for the presidency in 2005. The very fact that Khamenei and the Guardian Council allowed Rafsanjani to run for the CEO, given his animosity toward the wild policies of Ahmadinejad, is also an indicator that they want to make life more difficult for the president.
Victory for Rafsanjani, however, is doubtful, since both Ahmadinejad and Khamenei are opposed to him, and it is rumored that he is in favor of reaching a deal with the United States on Iran's nuclear program. In short, Khamenei has engineered elections that guarantee continuity of his post as the grand master of Iranian elections. Iranian observers are saying that out of the 86 seats contested at the CEO, only 17 new members will be voted into office. The remaining 69 clerics will all be pro-Khamenei.
For the above reasons, along with a recent Iranian poll affiliated with the Rafsanjani-led Expediency Council, show that the future is not promising for Ahmadinejad. Khamenei, however, has not come out to challenge Ahmadinejad - at least not yet - and insists on being a godfather to all Iranians. He has even called on all able citizens to vote, saying that it is a national and religious duty.
Despite that, Iranian observers claim that voter turnout will be no more than 49%. The poll showed that out of the Iranians surveyed, 90% said that their support for the president had diminished over the past 16 months. This was made clear by student demonstrators on December 11 at the Amir Kabir University of Iran, when young men burned pictures of Ahmadinejad and raised slogans that read "death to the dictator".
Unable to crack down on the rioters, for fear of losing support in the upcoming elections, Ahmadinejad did not arrest or harass them. On the contrary, he released a statement saying that he was pleased by the demonstrations. They reminded him of his student days under the Shah in the 1970s when students were prohibited from expressing their views.
If he fails to control the COE, however, Ahmadinejad plans to take the municipality elections through a list of candidates headed by his sister, Parvan Ahmadinejad. Her list is called "The Enchanting Scent for Services", and it is campaigning on the same youth-related issues that Ahmadinejad touted when he was voted in in 2005. The ambitious president, however, will not be satisfied unless he wins the COE.
One might ask, how is it that this president, who surprised the world with his victory in 2005, finds himself in a difficult position today, unable to impose his will on Iranian society? Is the Ahmadinejad myth a fabrication created by the US? Is the superman president really human - and weak - after all? Perhaps the Americans concentrated on Ahmadinejad more than they should have, because the real powerbroker in Iran is Khamenei - not Ahmadinejad.
It is Khamenei who supports Hezbollah and Khamenei, rather than the president, who is stubborn when it comes to Iran's nuclear issue. Ahmadinejad is simply a figure of state who has limited domestic authority and by no means is a dictator like Saddam Hussein. He achieved victory not because of his revolutionary views, nor for his support and conviction in the Islamic Revolution, but rather because of his promises to grassroots Iranians. By rhetoric, action, dress and origin, he mirrored their plight and realities.
But Ahmadinejad promised more than he could deliver, forgetting during election time that he was not the ultimate ruler and would have to share power with the Majlis (parliament), the Guardian Council, the COE - and Khamenei.
Young Iranians, born after the revolution of 1979, had not experienced the autocracy of the Shah and were (and still are) unimpressed by the revolutionary rhetoric of the 1980s. They wanted a president who could provide jobs for the university-educated Iranians who were unemployed. They wanted a leader who could combat the 16% unemployment rate (21.2% among women and 34% in the 15-19 age group.)
Currently, 800,000 Iranian youth enter the job market every year and Ahmadinejad would have to double job creation efforts to meet this staggering number. This would require huge investment and an economic growth rate of more than 6% per year. Iran's economy is now down to 1.9%, after growth of 4.8% for 2004-2005.
One slogan devised under Ahmadinejad read: "$550 for every Iranian citizen", Ahmadinejad also won because he was Khamenei's man since the supreme leader did not want to deal with a political strongman like Rafsanjani. It was believed that Ahmadinejad would follow Khamenei's orders and not defy him.
Rafsanjani, however, would have worked with Khamenei as an equal. The supreme leader wanted someone he could manipulate. For the exact same reasons, he is now working against Ahmadinejad, who apparently no longer wants to be manipulated or overpowered.
Rather than criticize Ahmadinejad, the US could bide its time and see how Friday's polls play out. Change can be achieved - through evolution of the Iranian regime and its own system of checks-and-balances - rather than revolution, or war.Comment
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Comment
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www.cubaweb.com)
The immediate ongoing need is for the international community to come forward with the raw materials for further products and services. Yet, with the ongoing war on people of color and the poor, what can Caribbean countries and individuals like Amelia Cayo hope for from greedy capitalist nations?Comment
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Libyan civil society condemns "politisation" of medics` case
Tripoli, Libya, 12/29 - Libyan civil society organisations have expressed solidarity with families of the 426 children allegedly injected with the AIDS-causing virus, saying the case is of judicial nature and must not be politicised to serve foreign interest.
In a communiqué issued here late Wednesday in Tripoli, the organisations, after a solidarity match also called for "moral compensation of the victims and their families.
Five Bulgarian nurses and a Palestinian doctor were on 19 December sentenced to death by a Tripoli court after they were found guilty of deliberately inoculating Libyan children with HIV at the Benghazi Paediatric Hospital, about 1000 kilometres east of capital Tripoli.
The death sentence elicited varied reactions from the international community, with the outgoing UN secretary-general, Kofi Annan, expressing concern. Bulgaria has sought the help of the European Union to bear pressure on Libya`s political leadership to intervene.
However, through the communiqué, the organisations said Libyan courts were competent, could handle any case to international standards and must be independent from the executive or political interference, and can therefore not be forced to renounce its decisions.Comment
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As virtually every poll attests, people across the globe are discouraged about the state of the world. From the ravages of famine, to HIV/AIDS, to the numerous conflicts and war, not to mention the threats manifest in the belligerents of North Korea and Iran, there appears to be every reason to believe that ours is a world fraught with unprecedented problems.
Although that is an intuitively accurate appraisal it is, at the most fundamental level, incorrect. Therein lies the heart of our problem, which is the astounding lack of consensus regarding the most basic truths concerning successful civilizations. Indeed, an objective observer would be shocked that modern humans appear to have forgotten or have profoundly misinterpreted the lessons of over 2000 years of recorded history.
The most salient lesson is that human conflict is a timeless phenomenon that can be mitigated only by making the most serious demands of any nation or regime unwilling to comply with the rule of law. The only language that aggressors understand is that of another group willing to wreak carnage at the first sign of aggression. There are sufficiently large numbers of nations capable of taking such a collective stand, but the will to do so is conspicuous by its absence.
Underlying that reticence is our inbred habit of blurring--or inverting--good and evil. The result is that we are suffering from a powerful political anemia that hobbles the our ability to confront even the most glaring examples of evil, such as that in Darfur. If we find ourselves standing idly by as innocents are being slaughtered--a horrific repeat performance of Rwanda in the 90s--how, pray tell, are we to confront the likes of a fledgling nuclear menace such as North Korea, much less the would-be nuclearized Iran?
The answer is that we can't unless and until we recognize in our deep and long history the same pattern of human conflict and suffering that so much in evidence today. Indeed, evil never fully recedes but is merely reanimated in more lethal forms as time progresses. That leaves us few palatable options, but they become far more acceptable if we can demonstrate the likely result of inaction.
The politics that so deeply infuses this process both here in America and nearly worldwide, is causally implicated in the inexcusable inertia we are suffering. Desperate for political hegemony and willing to sacrifice every historically hallowed virtue, both parties, but in particular those on the left appear perfectly willing expose our nation to the threat of Islamic terrorism.
Coupled with the noxious cultural plague called political correctness, we gladly acquiesce to the charges of racism and xenophobia from the very agents who would decimate our nation. Political claudication is an unsightly thing to witness, but that is precisely what we are suffering, and there is no apparent end in sight.
All of that being stated, there is yet every reason to believe that 2007 will be a great year because political momentum is not only driven by internal events it is also compelled by events out of our control. Forthwith, the following observations are made:
1. Iraq will move towards greater stability because its own citizens will become more intimately involved in its security, not because our prospective talks with Iran and Syria bear any fruit.
2. Although Iran will move closer to obtaining a nuclear weapon, Israel's voice will be heard and it will clarify its intention to prevent Ahmadinejad from doing so; internal Iranian strife will also play a role in destabilizing his regime.
3. China will play a more direct--which is to say, resolute--role in dealing with North Korea, which will effectively keep Kim Jong Il in his box; Japan will also clarify its intent to become a nuclear power should the North make further threats.
4. Nominal progress will be made to stop the carnage in Darfur, and with respect to HIV/AIDS, with President Bush taking a stronger role in forcing the United Nations to act.
5. Finally, the likelihood of an attack on American soil is increased the further we are from 9/11 and therefore, we should brace ourselves for a serious assault in one or more of our major cities.
If that happens it will provide a belated wake-up call for those who breathe the rarefied air of liberalism, at which time from the ashes will arise, Phoenix-like, a United States finally acting in unison to confront the heinous forces of Islamic extremism.
Far from ideal, but as history demonstrates, it is real world circumstances that drive events and how we respond to them is the ultimate arbiter of whether we will prevail against the forces that are so dedicated to our destruction.Comment
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Sex and shopping brings HIV crisis in Iran
In a smart boutique displaying an array of minis***ts and skimpy tops, the shopkeeper was too busy attending to his female customers to listen to a sermon on HIV/Aids. "I don't know anything about it at all. Come back after I've finished with my customers," he told the volunteer health education worker.
The volunteer, Amir Fattahi, was unsurprised. Observation and experience told him he had interrupted no ordinary business transaction. The four young women, he surmised, were prostitutes striking a deal with the shopkeeper offering sex in exchange for free or cheap clothes, an increasingly common arrangement in Tehran's fashion shops.
Health education workers say the practice undermines efforts to combat HIV/Aids in Iran, where the disease is increasingly spread through sexual contact. Along with health officials they believe Iran's strict sexual mores are loosening among its predominantly young population. An official drive has been launched to raise HIV/Aids awareness, which lags behind that in the west.
However, experts say the fight to stop the disease spreading is being hampered by a lack of hard facts. While the latest figures show 13,704 registered HIV cases, World Health Organisation and Iranian health ministry estimates put the true figure at between 70,000 and 120,000. Experts believe many infected young people do not seek blood tests because they are too ill-informed or are afraid of their parents finding out.
In the Qaem mall in north Tehran's affluent Tajrish district, where two floors are dedicated to women's fashion, several shopkeepers admitted to first-hand experience of receiving offers of sex. Arash, 23, said he had been propositioned 40 or 50 times in his store. "I reckon that 50% of shopkeepers have accepted sex in return for clothes," he said.
Ahmed Reza, 23, admitted having accepted such offers. "I was sitting outside the shop when two women came and said they wanted to try various manteaus [overcoats]," he said. "They asked for a bargain and I offered them the standard discount. But they said, 'We cannot pay that - if you give us a good discount and your mobile number, we will serve you'. So I gave them more discount and got their mobile numbers.
"I can tell a prostitute by their attitudes and body language. When she asks the price of something, I say it's much more than it really is. Then I reduce it when she asks for discount, so she think she's getting a great bargain and offers sex."
Iran's Islamic authorities attempted a clampdown on the trade by deploying policemen and plainclothes security guards inside shopping malls.
"I don't think [the prostitutes] are HIV/Aids-aware," said Mr Fattahi, a team leader with Iran Positive Life, a volunteer group part-funded by Unicef. "If they are infected and have sex with three or four shopkeepers a day, you can imagine the danger. I think most of the shopkeepers know the risk but they can't resist the temptation. Most times, the opportunity arises too quickly to take precautions."
Iran Positive Life is trying to raise shopkeepers' awareness in the hope that it will rub off on the prostitutes. Every evening, teams of volunteers tour boutiques asking shop assistants about their level of HIV/Aids knowledge. On one tour, joined by the Guardian, most of those canvassed knew it could be contracted from unsafe sex and that using condoms could provide protection.
However, experts say this awareness often does not translate into personal practice and is not passed on to prostitutes. "We have found that while people know about HIV, their information is not necessarily enough for them to use precautionary methods when engaging in sex," said the group's managing director, Amir Reza Moradi, who became HIV positive after receiving an infected blood transfusion.
"At the same time, it's hard for us to reach sex workers, so our education workers go to malls and speak to shopkeepers ... If the shopkeepers become educated and change their attitudes, hopefully the sex workers will notice and change their own ways."
Iran Positive Life's volunteers have spoken to an estimated 5,000 young Iranians in shopping centres, parks and coffee shops since the group launched its "peer education" programme three months ago. It has opened counselling services at health centres in an effort to estimate how many cases result from sexual transmission, rather than from drug addicts' infected needles.
Official resistance to a more explicitly sexual message is strong. While the government has a five-year plan to tackle HIV/Aids, its information campaigns have been criticised as inadequate. Yet the religious hierarchy apparently needs no convincing. A recent survey of 17 senior ayatollahs produced a near-unanimous response condoning condom use and in favour of educating the young on sexually transmitted diseases.
In numbers
300,000
Estimated number of Iranian women who work as prostitutes.
20
Average age of prostitutes in Iran. Many are girls who have run away from home.
120,000
Estimated number of HIV cases is 70,000-120,000. Estimated number of infected women aged 15-49: 11,000. Number of Iranian deaths from Aids: 1,600 (2005 figures).Comment
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بر اساس آخرين آمار، شمار مبتلايان به HIV / ايدز در كشور تا تاريخ اول دى ماه 85، به 14 هزار و90 مبتلا رسيد كه از اين ميزان يكهزار و 760 نفر به علت ابتلا به ايدز جان خود را از دست دادند.
به گزارش خبرنگار بهداشت و درمان ايسنا از 14 هزار و 90 مبتلا به HIV و ايدز شناسايى شده تا كنون 13 هزار و 308 نفر مرد (4/94 درصد) و 782 نفر زن ( 6/5 درصد) هستند. همچنين از 864 فرد مبتلا به ايدز (مرحله نهايى بيمارى) در كشور، 789 نفر مرد (3/91 درصد) و 75 نفر زن (7/8 درصد) هستند.
بر پايه اين گزارش آماري، تعداد فوت*شدگان بر اثر ابتلا به ايدز تا كنون يكهزار و 760 نفر گزارش شده كه از اين تعداد يكهزار و 695 نفر (3/96 درصد) مرد و 65 نفر (7/3 درصد) زن هستند.
بر اساس آمار نهايى مبتلايان به HIV /ايدز، بر حسب جنس و سن، در رده سنى 25 تا 34 سال 4 هزار و 407 مبتلا به HIV / ايدز (8/40 درصد ) بيشترين مبتلا قرار دارد و رده سنى 35 تا 44 سال با 3 هزار و 338 مبتلا (9/30 درصد) در مرحله بعدى به لحاظ فراوانى ابتلاست.
به گزارش ايسنا، راه انتقال غالب در مبتلايان به HIV / ايدز شناسايى شده در كشور اعتياد تزريقى (9/64 درصد) و سپس راه انتقال نامشخص (5/25 درصد)، آميزشى (5/7 درصد) دريافت خون و فراورده*هاى خونى (7/1 درصد) *و بالاخره مادر به كودك 5/0 درصد است.
بر اساس موارد ابتلا به HIV* / ايدز بر حسب راه انتقال و سن نيز در رده سنى 25 تا 34 سال راه انتقال به ترتيب اعتياد تزريقي، نامشخص، آميزشي، دريافت خون و فراورده*هاى خونى و بالاخره مادر به كودك گزارش شد.
اين در حاليست كه در رده سنى 35 تا 44 سال نيز اعتياد تزريقي، راه انتقال نامشخص، آميزشى و بالاخره دريافت خون و فراورده*هاى خونى به ترتيب راه*هاى انتقال غالب گزارش شده است.
به گزارش ايسنا براساس موارد ابتلا به ايدز بر حسب جنس و سن در كشور نيز، رده سنى 25 تا 34 سال با 298 مبتلا (5/35 درصد) و سپس گروه سنى 35 تا 44 سال با 296 مبتلا (2/35 درصد) بيشترين مبتلايان را به خود اختصاص داده*اند. همچنين راه انتقال 864 مبتلا به ايدز به ترتيب، اعتياد تزريقى (9/56 درصد)، آميزشى (1/19 درصد)، دريافت خون و فراورده*هاى خونى (6/14 درصد)، راه انتقال نامشخص 8 درصد و بالاخره مادر به كودك 2/1 درصد گزارش شده است.
بر پايه اين گزارش بيشترين مرگ ناشى از ايدز در مردان 25 تا 34 سال (577 نفر) و سپس مردان 35 تا 44 سال (542 نفر) بوده است.
اين در حاليست كه راه انتقال غالب در فوت شدگان بر اثر ابتلا به ايدز به ترتيب اعتياد تزريقى (1/72 درصد)، راه انتقال نامشخص (5/10 درصد)، آميزش (7/9 درصد)، دريافت خون و فرآورده*هاى خونى (1/7 درصد) و بالاخره از مادر به كودك (6/0 درصد) گزارش شده است.
Comment
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A large number of people complain that external interference in Pakistan’s domestic political and societal domains has had negative ramifications for its sovereignty and independence. They often talk of the role of international financial institutions like the World Bank, International Monetary Fund (IMF) and Asian Development Bank in determining Pakistan’s economic priorities. Donor countries play a similar role, especially the Paris Aid to Pakistan Club of the developed countries. Economic assistance and technology transfers are said to have declared or undeclared strings attached to them.
The issues of the ‘foreign role’ in Pakistan’s domestic politics crops up from time to time. In the course of the 1977 Pakistan National Alliance (PNA) agitation against Zulfikar Ali Bhutto, the ambassadors of some Arab countries attempted to defuse the confrontation between the government and the opposition. Bhutto accused the United States of encouraging his government’s over-throw in July 1977.
Most political analysts agree that there were periods in Pakistan’s history when the United States exercised considerable influence over some policies in the domestic and security spheres. The latest phase of US influence on Pakistan’s dates back to the latter’s participation in the US-led global effort to check terrorism. The US withdrew all sanctions against Pakistan in November-December 2001 and offered economic assistance and military sales to Pakistan. It facilitated economic assistance from international financial institutions and fora, including a favourable rescheduling of international debts. This was conditional on Pakistan’s cooperation for containment of terrorism, including taking military action against the Al Qaeda-Taliban coalition in Afghanistan. Counter-terrorism considerations in the region are the main reason for US support to the Musharraf government. This support is viewed in Pakistan as one of the major reasons for Musharraf’s political survival.
If external actors play such a significant role in policy-making, does this not raise serious doubts about Pakistan’s sovereign and independent status? A large number of people view these developments as a negation of Pakistan’s sovereignty. Why should Pakistan submit to external influences that weaken its internal resolve to act as an independent and sovereign entity? The sovereignty issue received much attention when the U.S. aircraft attacked the village of Damadola in the Bajaur Agency in January 2006, which was condemned by leaders of public opinion and the major media organisations.
The assumption underlying these comments is that as a sovereign and independent state Pakistan must be absolutely free to make its domestic and external policies. Other states and international institutions have no right to interfere with Pakistan’s policy-making. The other aspect of this argument is that Pakistan should assert its sovereign status by making its policy exclusively on the basis of its national interest and resist external pressures even if these accompany economic and military assistance. Pakistan should stop paying attention to what the US and other western countries suggest, unless their advice serves Pakistan’s national interest.
The concept of the sovereign state goes back to 1648, when the rulers of German states discarded the authority of the Pope over governance and policy making. Gradually the state was recognised as a sovereign entity, implying that it is the supreme authority within its territorial jurisdiction and that there was no legal authority above the state that could impose its will.
The classical notion of an absolutely free and completely sovereign state exists only in theory. At the operational level, states accept constraints on their sovereign status to ensure peace and stability in the international system. The principle of enlightened self-interest enables states to work together in global, regional and bilateral contexts. For example, the membership of the United Nations enjoins the member-states to respect the UN Charter, although some states disregard it.
The growing interdependence in the international system makes it difficult for a state to exercise its sovereign status without taking into account the dynamics of world politics and the global economy. The end of the Cold War and the emphasis on free trade and globalisation had a profound impact on how states exercise their domestic and foreign policy options. This is in addition to the impact of foreign economic assistance (loans and grants) and military assistance or sales on domestic and foreign policy formulation. Such assistance is inconceivable without some adjustments in foreign policy and economic priorities.
Further, modern means of communication and transportation, including the satellite communication system and Internet, have totally transformed the context in which the states and their citizens function.
The modern state system is also influenced by the surge in the activities of transnational non-state groups. Their role has implications for individual states as well as the international community.
Given these constraints, a country like Pakistan faces the challenging task of charting a course of action that will protect its national interests. This objective cannot be achieved either by subservience to external pressure or by defying powerful states. Similarly, dropping out of the international system to protect its exclusive identity and sovereignty is not a sensible course of action.Comment
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رئيس مركز مديريت بيماريهاى وزارت بهداشت گفت: خطر موج سوم بيمارى ايدز از طريق ارتباط جنسى كم كم خودش را نشان مي*دهد و اگر به موقع مداخله نكنيم با افزايش ناگهانى اين بيمارى در كشور مواجه مي*شويم.
محمد مهدى گويا، در گفت و گو با خبرنگار اجتماعى فارس،* افزود: موج اول بيمارى ايدز در ايران از سال 66 با شناسايى بيمارانى كه از طريق فرآورده*هاى خونى وارداتى به اين بيمارى مبتلا شده بودند شروع شد، موج دوم اين بيمارى از حدود سال 75 و 76 با شناسايى بيمارانى كه عمدتا در زندانها يا خارج آن از طريق اعتياد تزريقى و تزريق مشترك مبتلا شده بودند ادامه يافت و اكنون نيز در اين موج قرار داريم.
وى ادامه داد: از يكي، دو سال پيش علايم ورود به موج سوم اين بيمارى به چشم مي*خورد و اگر به موقع مداخله نكنيم و آموزش همگانى در اين زمينه به خصوص در بين جوانان و همسران افراد آلوده به خوبى انجام نشود از يكي، دو سال آينده وارد موج سوم بيمارى ايدز مي*شويم كه از طريق رابطه جنسى افزايش ناگهانى تعداد مبتلايان به اين بيمارى را باعث مي*شود.
رئيس مركز مديريت بيماريهاى وزارت بهداشت گفت: برنامه*ريزى براى مداخله و كنترل موج سوم بيمارى ايدز در كشور از حدود يكسال پيش شروع شده و تدوين استراتژى دوم برنامه كنترل ايدز در ايران نيز به همين منظور انجام شده است كه با تصويب بودجه هاى مورد نياز آن از سال آينده اجرا مي*شود.
گويا افزود:* اساس اين برنامه بر پيشگيرى از بروز بيمارى ايدز در بين جوانان و گروههايى كه احتمال رفتار پر خطر جنسى و اعتياد ترزيقى در آنها وجود دارد استوار است و تلاش مي*شود به آنها آموخته شود كه چگونه خود را در برابر اين بيمارى مراقبت كنند.
وى گفت: اكنون مراكز دولتى و تعداد زيادى سازمانهاى غير دولتى براى كنترل بيمارى ايدز مشغول فعاليت هستند و تلاش مي*شود به مردم آموخته شود كه اولا روابط خارج از حريم خانواده را كنترل كنند و در هر صورت با استفاده از كاندوم در رابطه جنسى و استفاده از سرنگ و سوزن يكبار مصرف از بروز بيمارى ايدز جلوگيرى كنند.
وى ادامه داد: خوشبختانه سازمانهاى دولتى و غير دولتى و سازمان مديريت و برنامه ريزى در اجراى برنامه دوم كنترل ايدز در ايران جدى هستند و هيچ دليلى وجود ندارد كه اين برنامه به طور كامل اجرا نشود.
رئيس مركز مديريت بيماريهاى وزارت بهداشت اضافه كرد: در صورتى كه برنامه هاى كنترلى و آموزش عمومى در مورد بيمارى ايدز به طور كامل اجرا نشود مانند برخى كشورها از جمله روسيه، اوكراين، برخى كشورهاى آسياى ميانه و برخى كشورهاى آفريقايى با افزايش ناگهانى موارد جديد بيمارى ايدز كه عمدتا از طريق تماس جنسى به وجود مي*آيند، مواجه مي*شويم.
گويا همچنين گفت: زنان به علت فيزيولوژى زنانه خود در برابر بيمارى ايدز بسيار آسيب پذيرتر و حساس تر از مردان هستند و امكان انتقال ويروس اين بيمارى در رابطه جنسى در زنان بيش از مردان است.
بر اساس آخرين آمار اعلام شده از سوى وزارت بهداشت تاكنون 14 هزار و 90 نفر بيمار مبتلا به ويروس ايدز در ايران شناسايى شده اند و طى سه ماه گذشته 388 مورد جديد اچ آى وى مثبت در ايران شناسايى شد.
اين آمار همچنين نشان مي*دهد كه تاكنون 1760 نفر در ايران بر اثر اين بيمارى جان خود را از دست داده*اند و 864 نفر وارد فاز بيمارى ايدز شده*اند.
4/94 درصد مبتلايان به ويروس ايدز مرد و 6/5 درصد كه 782نفر را شامل مي*شود، زن هستند، 9/64 درصد اين مبتلايان بر اثر اعتياد تزريقي، 5/7 درصد رابطه جنسي، 7/1درصد دريافت خون و فرآورده خونى آلوده، 5/0 درصد مادر به كودك به اين بيمارى مبتلا شده*اند و راه ابتلاى 5/25 درصد مبتلايان نامشخص است كه احتمالا رابطه جنسى يا تزريق با سرنگ آلوده علت ابتلاى بخش عمده* اين گروه است.
همچنين رده سنى 25 تا 35 سال بيشترين تعداد مبتلايان به ويروس HIV را در خود جاى داده است.
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Sex and shopping brings HIV crisis in Iran
In a smart boutique displaying an array of minis***ts and skimpy tops, the shopkeeper was too busy attending to his female customers to listen to a sermon on HIV/Aids. "I don't know anything about it at all. Come back after I've finished with my customers," he told the volunteer health education worker.
The volunteer, Amir Fattahi, was unsurprised. Observation and experience told him he had interrupted no ordinary business transaction. The four young women, he surmised, were prostitutes striking a deal with the shopkeeper offering sex in exchange for free or cheap clothes, an increasingly common arrangement in Tehran's fashion shops.
Health education workers say the practice undermines efforts to combat HIV/Aids in Iran, where the disease is increasingly spread through sexual contact. Along with health officials they believe Iran's strict sexual mores are loosening among its predominantly young population. An official drive has been launched to raise HIV/Aids awareness, which lags behind that in the west.
However, experts say the fight to stop the disease spreading is being hampered by a lack of hard facts. While the latest figures show 13,704 registered HIV cases, World Health Organisation and Iranian health ministry estimates put the true figure at between 70,000 and 120,000. Experts believe many infected young people do not seek blood tests because they are too ill-informed or are afraid of their parents finding out.
In the Qaem mall in north Tehran's affluent Tajrish district, where two floors are dedicated to women's fashion, several shopkeepers admitted to first-hand experience of receiving offers of sex. Arash, 23, said he had been propositioned 40 or 50 times in his store. "I reckon that 50% of shopkeepers have accepted sex in return for clothes," he said.
Ahmed Reza, 23, admitted having accepted such offers. "I was sitting outside the shop when two women came and said they wanted to try various manteaus [overcoats]," he said. "They asked for a bargain and I offered them the standard discount. But they said, 'We cannot pay that - if you give us a good discount and your mobile number, we will serve you'. So I gave them more discount and got their mobile numbers.
"I can tell a prostitute by their attitudes and body language. When she asks the price of something, I say it's much more than it really is. Then I reduce it when she asks for discount, so she think she's getting a great bargain and offers sex."
Iran's Islamic authorities attempted a clampdown on the trade by deploying policemen and plainclothes security guards inside shopping malls.
"I don't think [the prostitutes] are HIV/Aids-aware," said Mr Fattahi, a team leader with Iran Positive Life, a volunteer group part-funded by Unicef. "If they are infected and have sex with three or four shopkeepers a day, you can imagine the danger. I think most of the shopkeepers know the risk but they can't resist the temptation. Most times, the opportunity arises too quickly to take precautions."
Iran Positive Life is trying to raise shopkeepers' awareness in the hope that it will rub off on the prostitutes. Every evening, teams of volunteers tour boutiques asking shop assistants about their level of HIV/Aids knowledge. On one tour, joined by the Guardian, most of those canvassed knew it could be contracted from unsafe sex and that using condoms could provide protection.
However, experts say this awareness often does not translate into personal practice and is not passed on to prostitutes. "We have found that while people know about HIV, their information is not necessarily enough for them to use precautionary methods when engaging in sex," said the group's managing director, Amir Reza Moradi, who became HIV positive after receiving an infected blood transfusion.
"At the same time, it's hard for us to reach sex workers, so our education workers go to malls and speak to shopkeepers ... If the shopkeepers become educated and change their attitudes, hopefully the sex workers will notice and change their own ways."
Iran Positive Life's volunteers have spoken to an estimated 5,000 young Iranians in shopping centres, parks and coffee shops since the group launched its "peer education" programme three months ago. It has opened counselling services at health centres in an effort to estimate how many cases result from sexual transmission, rather than from drug addicts' infected needles.
Official resistance to a more explicitly sexual message is strong. While the government has a five-year plan to tackle HIV/Aids, its information campaigns have been criticised as inadequate. Yet the religious hierarchy apparently needs no convincing. A recent survey of 17 senior ayatollahs produced a near-unanimous response condoning condom use and in favour of educating the young on sexually transmitted diseases.
In numbers
300,000
Estimated number of Iranian women who work as prostitutes.
20
Average age of prostitutes in Iran. Many are girls who have run away from home.
120,000
Estimated number of HIV cases is 70,000-120,000. Estimated number of infected women aged 15-49: 11,000. Number of Iranian deaths from Aids: 1,600 (2005 figures).Comment
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يک گزارش جديد پزشکی برای اولين بار نشان می*دهد که مبتلايان به ايدز در ايران در اثر ترس و عدم اطلاع کافی دندانپزشکان از مراقبت*های دندانپزشکی محروم هستند.
نشريه* کنترل بيماری*های عفونی و همه*گيری*های بيمارستانی، که در شماره* ژانويه ۲۰۰۷ خود نتايج اولين آمارگيری اطلاعات دندانپزشکان ايران درباره* ايدز را منتشر کرده، نشان می*دهد عليرغم دستورالعمل*های مرتبط با نحوه* جلوگيری از انتقال ويروس ايدز همچنان بسياری از دندانپزشکان از مداوای بيماران مبتلا به ايدز خودداری می*کنند.
بنابر گزارش جديد که حاصل مطالعه مشترک پژوهشگران ايرانی و دو مؤسسه* بهداشتی بريتانيايی است اطلاعات دندانپزشکانی که از ۱۸ دانشگاه علوم پزشکی مختلف در ايران فارغ* التحصيل شده* و اکنون در استان فارس مشغول به کار هستند به عنوان جامعه* آماری اين تحقيق مورد استناد قرار گرفته *اند.
نتايج اين تحقيق به طور خيره کننده*ای نشاندهنده* فقدان اطلاعات پايه*ای درباره* بيماری ايدز در ميان فارغ *التحصيلان دانشکده*های دندانپزشکی* ايران است.
مفروضات غلط
به عنوان مثال، ۷۹ درصد از دندانپزشکان از بوسيدن به عنوان يکی از راه*های انتقال ويروس ايدز نام برده*اند در حالی که ۶۰ درصد از آن*ها انتقال ويروس از مادر به جنين را رد کرده*اند.
ويروس ايدز با بوسه منتقل نمی شود اما احتمال انتقال آن از مادر به جنين وجود دارد.
علاوه بر اين ۸۰ درصد از دندانپزشکانی که در اين طرح مورد پرسش قرار گرفته *اند - باز هم به اشتباه - انتقال ويروس ايدز از طريق نوشيدن از ليوانی که مورد استفاده* بيمار بوده را تائيد کرده*اند.
۷۹ درصد از دندانپزشکان از بوسيدن به عنوان يکی از راه*های انتقال ويروس ايدز نام برده*اند در حالی که ۶۰ درصد از آن*ها انتقال ويروس از مادر به جنين را رد کرده*اند
پژوهشگران در بخش ديگری از تحقيق نشان داده*اند که تنها ۱۰ درصد از دندانپزشکان مورد مطالعه اظهار داشته اند که انجام معالجات ساده* دندانپزشکی موجب انتقال ويروس ايدز نمی*شود و در عوض ۹۰ درصد ديگر حتی از معالجات ساده* نيز به عنوان عامل انتقال ويروس نام برده*اند.
اولين آمارگيری اطلاعات ايدز در ميان دندانپزشکان ايرانی نشان می*دهد بيش از ۹۰ درصد از دندانپزشکان مورد پرسش در اين طرح اظهار کرده*اند که ايرانی*ها در مقابل ويروس ايدز مقاوم*تر از ساير ملل جهان هستند و بيش از ۷۳ درصد آن*ها اعلام کرده*اند که افراد در سنين خاصی به ايدز مبتلا می*شوند.
بخشی از پرسشنامه* مربوط به اطلاعات ايدز به چگونگی ضدعفونی کردن وسايل دندانپزشکی اختصاص داشته است و نتايج نشان می*دهند که همواره بيش از نيمی از پرسش شوندگان در مورد روش*های ضدعفونی اطلاعات کافی نداشته يا درباره* چگونگی انجام ضدعفونی ترديد داشته*اند.
دندانپزشکانی که مورد مطالعه قرار گرفته*اند به طور ميانگين ۳۶ سال سن داشته*اند و در زمان آمارگيری دستکم در حدود ۹ سال به عنوان دندانپزشک حرفه* ای در مراکز دولتی و خصوصی مشغول به کار بوده*اند. با اين همه تنها ۸ درصد آن*ها از اطلاعات کافی درباره* ايدز برخوردار بوده*اند.
عدم رعايت کامل بهداشت
نتايج اين تحقيق می*تواند زنگ خطر برای مراکز پزشکی ايران نيز به صدا درآورد زيرا بر اساس آمار نشان داده شده که با وجود اين که بيش از ۹۰ درصد از دندانپزشکان در هنگام معالجه* بيماران از ماسک استفاده می*کنند اما تنها ۳۰ درصد آن*ها بعد از معالجه* هر بيمار ماسک خود را تعويض می*کنند.
در مورد شستشوی دست نيز آمار مشابهی ثبت شده به طوری که کمتر از ۴۰ درصد از دندانپزشکان پس از استفاده از دستکش طبی دست*های خود را ضد عفونی می*کنند و مابقی تنها تعويض دستکش را کافی می*دانند.
در مجموع بيش از ۶۰ درصد از دندانپزشکان مورد مطالعه نسبت به درمان بيماران مبتلا به ايدز نظر منفی داشته* و درمان آن*ها را جزوی از مسئوليت مراکز تخصصی ديگر دانسته*اند.
پژوهشگرانی که نتايج اين تحقيق جديد را منتشر کرده*اند می*گويند بر خلاف دندانپزشکان جوان در بريتانيا و آمريکای شمالی که به دليل دانش بيشتر درباره* بيماری ايدز با اطمينان به درمان بيماران مبتلا می*پردازند، دندانپزشکان جوان *تر در ايران به دليل اطلاعات کم از درمان بيماران مبتلا به ايدز پرهيز می*کنند.
پژوهشگران نتيجه گيری کرده*اند که نقص عمده* برنامه*های آموزشی درباره* ايدز در ۱۸ دانشکده* دندانپزشکی ايران علاوه بر ايجاد مشکلات دندانی بيشتری برای بيماران، به پنهانکاری مبتلايان به ايدز و در نتيجه گسترش بيشتر بيماری در ميان افراد جامعه منجر خواهد شد.
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وزير بهداشت, درمان و آموزش پزشكى, اعلام*كرد: براى كاهش بيمارى ايدز از طريق روابط جنسي، از سال آينده به كنترل ناهنجاري*هاى جنسى مي*پردازيم.
دكتر كامران باقرى لنكرانى, وزير بهداشت, درمان و آموزش پزشكى, گفت: تاكنون در كشور بيشتر موارد ايدز بر اثر اعتياد تزريقى به ثبت رسيده است؛ اما اين الگو در حال تغيير به سمت روابط جنسى است.
وي، در خصوص پيشرفت ايران در زمينه مباحث پزشكى, يادآورشد: حدود 6 سال پيش تعداد مقالات ايران در سايت*هاى بين*المللى حدود 350 مقاله بود كه بر اثر پيشرفت ايران در حوزه پزشكى امسال به حدود 4 هزار مقاله رسيده است.
وي، يادآور شد: بيمارى ايدز يكى از بيماري*هاى خطرناك و مهلكى است كه تمام دنيا را در بر گرفته و براساس آمارهاى اعلام شده 25 ميليون بيمار ايدزى در دنيا زندگى مي*كند.
وزير بهداشت, درمان و آموزش پزشكى, با اشاره به شرايط ايران, خاطرنشان*كرد: در حال حاضر 14 هزار بيمار ايدزى در ايران زندگى مي*كنند كه يك هزار و 700 نفر از آنها از ابتداى شروع اين بيمارى تاكنون فوت كرده*اند.
لنكرانى, گفت: خوشبختانه در دو سال اخير با كاهش روند ابتلا به اين بيمارى روبه*رو بوده*ايم؛ اما اين خطر در كشور هميشگى است و با شيوع مجدد اين بيمارى روبه رو خواهيم شد.
وى, با اشاره به اين كه بيمارى ايدز در جهان روند رو به رشدى داشته است, يادآور شد: طبق آمارهاى اعلام شده در هر 15 ثانيه يك كودك بر اثر فوت پدر و مادر مبتلا به ايدز خود يتيم مي*شود كه بر اين اساس، تمامى كشورها به موضوع ايدز توجه ويژه*اى دارند.
وزير بهداشت, درمان و آموزش پزشكى, افزود: بيمارى ايدز بسيار سنگين است و ما تنها كشورى هستيم كه داروى بيماران ايدزى را به صورت رايگان در اختيار آنها مي*گذاريم.
به گفته لنكرانى, بيمارى ايدز باعث ضعف سيستم ايمنى بدن شده و زمانى خود را نمايان مي*كند كه سلول*هاى دفاعى بدن فرد به كمتر از 500 عدد برسد.
وي، با اشاره به داروهاى مختلف كنترل ايدز, گفت: داروهاى مختلفى براى كنترل ايدز, توليد شده كه متاسفانه اثرگذارى مناسبى نداشته و عوارض جانبى آنها بسيار زياد است.
وي، خاطرنشان*كرد: محققان به اين موضوع توجه كردند كه دارويى توليد كنند تا سيستم ايمنى بدن فرد مبتلا به ايدز را تقويت كند و خوشبختانه اين تحقيق و دستاورد براى اولين بار در ايران به ثبت رسيد.
وزير بهداشت, درمان و آموزش پزشكى, گفت: داروى توليد شده در ايران كه ريشه گياهى دارد, ايمنى بدن را در مقابل عوارض عفونت تقويت كرده و طول عمر افراد مبتلا به اين بيمارى را افزايش مي*دهد.
لنكرانى, با اشاره به انجام تحقيقات گسترده براى به نتيجه رسيدن اين دارو, گفت: براى توليد اين دارو, 15 مركز تحقيقاتى و مطالعاتى و تعداد زيادى از متخصصان علوم پايه و بالينى در كنار يكديگر تلاش كرده*اند، تا به اين موفقيت رسيده*اند.
وي، معتقداست: توليد داروى جديد ايدز نشان*دهنده افق روشن توليدات علمى ايران است و ايران مي*تواند هرروز به پيشرفت*هاى بيشترى نائل شود.
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