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SUDAN: HIV/AIDS swell feared when refugees return: UN

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NAIROBI, Oct 18, 2004 (IRIN) — The anticipated return of hundreds of thousands of Sudanese refugees, once peace returns to the south and west, could lead to a further spread of HIV/AIDS which already affects 2.6 percent of the general population, the UN Population Fund (UNFPA) warned in a report.

The HIV-infection rate in Sudan, according to UNFPA, is already considered an epidemic, making Sudan the country with the highest infection rate in North Africa and the Middle East region. The infection rates are particularly high among vulnerable groups, such as internally displaced persons (IDPs) and refugees.

Data from the mid-1990s onwards suggested the infection rates had risen rapidly in the conflict-affected areas of southern and western Sudan. According to a national prevalence and behavior survey conducted in 2002, HIV infection prevalence was already four percent among pregnant women attending clinics in the refugee camps.

Ishmael Gulliver of the Sudan Evangelical Mission, which has been running HIV/AIDS awareness-raising programs in southern Sudan since 2000, told IRIN on Friday that the situation in the region was "severe". Voluntary counselling and testing centers in the region, he added, had found preliminary HIV-infection rates of four to 10 percent among those tested in the southern town of Rumbek and up to 17 to 21 percent in Yambio, near the border with the Democratic Republic of the Congo.

"The fact that many Sudanese will return to their homes from countries where the HIV/AIDS prevalence is very high, will doubtless increase the likelihood of a further spread of the epidemic," UNFPA said in its Sudan newsletter for August, adding that while many of the returnees had heard about the disease, access to information on prevention was not universal.

HIV/AIDS prevention efforts were also likely to be affected by social bias, attitudes towards condom use, poor availability of general health services and lack of trained counsellors. The health workers, UNFPA added, were often not well motivated, lacked the necessary knowledge and were ill supplied with blood-testing equipment to protect them from cross infection.

Other experts said factors that had contributed to the increasing vulnerability of the population to the HIV/AIDS pandemic in Sudan included war, massive poverty and inadequate health care facilities around the country.

"Sudan is on the verge of an HIV/AIDS epidemic," Professor Ali Biely of Ahsad University in Omdurman, near Khartoum, told IRIN. Little, he added, was "being done about it because of the urgency of the humanitarian crisis and the need to respond to those that are immediately dying from curable diseases".

Conflict in Sudan has displaced millions of people and sent hundreds of thousands fleeing across borders. In the south, a 21-year war between the government and the Sudan People’s Liberation Movement/Army (SPLM/A) has displaced an estimated four million people internally, with over 500,000 Sudanese living in neighbouring states as refugees. The bulk of these refugees live in Uganda, Ethiopia and Kenya, according to the UN Refugee agency (UNHCR).

The conflict in the western Darfur region between the Sudanese military, reportedly supported by Janjawid militias, and rebels fighting to end alleged marginalisation and discrimination of Darfur residents by the state, has displaced about 1.45 million people and sent another 200,000 fleeing across the border into Chad.

However, hope for a peaceful resolution to the southern conflict has risen with ongoing talks in Kenya between the SPLM/A and the Sudanese government. In May, both sides signed six key protocols covering power-sharing arrangements and the administration of three contested areas during a six-year interim period that will precede a referendum to determine whether the south would remain part of Sudan.

Analysts believe the talks, which resumed last week, could be concluded in six weeks. The conflict in Darfur, however, could take longer to resolve, analysts noted, delaying the return of the refugees in Chad.

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