Tehran, June 11, 2008 – On the occasion of the United Nations General Assembly High-Level Meeting on AIDS, the United Nations Development Programme (UNDP) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) proudly announced the 25 winners of the Red Ribbon Award 2008. For the first time in the history of the country, an Iranian NGO, Mashhad Positive Club, has been selected as one of the winners in addition to twenty five organizations from other countries. The UN Technical Review Committee found the action and leadership of Mashhad Positive Club exceptional in terms of sustainability and adaptability, impact, innovation, empowerment, involvement of People Living with HIV and establishing strategic partnerships.

The "Red Ribbon Award: Celebrating Community Leadership and Action on AIDS" is established to provide a unique opportunity to support and publicize the work of communities who are finding innovative and effective ways to address the AIDS epidemic and secure livelihoods around the world.

Following a call for nominations launched on World AIDS Day 2007 from Mexico City, Geneva, New York and Colombo, over 550 nominations were received from 147 countries across the globe. A Technical Review Committee of experts in the community response to HIV selected 25 community-based organizations demonstrating remarkable efforts in terms of innovation, impact, sustainability, strategic partnerships, gender sensitivity and social inclusion. The innovative and sustainable approaches taken by the 25 winning organizations to provide HIV prevention, care, treatment and support to people living with HIV give inspiring evidence that effective community leadership is an essential component in the response to the global epidemic.

UNDP Iran’s Communication Unit has interviewed Dr. Vahid Nobahar (29), Director of Mashhad Positive Club and a medical doctor, about his thoughts on receiving this award, the NGO’s activities in Khorasan Razavi Province, and about the current HIV situation in the Islamic Republic of Iran. The NGO was established in May 2007 as a joint initiative between UNAIDS, the Family Planning Organization of the I.R. Iran and the Center for Disease Control (Ministry of Health), and is one of the beneficiaries of the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) project “The Prevention and Control of HIV/AIDS in I.R. Iran through Public, Civil Society and Private Partnerships.” The project has been implemented in I.R. Iran from 2005 by UNDP as Principle Recipient and with the Center for Disease Control, I.R. Iran State Prisons Organization, Ministry of Education, UNAIDS and the Family Planning Organization of the I.R. Iran as key partners.

The Global Fund to Fight AIDS, Tuberculosis and Malaria was created to dramatically increase resources to fight three of the world's most devastating diseases, and to direct those resources to areas of greatest need. As a partnership between governments, civil society, the private sector and affected communities, the Global Fund represents an innovative approach to international health financing.

Dr. Vahid Nobahar, Director of Mashhad Positive Club, (second from left to right) in the seminar
"The Role of Religious Leaders and People in High Risk Behaviors, HIV prevention and PLHIV
Support."

Interview with Vahid Nobahar – Director of Mashhad Positive Club

UNDP: Congratulations as the winner of the United Nations’ Red Ribbon Award 2008. How does it feel to be honored with one of the most prestigious acknowledgments related to HIV/AIDS prevention in the world?

Vahid Nobahar: Actually, we are shocked! We had never believed that it was possible to get such an award less than one year after the organization was established. I remember sitting at home late one night writing our nomination without any hope of being able to compete with organizations that might have been active for several years, even decades, but I thought I would compose a short application just to have sent our contribution. Despite the fact that I was sure we would not get the award, I concentrated on referring to the comprehensive number of activities initiated and achievements made in our first year. I think this made us a good candidate for this year’s award. But in reality this Award does not belong to us. It belongs to the whole country and especially all Iranians living with HIV.

UNDP: In the Red Ribbon Award guidelines it is specified that the award is “designed to honor and celebrate outstanding community initiatives that show leadership in reducing the spread and impact of AIDS”. In what way would you say Mashhad Positive Club has shown such leadership?

Vahid Nobahar: Good leadership is one of the most important factors in achieving good results. In comparison with many other organizations we are working towards clear goals which give us the opportunity to work more structured and to lead our activities based on well defined terms of reference. From the establishment of Mashhad Positive Club in May 2007 we have developed detailed work plans and indicators every month for all people working with the organization, and we have monitored and evaluated our activities frequently. Therefore, the path to follow and where it should lead has always been clear. Also, we have managed to be selective when choosing areas of activity. In order to reach the goals we have prospected we find it utmost important that we are specialized on what we do and that we do not engage in all fields of activity where there are funds to obtain. Finally, I want to emphasize that although we have a Terms of Reference for our activities and we concentrate on covering all the issues in this, we also look at this guideline as an opening to support the needs of people living with HIV in a wider sense. It is important for us that we do not limit ourselves to strictly project defined work, and to always keep in mind and have people remember that we are doing this based on common human feelings.

UNDP: It is required that the winners of the Red Ribbon Award show leadership in five different areas related to reducing the spread and impact of AIDS. The first of these is providing access to care, treatment and support for people living with HIV. How would you define your activities related to these three areas?

Vahid Nobahar: Firstly, I would like to emphasize that private organizations in Iran are not directly engaged in treatment of people living with HIV since this responsibility lies with governmental organizations and health institutions. However, we are very active in providing care and support for the target groups. When a person approaches us we always start by asking what problems the individual is experiencing related to HIV/AIDS. Based on the answer, we introduce the person to relevant places where his or her specific needs can be addressed. As an example, a substantive part of those who are living with HIV are drug addicts in a situation where they are in a dire need of basic life necessities, such as having a place to stay. We introduce them to places where they can live for free or by paying a very low rent. In this particular case we have received very good support from the Imam Khomeini Charity Committee, which in addition to financing shelter offers property loans with low interest rate and covers up to 90 % of the treatment relevant expenses (other than Anti Retroviral Drugs which are free in Iran) of many poor living with HIV. We also get food products, such as rice, flour and oil, from charity organizations, which we hand out to the neediest for them to take home. As many of the people coming to us are still abusing narcotic substances or are conducting high risk behavior, we have produced a Harm Reduction Package that is handed out without cost and is intended to reduce the probability of getting infections and prevents transmitting the virus to others. This package includes such facilities as syringes, needles, condoms, soap, shavers, shampoo and scissors.

Another activity, which importance I cannot emphasize enough, is our offer for people living with HIV to participate in life skills training. For people who have been living in loneliness with HIV/AIDS or have recently found out that they are infected, it is crucial to know that they are not alone in this difficult situation. We bring people together and inform them how it is possible to live with HIV, encouraging them to be happy and not to quickly get angry over what could be considered less important things. As part of this initiative we have until now organized three recreational tours where both people living with HIV and their dependents have had the opportunity to join. In addition to this, we offer home-based counseling to ensure that individuals in need of having someone to talk to will have full confidence and trust in the consultant in an environment associated with safety.

Furthermore, we have put much emphasize on education as a part of the support we offer. We have held several workshops and training sessions on such subjects as “HIV Prevention”, “Sexual and Reproductive Health and Rights”, “HIV and Pregnancy”, “Positive Nutrition” and “Living with HIV.” For example, many people living with HIV do not have sufficient information on how their medication reacts with various types of food, and when they become nauseated or throw up as a result of mixing medicines and food they put aside their medicine in order to avoid this. This is not advisable and it is important for the individuals to understand why this is happening and how important it is to continue using the medicines. In addition to this activity, we have translated and simplified a significant amount of literature related to HIV/AIDS that has earlier not been publicly accessible because of language limitations and not being understandable for people living with HIV. This has been met with very positive feedback and is a service we absolutely will continue to provide.

UNDP: Concentrating on a second area related to reducing the impact and spreading of HIV/AIDS, how would you say your activities have contributed to promoting human rights and addressing social injustices?

Vahid Nobahar: It is always important for everyone to remember that people living with HIV are also human beings. Far too often we see that people are distancing themselves when they experience that their family members, friends or employees are identified with HIV. As a result, many are no longer in contact with their families, they lose their friends or they get fired from their jobs. All these reactions are usually based on fear and a lack of sufficient information about the disease. To meet this challenge we have organized thirty-one advocacy meetings for people that in one way or another are related to people living with HIV in order for them to confront these stigmas and not distance themselves from their relatives, friends and employees. We have also approached religious leaders, people and organizations, and as an outcome of our meetings and communications a fatwa – an Islamic ruling issued by an Islamic Scholar– has been issued, founding arguments for the protection of the rights of people living with HIV on Islamic principles.

Thus, to assist people in having the opportunity to live like others is to help them in promoting the rights they have as human beings. As a concrete example: We have supported individuals who want to be in physical activity through work-out, but have been denied access to sports complexes because of their health status, by signing a Memorandum of Understanding with a sports center in Mashhad, giving people living with HIV access to the same work out hours as other members, but for the much lower fee of approximately one dollar per month.

For the purpose of giving people living with HIV official recognition and to establish common respect for them as fellow citizens, we have had several meetings with governmental offices and organizations, of which almost all of these have fully supported our activities and contributed strongly in giving people living with HIV a face to the world. As an example of this, many Governmental organizations in Khorasan-e Razavi Province have fully embraced our activities, and when we organized a large seminar titled “The role of religious leaders and people in high risk behaviors, HIV prevention and PLHIV support” on 15 May, representatives from 12 governmental offices were present, showing more commitment than ever before. As another example of how significant the support has become, the Imam Khomeini Charity Committee three weeks ago announced that they would support Khorasan Razavi Health Center with US$ 20,000 to be used solely for the purpose of people living with HIV support activities. Before the establishment of Mashhad Positive Club assistance of such caliber did not occur in Mashhad.

UNDP: Closely related to human rights and social justice I would like to ask you in what way Mashhad Positive Club has worked for empowering women and girls, and addressing gender inequalities that fuel the spread of HIV/AIDS?

Vahid Nobahar: The first month after Mashhad Positive Club activities were initiated in 2007 we established a Women and Family Committee, where several woman experts on HIV/AIDS volunteered to consult impoverished women, wives of people living with HIV and HIV positive women with no place to live on health issues, job creation, employment and information about HIV/AIDS. Many of the fixed members in the committee are women living with HIV/AIDS, such as the Committee Secretary. It is especially important to mention that this committee, where many of the members are people living with HIV, as the first in Iran has been enrolled in the International Community of Women living with HIV (ICW). Furthermore, we have established job counseling and creation centers that are able to find jobs quickly for women living with HIV and their families, and we have made an agreement with two computer training centers where both men and women separately can attend classes for the sum of US$ 7 per course instead of US$ 150 that others have to pay.

UNDP: One of the groups that are seriously affected by HIV/AIDS is children. To what extent have your activities provided support to children living with HIV/AIDS?

Vahid Nobahar: Our strongest emphasis has been on supporting vulnerable children, especially children who have dropped out of school or are living in high risk. For these we have focused on life skills training, including activating and motivating them to come for education through organizing painting competitions and arranging recreational tours, and also by offering counseling services. Especially the motivating activities have been very successful, and it quickly creates awareness among friends as well.

In Mashhad we have already initiated a joint project with the Center for Disease Control and UNICEF titled Mashhad Community Based HIV Prevention Project for Most at Risk Children, Youth and Women. Project activities have started in high risk areas, focusing on bringing the target groups into an educational and counseling environment where they can feel comfortable and build their capacity on how to live a healthy life despite the problems they are experiencing.

UNDP: As you earlier mentioned, creating awareness on what opportunities that exist for people living with HIV by sharing knowledge and experiences through networks and gatherings are important factors in prevention work. To what extent have you promoted HIV prevention programs and services?

Vahid Nobahar: I would say we have done this through three channels. The first is our seasonal bulletin titled Hamyaran, where we inform about our activities and seek to raise awareness on issues concerning people living with HIV, especially targeted at our members, Governmental organizations and universities. Until now we have published three issues and a fourth is due to be printed in short time. The second is advocating through informational, educational and communicational material, such as posters, flashcards and billboards, of which in the two latter we have had very good help from the Khorasan Razavi Police and the Khorasan Razavi Health Center. The third is our website, where most information on Mashhad Positive Club and its activities now can be found in Farsi, English, French and Russian, and where we are preparing the launch of an Arabic site in order to hopefully establish stronger contact with the rest of the Middle East and North Africa.

UNDP: How would you describe the HIV/AIDS situation in Iran, and especially in Khorasan Razavi Province and Mashhad?

Vahid Nobahar: I would say that the HIV/AIDS situation in Iran has developed through three main waves. The first wave started about twenty years ago with polluted blood transfusions. The second wave came with the increase in number of injecting drug users becoming infected by sharing injection equipment. We are now in the very beginning of the third wave, where unprotected sex is increasingly becoming a serious factor when it comes to HIV transmittance. As a result of especially this latest wave, more women are becoming affected that before and children are especially vulnerable.

In Khorasan Razavi Province, and especially in Mashhad, we are experiencing the same challenges as the rest of the country and we have gone through the same three waves. However, because Khorasan Razavi is situated on the border to Afghanistan, one of the largest drug exporters in the world, we are especially facing a problem with drug addiction and HIV transmitted through the sharing of injection equipment. The government has taken several very good initiatives for drug users in the province, among others by establishing drop-in centers. However, we are still facing several challenges in locating the drug users, sex workers and wives of people living with HIV since they are reluctant to seek consultation or volunteer for testing themselves.

UNDP: What would you say are the most important challenges facing HIV prevention work in Iran?

Vahid Nobahar: We are facing three particular areas of challenges concerning HIV prevention in the country. Firstly, if an organization wants to initiate an activity there has to be made several basic considerations before starting and there is a need for substantial support from a variety of organizations to be able to make significant achievements. Our close cooperation with religious leaders and the police has been important factors in our activities and these have contributed in a very positive way to address the province’s HIV/AIDS problems.

Secondly, NGOs have until now not been able to establish the proper degree of trust in Governmental organizations. The Government has done very good planning through the two National AIDS Programmes, and it is important that instead of working towards individual goals that the NGOs try to define themselves within the national context. We should ask ourselves: When we have the legal ground for operating as NGOs in the field of HIV/AIDS, why are we not cooperating?

Thirdly, the NGOs’ programmes in Iran are currently fully project based. If funding is not attracted for another project this will result in the closing down of the NGO since there will be no financial means to sustain their existence. In order for the NGOs to stay alive and be able to do long term planning it would be positive if the Government could come in and provide a basic financial support so that the NGOs can continue to provide substantial and important assistance to the Government.

UNDP: When receiving such an award as you have now it must be a good push to continue working for people living with HIV in Iran. How do you see the next couple of years for Mashhad Positive Club?

Vahid Nobahar: For the moment, we have planned our activities for 2008 and 2009, based on the funding we have been granted by UNAIDS through the Global Fund for fighting AIDS, Tuberculosis and Malaria (GFATM). One of our most important focus areas will be to develop a programme and a closer cooperation with religious leaders for HIV prevention. We will continue conducting workshops for people living with HIV based on some of the previously mentioned topics, such as “HIV and Pregnancy” and “HIV and Nutrition”, and we will continue to provide education, counseling services, advocacy, networking opportunities, access to harm reduction equipment – such as free condoms and personal hygiene equipment -, and facilitate programmes for physical health for people living with HIV.

We have programmed the supporting of drug addicts in finding treatment and in reducing the costs of such treatment to a minimum, and to offer counseling services to these. Our home-based services have been very successful until now, and based on this we will concentrate on sustaining this programme. The job consultation we have offered has also been popular and successful and we are planning to establish a provincial network for the purpose of improving access to employment for people living with HIV.

We will continue doing research and making important literature resources available for the public and the production of our seasonal bulletin Hamyaran continues. For the latter we hope to increase the rate of people living with HIV working for the bulletin from the current sixty percent to above seventy. In addition, we want to give importance to helping children affected by HIV not to drop out of school and to provide them with education through organizing training tours. For the moment, we have called this initiative “HIV Tourists”. For the sake of improved knowledge exchange, we hope to expand our network to other countries in the Middle East, and we will to continue fighting against stigmatization and discrimination of people living with HIV. All in all, we are working towards deserving and winning the Red Ribbon Award again in two years.