Even Behind Bars, HIV Physicians Continued Humanitarian Work

Two brothers are recipients of the inaugural Elizabeth Taylor Award in Recognition of Efforts to Advocate for Human Rights in the Field of HIV

Hailed worldwide for the successful HIV/AIDS harm reduction program they pioneered in their home country of Iran, Drs. Kamiar and Arash Alaei suffered an abrupt reversal of fortune when they were arrested on dubious charges and imprisoned in 2008. Reunited as free men a year ago, the brothers were honored at the XIX International AIDS Conference with the inaugural Elizabeth Taylor Award in Recognition of Efforts to Advocate for Human Rights in the Field of HIV.

 

In the late 1990s, statistics were beginning to show that a serious HIV/AIDS problem was developing in Iran, and that it was concentrated in prisons and among drug users.  Deciding to put their training to use, the Alaei brothers opened a “triangular clinic” in their hometown of Kermanshah to treat the triad of drug abuse, HIV/AIDS, and sexually transmitted infections (STIs).  They ran the clinic with what Kamiar has described as a restaurant approach, where they gave customers—patients, in this case—what they wanted.  If patients wanted clean needles, they offered clean needles.

The key to the success of the triangular clinics lie in grouping drug abuse, HIV/AIDS, and STIs together.  This strategy not only allowed doctors to utilize successful integrated prevention and treatment strategies, but also minimized stigma associated with HIV/AIDS by making it a part of the larger group rather than singling it out.

It was a highly effective approach. After a few years of hard work the Alaeis won the support of local clerics and the government and began to expand nationwide.  Concerned about the sustainability of the program, the brothers applied for a grant from The Global Fund to Fight AIDS, Tuberculosis and Malaria.  The Global Fund awarded them $15.8 million to replicate their clinic’s success across Iran.

In 2004, the World Health Organization described the clinics as a “best-practice” model for the Middle East and North Africa regions, and triangular clinics went global.  Today, the model has been implemented in 12 different countries, including Afghanistan and Tajikistan, and the brothers have participated in an array of international health advocacy and global information exchanges.

Ironically, it was this international success that provoked Iranian officials to arrest the brothers.  However, even in prison their drive to help others was undeterred.  The brothers weren’t allowed to practice medicine, so they taught good hygiene habits, encouraged prisoners to get exercise by setting up football and volleyball championships, and helped prisoners stop smoking.

The rationale behind their arrests in June 2008 is still a relative mystery.  In a one-day trial the brothers were convicted of drawing domestic and foreign attention by holding conferences on AIDS, as well as the more sinister crime of holding trainings abroad that were “of the nature of a velvet revolution.”

 

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