He says that in 1364, the first cases of AIDS were discovered in Iran in Saravan. He still emphasizes that the issue has been taboo both then and now, and society must nurture itself and let go of taboos. He is Dr. Malek Fazeli, an ophthalmologist and member of the Health and Treatment Commission in the Eleventh Islamic Consultative Assembly. He, who is seen as the head of the Saravan Health Center in his executive background, talks about the description of AIDS, its emergence and discovery in Iran from the first efforts in Saravan, and of course emphasizes that the officials are aware of the issue and even in regards to sexual workers, “the country’s health and treatment system and those who should be aware in this field are currently working on it.”

The representative of Saravan in the Islamic Consultative Assembly also talks about the taboo of AIDS in Iran and cultural work in this regard, saying, “If you don’t accompany your society

One of the problems related to AIDS in Iran is related to disease detection. What is the situation in this regard?

If we go back to the history and background of the disease AIDS or HIV infection, the first cases of this disease were reported in 1981 in America and Africa, mostly among homosexuals and related to this group of people! Later, it spread to others as well. It was a major problem for the global community for a period of time. Fortunately, from the beginning of the spread of this disease, the country’s healthcare system was actively working towards disease prevention and management. In 1985, in Saravan, we implemented a comprehensive awareness program with the help of health centers, influential leaders in the community, and teachers, and held classes every three to six months for various groups. I can say that at that time in Saravan, we had what international standards required. Our disease detection rate and transmission methods were exactly in line with global standards. In fact, I can say that Saravan was one of the counties in the country where we focused specifically on this disease. Our community’s

Research on blood and contaminated needles and similar topics.

Yes. Syringes contaminated. Toothbrush contaminated. Razor contaminated. All of these. At first, people thought it was just a matter of sexual transmission. They did not take care of these issues and the contamination spread. The problem of injection drug users is also present. All of these were there. Later, fortunately, a national plan was created. Sirovan County was one of the first counties where its centers became active in the national level and now there are programs in place for the care and prevention of HIV patients and all projects that are being implemented for the preservation of the health of those infected or prevention. The national health system also provides extensive facilities and services.

If we look at what is happening in our country, fortunately, we have an extensive health care system that can even serve as a model on a global level, especially for developing countries. The extent of our system, in terms of health centers, health care centers, and similar facilities, is such that we can say that

One of the indicators of fighting against AIDS is reducing mortality rates. Have we been successful in this regard?

As I mentioned before, from the beginning, work was done in two directions: prevention of the disease and treatment of the disease. Most viruses do not have an effective treatment. Our treatments are helpful for viral patients. From the beginning of this disease, drug companies were looking for drugs that could cure the disease definitively. That is, to eliminate the virus. You know that to destroy a virus, its structure must be broken down. Unfortunately, an effective treatment has not been found to eliminate this virus. But with recently invented drugs, we have been able to minimize the virus’s ability to reproduce and cause disease, meaning we have reduced its pathogenicity and its ability to cause disease to a minimum. This reduction has allowed a person with the disease to have a normal, desirable life as long as they adhere to health standards in drug use and maintain their health through nutrition.

Unfortunately, we have not been successful in developing an HIV vaccine. One reason for this is that this virus has various types

Does it seem to you that we have approached or accompanied the global standards in this field?

We discovered the first case of HIV in 1364 in Saravan. If it wasn’t the first, it was among the first cases. In that year, we found a patient who had come from the Emirates and had passed away, and we discovered that they were infected with this virus. When we compare ourselves to other countries in the world, without any exaggeration, we are in a favorable global position in terms of disease control, especially regarding HIV. Considering what you know, our country has a unique culture and situation. At first glance, people may not believe this. But our society has reached the global standard level due to the widespread awareness of the healthcare system and has the ability to protect itself and be aware of the disease.

Last year, unfortunate events were reported in Lordegan, Chaharmahal and Bakhtiari, specifically in the parliament as the house of the nation, entered this field? How do you evaluate the support for the people of Lordegan?

I was not a representative at that time. This is an issue that happened in Lardgan at that time. The discussion only reached a point where they raised the issue of contaminated needles. But you see, sometimes we make things worse and bigger. In closed communities like rural communities, for various reasons, when an infectious disease emerges, if we are not careful, the chances of its transmission in a short period of time are high and this disease (whether it is HIV or coronavirus) will spread quickly. When this spread is concentrated in a specific location, of course, health organizations and institutions responsible for the community’s health focus on it. This focus, by a specific institution, individual, or group, creates a deviation from the norm and shows that person or system as more guilty than they actually are. This is what, in my opinion, as a doctor and someone who has been working in the field of health and medicine for about forty years, has been done. The community is also sensitive

Has “Criminalization and Punishment of HIV Transmission Behaviors” been legislated?

I do not believe in punishing individuals in the field of public health, even for this coronavirus disease. We must educate our society and let the community come to the realization that they need to take care of themselves. Punishing individuals will not solve the problem. This is a type of illness and a virus. If we want to have a positive impact on our society, the most effort we should make is to educate the community. Also, when we educate, we should provide the person being educated with access to facilities that protect their health. When we teach and provide easy, affordable access to health facilities, the community will take care of themselves. There is no need for coercion or forced measures. Voluntary issues and education have a better effect and are accepted and sustainable within the community.

Does this mean that you prioritize cultural value over punitive value in this area?

Exactly. This is what solves the problem. Force will never be a barrier in these cases. In order for society to think that I am not doing anything to be punished! It is a process of life in which one does not know how to take care of oneself. He behaves naturally in his own eyes and does his normal work. That is, the person is not aware of the problem he is causing for himself. A person who is not aware of this issue has not committed a crime. He is not aware. When he becomes aware, he also protects himself.

Mohammad Naeim Amini Farad, a former member of the Health and Treatment Commission of the previous Islamic Consultative Assembly, said in December 2018: In the early 1960s, the transmission of AIDS through unprotected sexual intercourse was less than 10%, but currently this statistic has reached over 40%. However, the most common way of transmission of this disease in our country is still through shared injections. What is the reason for this issue?

As I mentioned, at the beginning of our work in Saravan, our statistics were in line with international standards and mostly related to sexual issues. What the late Mr. Aminifar, may God have mercy on him, said was correct. The lack of necessary spread of this disease in that year, which was 1364, was the issue. We used to investigate dangerous centers such as injection drug users. The spread of the disease was limited. When we investigate a specific group, disease detection is done in that community. But because we did not go deep into society, the spread of the disease, its mode of transmission, and the results obtained are deviated from the standard. At the same time that I was in charge in Saravan, I made the healthcare system aware that without causing any harm to the community, disease detection should be done actively and confidentially. At that time, the majority of our cases were related to sexual issues. And most of them were deportees from

Given that there is no legal definition for sexual labor in Iran and as a result there is no way to monitor it, is there an alternative solution to reduce the transfer through risky and unregulated relationships?

From the very beginning of our work, it has been believed among the officials of the country that with these conditions, how should we carry out our duties. Now it is still the same. It is true that what you say is not planned. Because our society does not accept this issue. But on the other hand, the duty of health and treatment regarding disease detection and care for people who are somehow at risk is not neglected, and the country’s health and treatment system is well aware of this and is doing its job. Outside the country, it is easier, more comfortable, and cheaper to work for the health and treatment system of that country. But here, the work is a bit harder. However, the country’s health and treatment system and the individuals who must have some knowledge in this field are currently doing their job.

Speaking out and fear of losing face have become important factors in preventing further progress of AIDS in Iran. What cultural programs have been implemented in this regard?

What you say is a special issue and requires a special delicacy. That you can go and communicate with society. In fact, you are facing a society that must accept you. We are facing a society that does not allow you to reveal certain structures. Society does not allow you to raise certain discussions. If you do not accompany yourself with your society and what your society’s culture is, you will not optimize the culture. Society will suffer culturally. When it breaks, it is another problem to accompany you. We have tried since 1985 to present what is taboo in society, but at the same time, we have fulfilled our duty. So that society itself can put aside this taboo and know how to take care of itself.

It means you believe that society should be nurtured to let go of taboos?

Yes. Other than this, you will not succeed and you will face confrontation.

Last December, at the suggestion of the Women’s Commission of the Parliament, a meeting was held with the aim of presenting proposals from relevant executive bodies to focus on the area of prevention and treatment of AIDS and raising awareness about it. Since then, what steps have we been able to take forward from the beginning of the eleventh Parliament? How can relevant organizations and the Parliament work together constructively in the field of AIDS and specific diseases?

One of the duties of any organization, system, and government is to deal with the daily problems and crises of that society. As the Health and Treatment Commission, our main concern has been the main problem of our society and the global community, which is the COVID-19 pandemic. And ultimately, perhaps eighty percent of our efforts in the Health and Treatment Commission have been actively and comprehensively focused on this issue. Of course, we have been aware of all the issues related to public health, but we have mainly discussed the issue of COVID-19. Our first meeting started with COVID-19 and our last meeting was also about COVID-19 and the COVID-19 vaccine. Of course, the issue of HIV/AIDS, being a viral disease, has been a guiding light for us in terms of how to care for COVID-19 patients.

Do we have specific statistics about AIDS patients in Iran?

Based on what we have discussed and considering its acceptance by society, today’s statistics are more revealing than the past. When we compare our country to many other countries, we can say that we have a much better situation in terms of awareness of our own HIV patients compared to many developing countries.

Can you tell me a number?

It is not possible to give an exact number considering the characteristics of this disease. However, according to our culture and what we have discussed and the perspectives that exist regarding this disease and the process we have taken, our statistics are close to reality. But I do not know the exact number.

What measures have been taken during the coronavirus period to support people with AIDS due to their vulnerability?

We have vulnerable groups against coronavirus. Our first vulnerable group is those whose immune system has weakened. And this virus is the one that weakens the immune system. HIV patients are among the most vulnerable patients against coronavirus and the Ministry of Health and Medical Education, especially the Health and Medical Treatment Commission, has focused on this issue. We have also advised our healthcare system and emphasized on measures such as staying at home and following protective guidelines.

Thank you for the time you have dedicated to the peace line.