WHO-EM/GPNI08/E
ACQUIRED IMMUNODEFICIBNCY SYNDROME
Report on the
INTERCOUNTRY \VORKSHOP ON AIDS EDUCATION AT THE WORKPLACE
Lahore, Pakistan, 25-27 September 1995
World Health Organization Regional Office for the Eastern Mediterranean
Alexandria, Egypt 1995
This document is not issued to the general public and all rights an: reserved by the World Health Organization (WHO). The doaunent may not be reviewed, abs1nCIN, quoted, reproduced or translated, In part or in whole, without the prior written permission of WHO. No part of Ibis doaunent may be.stored in a retrieval system or transmitted In any form or by any means - electronic, mechanical or other - without the prior written permission of WHO.
The views expressed in doaunents by named anthors an: solely the responsibility of those authors.
WHO-EM/OPNl08/E"JL/l 1.95/170
CONTENTS
I. INIRODUCilON I
2. EPIDEMIOLOGY OF HIV/AIDS 3
3. COUNTRYPRESENrATIONS 4
3.1 Egypt 4 3.2 Pakistan 5 3.3 Tunisia 5
4. RATIONALE FOR AIDS EDUCATION ATTIIB WORKPLACE 5
5. AIDS EDUCATION ATTIIE WORKPLACE, POL ICY AND SfRATEGYDEVELOPMENT 6
5.1 Approaches 6 5.2 Strategy Component 7
6. DEVELOPMENT AND MANAGEMENT OF AIDS EDUCATION PROGRAMME ATTIIE WORKPLACE 8
6.1 Collection of Baseline lnfonnation · 9 6.2 Development of a Plan of Activities 9 6.3 Implementation and Monimring 9
7. PLAN OF ACilON FOR AIDS EDUCATION ATTIIE WORKPLACE 10
8 . RECOMMENDATIONS
8.1 To National Authorities 8.2 To International Organizations
Annexes
I. Agenda 2. Programme 3. List of Panicipants
12 12
13 14 15
EM/GPNJOS-E
I. INTRODUCTION
Available data have shown that people with HN/AIDS are predominantly adults in their economically most productive years. As HN/AIDS epidemic continues to spread, there will be millions of HN infected individuals and millions of AIDS cases worldwide, over 80% of them in working age-group of 20-49 years.
Within this context. the WHO Regional Office for Eastern Mediterranean (EMRO) organized an intercountry workshop on AIDS education at the workplace, in Lahore, Pakistan, from 25 to 27 September 1995. The objectives of this workshop were:
• to highlight the importance of AIDS education at the workplace. • to review current activities in AIDS education at the workplace in the
Eastern Mediterranean Region (EMR), and. • to develop strategies and approaches for AIDS education at the workplace.
The agenda and programme of the workshop are presented as Annex 1 and 2 respectively. Twenty-four participants representing 11 Member States in the Region as well as WHO staff from Pakistan and EMRO and staff from Il.O, UNDP and the World Bank attended the workshop (see list of participants in Annex 3).
Dr M.A. Barzgar, WHO Representative to Pakistan,read out a message from Dr Hussein A Gezairy, Regional Director for the Eastern Mediterranean Region. Dr Gezairy, in his message, emphasized the importance of protecting the productive segment of the population (between 20 and 49 years of age) from HN infection, as they represented the backbone of any society and are the most economically active people.
HN/AIDS is not merely a simple medical problem, but has social, economic and cultural implications as well. For this reason, several sectors other than health including the Ministries of Labour, Commerce. Industry, and other sectors, public or private, involved in the welfare of employed people will have to be involved in the prevention of HIV transmission.
Today, there are 2400 million economkally active people in the world. As there is no cure or vaccine for prevention of HN/AIDS. AIDS education is the only means to educate the people on the topic, and thus prevent HN transmission.
WHO has been active in AIDS education at the workplace since the early days of the AIDS epidemic. In 1988 a consultation on AIDS and the workplace was convened by WHO headquarters (Office of Occupational Health) and Il.O. and a consensus statement was developed that addressed three themes, namely risk factors associated with HN infection at the workplace, response by business and workers to HN/AIDS and the use of the workplace for health education activities.
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Although HN/AIDS is spreading rapidly all over the world, the Eastern Mediterranean Region is fortunate rnough not to be affected seriously as yet. However, there should be no complacency and efforts should continue to maintain this status.
Since AIDS is essentially linked with people's personal behaviour, particularly in relation to sexual practices, advantage should be taken of all positive aspects of the
· Region's culture. namely abstinence, mutual fidelity to one's spouse, avoidance of promiscuous sexual encounters and drug use. Early and timely marriage, not premature marriage, should also be encouraged, and not delay it too long as this may burden young people from both sexes and push them towards illicit sex.
Following Dr Gezairy's message. Mr Rana lkram Rabbani, Minister of Health of Panjab Province, addressed the participants. Mr Rabbani said that HIV/AIDS is a universally knowo expression by now. It has been the subject of discussion by everybody and talked of everywhere-in homes, streets, offices and shops. This has generated fear and panic among the people, which has stimulated governments and NGOs to take action. National AIDS programmes had been established in all countries and action plans for AIDS prevention and control developed.
With the evolution and development of the AIDS epidemic, researchers started discovering many new features related to this disease. At first it was dealt with as a purely medical problem, and then other non-medical aspects. psychological, social and economical came into picture, particularly in relation to the management of HIV seropositives and AIDS patients.
Prevention of HIV transmission is also becoming complex as data demonstrated that sexual transmission is becoming the most predominant mode of infection. Scientists ti11 now have neither succeeded in discovering a cures, nor a vaccine. Hence, education is the only available means to counter this challenge. It is possible to motivate people to adopt a safe or reduced risk behaviour through education. However, discussing sex is not an easy task. The subject is very sensitive because it is very personal and private, as well as culturally not easily acceptable.
It was obvious from the data available that the group most affected and most threatened by the HIV/AIDS epidemic represents the productive group of the community-men and women between 20 and 49 years of age.
In conclusion, he said that he was looking forward to new ideas in addressing the subject of AIDS education at the workplace and that his country, similar to others in the world. would be striving towards protecting the workforce in Pakistan against HIV infection and would use all the necessary resources to achieve that goal.
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2. EPIDEMIOLOGY OF HIV/AIDS
AIDS is essentially a sexually transmitted disease (STD), but like any other STDs, it can also be transmitted through blood and blood products and from infected woman to the newborn baby. Sexual transmission is the predominant mode of transmission of HN because of the large number of sexual exposures every day, although the probability mode of transmission of lilV because of the large number of sexual exposures every day, although the probability of transmission in any single exposure is low. About one-third of babies born to infected mothers become HN infected, about half of them through breast milk.
Up to mid-1995, a cumulative total of I 169 811 AIDS cases had been reported to WHO from all over the world. However the actual number is estimated to be more than 4.5 million, the vast majority of them in sub-Saharan Africa. As AIDS represents the late stage uf lilV infection, an estimate of the latter gives a better indication of the magnitude of the current AIDS problem. More than 18.5 million adults and 1.5 million children are estimated to have been already infected with mv.
Sub-Saharan Africa is the worst affected area, but the epidemic is spreading very fast in south and south-east Asia.
In the Eastern Mediterranean Region, a cumulative total of 3704 cases of AIDS and AIDS-related complex has been reported up to I August 1995. But the actual number is considered to be many times more and the number of new cases reported is increasing every year. More than 150 000 HN infections are estimated to have already occurred in the EMR. Three-quarters of the AIDS cases are among males, but the female-to-male ratio is increasing every year. About 74% of cases are due to heterosexual transmission and a further 5% due to homosexual transmission. The proportion of AIDS cases due to transmission through blood and blood products has been decreasing over the years. Ninety per cent of the cases have occurred among the productive age-group of 15-49 years. One-third of all cases have occurred in the age-group of 20-29 years.
Available information indicates that ttN infection is spreading rapidly in the EMR, particularly among people at increased risk such as STD patients, prostitutes aod bar girls. In a few countries, the infection has also spread within other groups, such as tuberculosis patients. pregnant women and blood donors.
The spectrum of lilV infection has severd! stages through all of which ao infected person may or may not pass. These stages are:
• Acute illness: with influenza-like symptoms which appear about two weeks after infection and last for 1-2 weeks.
• Latency period: the infected person feels fully normal, but the virus continue multiplying.
• Persistent generalized lymphadenopathy: enlarged lymph modes in two or more extrainguinal sites, persisting for more than three months. with no other identifiable cause.
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• AIDS-related complex: development of generalized symptoms, such as weight loss, diarrhoea, fever.
• AIDS: signs and symptoms of opportunistic infection or cancer appear. Patient dies usually within I to 2 years of diagnosis.
An HN-infected person is highly infectious during the acute illness stage. However, it takes six weeks or longer before the antibodies become detectable in blood. This period is called the "Window Period". This must be kept in mind if a person who has been exposed to the risk of infection wants to find out the infection status.
3. COUNTRY PRESENTATIONS
Representatives from Egypt. Pakistan and Tunisia made presentations describing activities undertaken in their respective countries in AIDS education at the workplace. These presentations were followed by plenary discussions.
Topics presented and discussed included strategies and approaches used in the implementation of AIDS education at the workplace, as well as future perspectives based on lessons learned.
The overall strategy for workplace AIDS education was designed through a multisectoral approach involving public and private sectors. particularly those dealing with promotion of workers' health within organized institutions. In the public sector the main partners are the Ministries of Labour and Employment as well as Social Affairs. In the private sector. NGOs, workers' syndicates, doctors' syndicates as well as institutional health services of private companies collabor,ted in developing AIDS education activities targeted at workers.
Areas that needed particular attention in the future are policy development and the establishment of complete and sustainable support services within the work setting. On the other hand. many activities had already been implemented rather successfully in the areas of training of educational staff and the implementation of educational activities. Training included 1he development of a network of educators within the workplace who played a key role in implementing AIDS educational activities.
3.1 Egypt
Strong collaboration and working relationship were developed with local councils in many cities and governorates. Steps were also taken to establish partnership with major industries within these localities. A general meeting was then held. chaired by the director of the city council, focusing on AIDS in the workplace and the role of business and industry to respond to the AIDS epidemic. This meeting resulted in the fonnation of a health committee to develop a coordinated plan for AIDS prevention in factories.
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In paralle],' panel discussions with business and community leaders were conducted aiming at sustaining AIDS education activities being implemented in the workplace. Media were called upon periodically to cover these events and promote AIDS prevention among the workforce.
3.2 Pakistan
AIDS education at the workplace started with an advocacy phase in 1991. People from the education field, journalists, Jabour leaders and NGOs participated in this phase, and Undertook activities among truck drivers, commercial sex workers and eunuchs.
Workshops were organized for lawyers and judges by national and provincial AIDS programmes at federal and provincial headquarters, as well as AIDS/STD awareness and education workshops for coal mine workers in Baluchistan.
AIDS/SID education workshops were also conducted for workers of the textile industry in Faisalabad and for workers in the electronics industry in Gujrat.
3.3 Tunisia
AIDS education at the workplace started with the private sector involving several NGOs that implemented projects targeted at health professionals, young women workers and workers in the transport sector. These activities were canied out on a pilot basis to be used as a testing ground and learning experience prior to extending the programme to the public sector.
Among the lessons learned from the experience of the private sector are the importance of proper training of individuals in charge of conducting educational sessions, particularly in the a.rc:a of communication, and the development of an evaluation scheme aiming at assessing 'the impact of project activities.
Planning for AIDS education at the workplace through the public sector was elaborated during the National Consensus Workshop held in September 1993, where the roles of several sectors concerned, namely the Ministries of Social Affairs, Tourism, Interior, Transport and Religious Affairs, were defined.
4. RA TIO NALE FOR AIDS EDUCATION AT THE WORKPLACE
Major reasons for developing AIDS education at the workplace include:
• The population segment most threatened by HN infection is the most productive one.
• According to WHO, 90% of the people infected with HIV worldwide are in the economically active age-group (20-49 years).
• The workplace is a convenient, effective and regular location to reach workers.
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• The workplace represents an environment conducive for caring for, and promoting workers' health.
• Organized workers' institutional settings (e.g. syndicares, factories, associations) may be used as suppon for the organization of HIV educational activities.
HIV/AIDS is having considerable socioeconomic repercussions on the individual and the family, and at community, national and inremational levels. AIDS education at the workplace may be one of the means for tackling them. However, in order for AIDS education activities to be efficient and effective, certain issues needed to be addressed-issues of policy nature, as well as suppon services, management and programme sustainability.
5, AIDS EDUCATION AT THE \VORKPLACE, POLICY AND STRATEGY DEVELOPMENT
As the workplace is pan of the larger social sysrem, HN/AIDS education programmes at the workplace must be considered in the conrext of general health promotion activities and developed at national and enre,prise levels through consultations between workers, employers and their organizations and, where appropriate, governmental agencies and other organizations.
The inevitable increase of AIDS cases over the coming years makes it imperative that those in the workplace be well trained and well infonned regarding this illness. The AIDS epidemic clearly represents a major challenge for employer and employee education. This challenge is based on:
• the rapidly increasing knowledge about AIDS and its causative agen� the HIV
, the psychological stress relared to AIDS and HIV infection affects not only those with illness, but also friends, families, co-workers, and supervisors
• issues related to confidentiality, duty to protect others from infection, and discrimination have significant impact on the workplace
• negative attitudes based on fear and prejudice must be overcome.
5.1 Approaches
There are two major areas of workplace education: occupational safety and health education activities, include safety training and hazard control, and health promotion at workplace.
AIDS education must deal with the basic factors in social relations; it should be preventive in approach and take into account the situation of all kinds of economic activities.
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AIDS education policies should address the following factors:
• AIDS is a threat to health. • Promotion of the health of HIV-infected people and people with AIDS in
the workplace. • Communication of accurate and up•to-date information on IIlV infection
to all personnel and their families. • Keeping HIV-infected persons and people with AIDS informed about their
rights. • Protection of workers considered to belong to high-risk groups. • Education is more effective than legislation in controlling AIDS. • Helping the prevention of the spread of HN infection and minimize fear
and anxiety concerning HN/AlDS. • Resource allocation (time, money, technical knowledge, people). • Monitoring of the implementation of AIDS education programmes, and
evaluation of their effectiveness.
An overall strategy should be developed highlighting HN/AIDS both as a danger and an opportunity to further promote workers' health. Specific programmes may be required for specific target groups. They should receive specific educational programmes.
5.2 Strategy Component
For the effective Strategy for HN/AIDS education at the workplace, the following components could be considered:
I. Development of AIDS education within the context of health promotion 2. Joint obligation of labour unions and management to training and AIDS
education at the workplace 3. Access to the workplace to provide counselling and information 4. Utilization of material and education techniques appropriate to the target
group: brochures, pamphlets, newsletters, videos, conferences. small group discussion, and individual counselling
5. Provision of current. accurate, and up-to-date information through a variety of channels in a flexible manner
6. Provision of programme activities to all workers and their families 7. Targeting the education message and material to specific groups 8. Consideration of the special needs of individuals with low literacy skills 9. The need for clear guidelines on safety precautions and for adequate
training and practices 10. Selection of training experts to deliver appropriate programmes 11. Involvement of the target personnel in programme development 12. Provision of ongoing programme activities throughout the year 13. Ensuring that workplace education programmes are incolJ)orated Into the
general workplace health programme 14. Programme evaluation to assess the Impact on goals and objectives.
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6. DEVELOPMENT AND MANAGEMENT OF AIDS EDUCATION
PROGRAMME AT THE WORKPLACE
The objective of AIDS education is to provide individuals wilh lhe appropriate conditions which will enable lhem to adopt and maintain a behaviour of rcduced risk of HN infection.
In order for Ibis objective lo be achieved, heallh education activities for HN/AIDS prevention have lo be properly managed. That is. Ibey have lo be designed wilhin a well !bought-out plao. based on ao assessment of lhe context in which Ibey will take place, lheir implementation bas to be monitorod and Ibey will have to be evaluated in order lo be improved and make lhem rcspond lo new situations.
A successful management of heallh education for HIV/AIDS requires a good access to the target community. If health education is a continuous, long process that includes infonnation dissemination, attitudinal change and motivation for sustained practice of reduced risk behaviour, the accessibility of the target community becomes imperative.
Furlhermore, so long as heallh education has not resulted in a sustained heaJthy behaviour among community members. it cannot claim any achicvemenL In fac� an individual may be well informed, she/he may have the proper attitude, but a.< long as she/he does not practice the desired behaviour, all health education efforts would have been in vain.
The workplace constitutes an ideal location for AIDS education for more than one reason:
• The workforce is one of the most vulnerable segment of the population for HIV infection and should be considered one of the prime target groups.
• The workplace malccs lhis target group very accessible for a long-term intervention. such as health education.
, Toe workplace environment is an organized and structured setting which can facilitate the managerial aspect of AIDS education activities.
The development and management of AIDS education in the workplace includes getting support from high-level decision-making. Decision-makers at the labour sector level should be involved from the very beginning in order to provide support to the programme and to create a sense of ownership within the labour sector.
At the implementation level, chiefs of departments, particularly those responsible for occupational health, should participate in the monitoring and evaluation process and their contribution should be sought in the development of activities.
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6.1 Collection or Baseline Information
Ideally baseline assessment may be conducted through a combination of a quantitative (i.e. through the use of a written questionnaire) and a qualitative (i.e. focus group discussions, in depth interviews) study. The infonnation collected through these studies is of crucial importance as it enables the educators to know where to start from, what needs to be done and what will be aimed to achieve. These elements are essential to the managem�nt (planning. implementation. monitoring and evaluation) of the educational process.
6.2 Development or a Plan or Activities
Based on the resources available in each work setting, a plan will have to be developed describing the types of activities to be undertaken duriog a certain time frame. Each type of activity should be designed to achieve one or several specific objectives.
6.3 Implementation and Monitoring
Activities related to specific objectives should be designed to work towards achieving the overall objectives of the plan. In the case of AIDS education, the overall objective should be to make the appropriate conditions available for individuals (i.e. workers) to enable them ta adopt a reduced risk behaviour for HIV infection. These conditions include making infonnation available about HIV infection. and how to protect oneself from it ensuring proper attitude vis-ii-vis HIV/AIDS and adopting a reduced risk behaviour through maintained practice of the behaviour.
Specific objectives should be aimed at moving the individual from the knowledge stage (infonnation dissemination) towards the convincing stage (developing the proper attitude) and finally the behavioural stage (maintaining the reduced risk behaviour).
The implementation and monitoring of the AIDS education activities at the workplace should be implemented within the above framework.
During the planning and implementation of AIDS education in the workplace, the use of peer leaders as a link between the programme and the target group (i.e. workers) should be given due consideration. These peer leaders should be selected from the target group itself based on their leadership qualities. After appropriate training. they can assume a major responsibility in the implementatiOn of CducationaJ activities both at group and individual levels. Their involvement will generate a better response from their colleagues (the target group) who will feel more at ease discussing with people who talk the same language.
The roles of public and private sectors vary from one country to another and depend on the social, cultural and political environment prevailing in a specific country.
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Generally speaking, however, in HN/AIDS prevention, the public sector is considered as the one whlch should be providing political support, policy enactment and large scale infrastructure for intervention. The private sector usually plays a role of advocacy and may supplement the public sector by developing activities that may represent certain difficulties for the public sector.
7. PLAN OF ACTION FOR AIDS EDUCATION AT THE WORKPLACE
AIDS education programme at the workplace can be developed with the following stages:
• Planning • Implementation • Evaluation • Reprogramming .
During situation analysis, infonnation should be collected, among others, on the following:
• Workforce, by age and sex • Nature of workplace • Types of employment • Organizations employing workers, and • Educational. recreational and social welfare activities at the workplace.
Issues to be considered while planning include:
• Targets • Responsible organizations, coordination • Types and methods of AIDS education activities • Time frame • Cost and source of funds; and • Monitoring and evaluation.
The plan of action for AIDS education at workplace should include the following activities:
• Establishment of a coordination committee • Situation analysis • Formulation of policies • Sensitization of management • Identification of target groups • Prioritization of target groups and setting up a pilot project • Training • Education • Monitoring and evaluation, and
• Reprogramming.
Group Work
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Working in three groups , the partlcipants identified the following policies and activities for a programme on AIDS education at workplace.
Po1icies
• People with HN/AIDS have shared rights and opponunitles and should be treated as such. Due attention should be given to the issue of women and AIDS.
• People with HN/AIDS do not pose a risk of transmission to their co workers through ordinary workplace contact There should be no discrimination against persons with HIV.
• The highest level of management and union leadership should endorse educatlonal programmes on AIDS.
• Employers should seek information about HN/AIDS and help set forums where accurate/up-to-date infonnatlon is given to employees for risk reduction to their personal lives.
• Employers have a duty to protect the confidentiality of employees' medical information, including AIDS.
• Unions and employers should help prevent the spread of HN and minimize fear and unnecessary anxiety concerning !IlV/ AIDS.
Planning
Situation analysis Objectives of the programme Identification of target groups Access to target group Strategy/methodology/materials Human/material/financial resources available and constraints Training or intervention Time frame Monitoring and evaluation.
Implementation
• Identification of the sectors concerned (private and public) • Designation of personnel who will manage the activity (committee
formation/multisectoral) • Establishment of pilot projects for selected workplaces • Identification or logistics support among the parties concerned • Development of training and educational materials • Training of trainers and educators. iticluding peer educators • Education of workers
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• Monitoring of the implementation of activities • Evaluation of the project • Reprogramming.
The participants then prepared plans of action for AIDS education at wodq,lace for their individual countries, after due consideration of the above points. These plans will be reviewed and refined by the authorities concerned in the countries.
8. RECOMMENDATIONS
8.1 To National Authorities
I . To formulate policies for AIDS prevention and control at the workplace.
2. To establish coordination committees at central and peripheral levels, including health sector, labour sector, education sector, social welfare, employers and workers.
3. To develop and implement programmes for AIDS education at the workplace.
4. To elaborate a strategy for the traihing of staff (both males and females) who will be in charge of implementing AIDS education at the wodq,lacc.
5. To provide support services on AIDS at the workplace, including information, education and counselling.
6. To mobilize resources including the resources from public and private sectors required for the implementation of the programme.
8.2 To International Organizations
7. To provide technical and financial support to the AIDS education programme at the workplace.
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I . Opening session
Annex I
AGENDA
2. Introduction and workshop objectives
3. Epidemiology of HN/AIDS
4. Country presentatios on AIDS education activities at the workplace
5. Rationale for AIDS education at the workplace
6. Policies, s1rategies and interventioos for AIDS education at the workplace, including the role of public and private sectors
7. Development and management of workplace AIDS education programme
8. Countries future action plans in AIDS education in the workplace
9. Recommendatioos
10. □osing session
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Annex 2
PROGRAMME
Monday, 25 September 199S
08.30 • 09.00
09.00 • 09.30
10.00 • 10.30
10.30 • 12.00
12.15 • 13.15
13.15 - 14.30
Registration
Opening session
Introduction Election of officers Objectives of the workshop, by Mr A Thraya
Epidemiology of HIV/AIDS, by Dr P.N. Shrestha
Country presentation on AIDS education activities in the workplace: Egypt, Pakistan, Tunisia
The rationale for HIV/AIDS education in the workplace, by Mr Thraya
Tuesday, 26 September 199S
08.00 - 09.30
09.30 - 11 .00
11.30 • 11.45
11.45 • 14.30
AIDS education . at the workplace, policy and strategy developmen� Dr M.A Khalil
Development and management of workplace AIDS education programme, Mr Thraya
Description of methodology for work sessions on preparing future country plans for HIV/AIDS education in the workplace, by Dr Shrestha
Work session on countries future action plan in AIDS education in the workplace
\Vednesday, 27 September 199S
08.00 - 13.30
13.30 • 14.30
Presentation on countries' future workplans
Recommendations and closing session
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Anncx 3
LIST OF PARTICIPANTS
CYPRUS
Dr Anna Nouska Medical officer Department of Medical and Public Health Services Ministry of Health Nicosia
Mr Mamas Georgiou Bank Employee Larnaka
EGYPT
Dr Mahmoud El Kest Director-General Information. Education and Communication Department Ministry of Health Cairo
Dr Ibrahim El Refai Director, AIDS Control Programme Gharbeya Health Directorate Responsible for Health Education El Mahala El Kobra
ISLAMIC REPUBLIC OF IRAN
Mrs Maryam (Farideh) Monshizadeh Samiee ,ert of Health Education
_,nistry of Health and Medical Education Teheran
Mrs Fatemeh Falaki Expert of Occupational Department Ministry of Health and Medical Education Teheran
JORDAN
Mr Nizar Al Bustami Health Education Physician Health Education Department Ministry of Health Amman
Dr Radwan Abdul Aziz Physician lrbid Governorate of Health Irbid
LEBANON
Mrs Nada Al Aghar Naja !EC Specialist National AIDS Programme Ministry of Public Health Beirut
Miss Nadia Bedran Social Worker SIDC Beirut
MOROCCO
Dr Hamida Khattabi
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Officer at Directorate of Epidemiotogy and Disease Control Ministry of Public Health Rabat
Mrs Souad Hanafi Chief of Division Family aud Children Affairs Ministry of Youth aud Spons Rabat
PAKISTAN
Dr Birjees Mazhar Kazi
EM/OPNI0&-E Page 17
National AIDS Programme Manager Ministry of Health Islamabad
Dr Najamuddin Najmi Director-General Workers Education Ministry of Labour Islamabad
Dr Shouket Ali Secretary-General Pakistan AIDS Prevention Society Karachi
Dr Sharaf Ali Shah Focal Person for AIDS Ministry of Health Karachi
SUDAN
Dr Oghail Al Nur Sewar Al Dabab National !EC/AIDS Coordinator Federal Ministry of Health Khartoum
Mr Muhielddin Jubara Worksite AIDS Education Coordinator Ministry of Labour Khartoum
SYRIAN ARAB REPUBLIC
Dr Issa Zaidan Al Marzouki Head of Health Education Division Ministry of Health Damascus
Dr Mahmoud Karim Minis tty of Health Damascus TUNISIA
Mrs Hayet Jedidi Chief of Health Education Service Division of Primary Health Care Ministty of Public Health Tunis
Dr Houda Ammar Physician
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Institut de Santt! et de Securitt! au Travail Tunis
REPUBLIC OF YEMEN
Dr Abdul Wahab Mohamed Al Ansi Ministty of Public Health Sanaa
Dr Shahid Mahmood Programme Assistant/Programmer Focal Point for AIDS Prevention International Labour Organisation Islamabad
Dr Bashir ul Haque Focal Point on AIDS Prevention The World Bank Lahore
Dr Sarnina Focal Point of AIDS Prevention
OBSERVERS
United Nations Development Programme Lahore
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WHO SECRETARIAT
Dr M.A. Barzgar WHO Representative to Pakistan Islamabad
Dr M.A. Khalil Special Adviser to the Regional Director EMRO
Dr P.N. Shrestha Regional Adviser Global Programme on AIDS and Other Sexually Transmitted Diseases EMRO
Mr A. Tbraya Health Education Specialist Global Programme on AIDS and Other Sexually Transmitted Diseases EMRO
Dr L. Zessler WHO Medical Officer Global Programme on AIDS Islamabad
Mr I. Chaudry WHO Operational Officer Lahore
MrsN. Zeid Secretary EMRO