HIV Trends: Defining “The Middle East”

To the Editor,

Although Gökengin et al. should be commended for a comprehensive and well-written study of HIV/AIDS trends in the Middle East and North Africa (MENA) region, their study is flawed by geographical syllogism.¹ MENA is based on a United Nations definition of ‘The Middle East’, which obsessively excludes one key country, Israel, for reasons that have nothing to do with Geography or Science. A PubMed search for the terms “HIV and Israel” lists over 2300 professional papers. The combined total for similar searches of bordering countries and territories (Jordan, Syria, Lebanon, Egypt, and Palestine) is only 964. Indeed, rates of AIDS in Israel are among the highest in the area, and are clearly relevant to any discussion of the problem (Figure 1 ).

Figure 1.

AIDS in Israel and bordering countries: annual rates (per 100 000 population).

A similar review of academia in the MENA region will conclude that only ten Nobel Prizes have been distributed among the 24 countries and territories of this region. Israel alone has produced twelve Nobel Laureates. So, how many Nobel Prizes have been awarded in the Middle East?

In 2003, an outbreak of severe acute respiratory syndrome (SARS) in the Western Pacific Region resulted in 916 deaths. One hundred and eighty (20%) of the fatal cases were reported by Taiwan, a country that is excluded from official reports and publications of the World Health Organization (WHO) Western Pacific Region – for reasons that (as in the case of Israel) are irrelevant to Geography or Science. If Gökengin et al. were to summarize the SARS outbreak based on WHO maps, they would conclude that these 180 deaths never occurred.

Funding: None.

Ethical approval: Not required.

Conflict of interest: No competing interest.

Corresponding Editor: Eskild Petersen, Aarhus, Denmark.