Humanitarian aid: some political realities

multicentre study on sexual relations among young people in developing countries. mproving sexual and reproductive health requires action by areas of society beyond the health sector. Poverty and sex inequality increase the vulnerability of women to sexually transmitted disease and HIV infection. Early child bearing and high fertility are barriers to improving the educational and economic status of women and young people. w2 The Arab human development report emphasised that sexual discrimination is paralleled by prejudice against the young. 10 Patriarchal dominance and discrimination is worst when the two prejudices overlap-as in the case of young females. Religion is often used to rationalise old cultural traditions and social prejudices, as in the case of female genital cutting. owerlessness shapes people's health and life. Alleviating poverty is one route to empowerment, and access to information and services is another. Supply of information and services is, however, not enough. Young people need to be seen as assets, not problems. They should not be denied access to education and services in the hope that they will remain ignorant about sexual health issues that society would rather sweep under the carpet. Information and education does not encourage promiscuity, it helps young people to make responsible decisions to prevent unwanted pregnancies and sexually transmitted disease. w3 In this issue, Obermeyer reviews the evidence about HIV in the Middle East and North Africa. Given the still relatively low prevalence of HIV and AIDS in most of the countries in this region, we have a window of opportunity to prevent what will otherwise be an epidemic, when the disease spreads beyond the high risk groups. The cost of ignoring this window of opportunity will be high. Sexually active people must be given information and the ability to act on it through provision of services otherwise the opportunity will be lost. Preaching abstinence alone is not enough. The millennium development goals in the Middle East will not be achieved if women and young people are powerless.