amfAR, The Foundation for AIDS Research

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

Drs. Arash and Kamiar Alaei never thought they’d be arrested.  "When I sleep, I go back to prison in my mind," Kamiar told the Times Union of Albany, NY, where the brothers now reside.  The brothers spent more than two years in Iran’s most notorious prison, including stints in solitary confinement, and upon Kamiar’s release it would still be nine months before Arash would also be a free man.

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.” 

495-Alaei Brothers
amfAR Fundraising Chairman Sharon Stone presents Kamiar and Arash Alaei with the Elizabeth Taylor Award in Recognition of Efforts to Advocate for Human Rights in the Field of HIV.

However, as Kamiar told interviewers, “We did nothing wrong.  We are doctors.  We heal people.”  While accurate, this is an understatement.  The brothers began a modest HIV/AIDS harm-reduction program that would later be held as a global gold-standard and replicated internationally.  

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 lies 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.

August 2012 marks the anniversary of Arash’s release and the brothers’ reunion as free men.   On July 22, the Alaeis were honored at the International AIDS Conference in Washington, D.C., with the inaugural Elizabeth Taylor Award in Recognition of Efforts to Advocate for Human Rights in the Field of HIV—presented to them by amfAR Global Fundraising Chairman Sharon Stone on behalf of amfAR and the International AIDS Society.

The brothers may not be able to return to Iran under the current regime, but they plan to continue their work combating HIV/AIDS in other countries in the Middle East.  Their courage, compassion, and will to push forward in spite of great hardship continue to inspire.