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AIDS: The Impact Of Unsafe Needles & Blood - 2003-08-22


The group Physicians for Human Rights says millions of HIV infections could be prevented by avoiding, what it calls, “unsafe health care.”

When HIV was identified 20 years ago as the virus that causes AIDS, western countries took action to protect their blood supplies. They also required medical personnel and dentists to wear gloves and masks and use only disposable syringes. That is, needles that can only be used for a single injection.

That wasn’t the case in many developing countries. It still isn’t. Holly Burkhalter is a member of Physicians for Human Rights.

She says, "Can you imagine going to the doctor and coming away with an incurable disease? That’s what’s happening."

She says, “In AIDS-burdened countries, leading authorities on the pandemic, as well as doctors and health ministers, have all failed to prevent infections from unsafe health care.”

She says current health policy focuses on heterosexual transmission as the overwhelming cause of HIV infection.

She says, "I think that’s the wrong way to look at the problem. I mean maybe their numbers are right or maybe they’re wrong. There are some who say, having scrutinized all of the available demography of the pandemic, that say there’s no way that 90 percent of the AIDS transmissions in Africa could be from heterosexual contact. That is not the way the epidemic has grown anywhere else on earth. In the United States, for example, it never broke out in the general population with that kind of speed or those kinds of percentages. It’s not that way in east Europe; it’s not that way in Asia."

Her Physicians for Human Rights colleague, Eric Friedman, says the emphasis on sexual transmission has left little money for other prevention measures.

He says, "Because dollars have been far, far too scarce and continue to be, the focus of the people working on this has been on sexual transmission. The particularly sad part is blood transfusion infections, we know how to prevent those. We know how to prevent, relatively simply, unsafe medical injections."

He says it’s a lot harder to change peoples’ behavior. Mr. Friedman also says many people in developing countries have a misperception about injections.

He says, "About 70 to 90 percent of injections in developing countries are given unnecessarily. Often it’s because there’s the perception that injections are the best form of medicine, from high tech western medicine. So they’re considered good when in fact many of the times injections are simply unnecessary at all. Other times, oral forms of medication could be given."

Holly Burkhalter has strong words for World Health Organization officials. She says of WHO’s 19 “core components” of effective AIDS policy safe injections is not among them.

She asks, "Why didn’t you? When you promoted your best practices for AIDS policy at the World Health organization meeting in Geneva three months ago – after all of this new data has come forward – how could you have missed, included in these 19 interventions you didn’t mention needles at all. And needles are thought to account by their own estimates for a quarter of the infections in India. How could they have missed it?"

On its website, The World Health Organization says, “Injections are meant to heal, not to harm. They should only be used safely and when needed.” It warns poor injection practices “are a waste of precious healthcare resources, transmit pathogens on a large scale; reduce productivity through an unacceptably heavy burden of disease.”

Ms. Burkhalter and Mr. Freidman expect the issue to get more attention next month at an international AIDS conference in Nairobi. Following that she says another meeting will be held in the Kenyan capital promoting safe injections.