Scapegoats for a real threat
PRESIDENT BUSH and other world leaders should use all possible diplomatic means to secure the immediate release of five Bulgarian nurses and one Palestinian doctor now jailed on trumped-up charges of infecting 400 Libyan children with the AIDS virus. A Libyan court commuted the medical workers' death sentences this week, but that reprieve is not enough. The larger issue behind their eight years of imprisonment needs to be addressed -- unhygienic medical practices.
The most common means of transmitting the HIV virus, which causes AIDS, are unprotected sex and the use of contaminated syringes by injection drug users. But especially in developing countries, blood transfusions and unsterilized needles and other items are also sources of infection.
In 2004, the World Health Organization estimated that blood transfusions account for 5 to 10 percent of all AIDS infections worldwide and contaminated needles in hospitals and clinics cause 5 percent. More recently, the National Academy of Sciences estimated that injections account for 1 to 3 percent of all infections. Any doubt that unsafe conditions at the Libyan hospital were the cause of the children's AIDS cases ended when a peer-reviewed study showed that some of the infections predated the arrival of the nurses and doctor at the hospital in Benghazi.
Helping countries to adopt anti-infection precautions and establish testing regimens for donated blood should be a priority of AIDS prevention efforts. President Bush's emergency AIDS relief program has earmarked more than $270 million for improving blood-supply safety, ensuring sterile needles and training medical workers in the safe use and disposal of contaminated equipment.
Of all the ways to prevent AIDS, ending infections in medical settings is among the simplest and least politically charged. It is far easier, for instance, than promoting safe sex or distributing clean needles to drug addicts, which some critics find morally objectionable.
Investments in a blood safety and universal precautions also help to prevent other blood-borne diseases, including hepatitis C. According to Eric Friedman of Physicians for Human Rights, the lack of safety in hospitals and clinics in the developing world is one reason for the brain drain of healthcare personnel to the industrialized world. Improvements in working conditions could keep nurses and doctors in the places where they are most needed.
Libya should not delay in releasing the five nurses and doctor. Their long detention has been unjust. Still, it will have served at least one purpose if it focuses the world's attention on the need to make medical settings safer.
