Public Health Leaders Should Use Global AIDS Initiative Funds to Curb Health Care Transmission of HIV, Sen. Sessions Says

Public health leaders should use the opportunity of "an unprecedented commitment" to fighting the HIV/AIDS pandemic on the part of the Bush administration and Congress to "mitigate the health care transmission aspect" of the epidemic, Sen. Jeff Sessions (R-Ala.) writes in a letter to the editor of the Washington Post. Sessions says that "a spokesman for the World Health Organization" in a Sept. 3 letter to the Post editor "was reluctant to address the extent of the spread of HIV in Africa through unsafe medical practices" (Sessions, Washington Post, 9/19). Paulo Teixeira, WHO HIV/AIDS program director, and Marika Fahlen, director of social mobilization and information for UNAIDS, wrote in their letter that unsafe sex "continues to be the predominant mode of HIV transmission in sub-Saharan Africa" and should therefore continue to be the primary focus of HIV prevention programs. Teixeira and Fahlen were writing in response to an Aug. 21 Post opinion piece by Holly Burkhalter and Eric Friedman of Physicians for Human Rights' Health Action AIDS Campaign that called for a shift in the focus of HIV prevention programs from safe sex programs to the prevention of unsafe medical practices. Although Burkhalter and Friedman "rightly" point out the need to address unsafe health care procedures as part of a "combination of prevention measures," such procedures account for only 10% of new HIV infections, Teixeira and Fahlen said. UNAIDS and WHO recognize that a comprehensive approach to HIV prevention is needed, including programs that target unsafe sex, mother-to-child HIV transmission, unsafe blood and blood products and unsafe injections, Teixeira and Fahlen concluded (Kaiser Daily HIV/AIDS Report, 9/3).

"Moral Failure"
According to Sessions, almost 1,000 people every day in Africa are infected with HIV through previously used injection equipment or contaminated blood product transfusions. Safe Blood for Africa, a not-for-profit group, says that about 15% of the blood supply in sub-Saharan Africa is contaminated with HIV and about 20% is contaminated with hepatitis, Sessions says, adding, "Far too little attention has been paid to the systematic correction of these widespread unsafe practices that result in disease transmissions." Although WHO estimates that 2.5% of HIV cases are attributable to unsafe medical practices, "a substantial body of evidence suggests that the true figure may be much higher," Sessions writes. He says that such "major" sources of HIV infection "can be almost eliminated" for about $70 million a year, which would go toward safe blood and clean needle programs in the 12 nations covered under the global AIDS initiative. If HIV transmission through unsafe medical practices is not stopped, "the result will be a colossal health care and moral failure," Sessions concludes (Washington Post, 9/19).

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