UN Report Rejects African AIDS Data

The World Health Organization and UNAIDS yesterday rejected studies from a British medical journal that attributed two-thirds of AIDS cases in Africa to contaminated blood and dirty needles used by hospitals, clinics, and medical practitioners. A meeting in Geneva was called to review articles published this month in the British Royal Society of Medicine's International Journal of STD & AIDS (2002; Vol. 14; No. 3).

"Following a review of evidence, which included recent articles suggesting that a majority of HIV infections in sub-Saharan Africa are due to unsafe medical practices, particularly injections, the experts concluded that such suggestions are not supported by the vast majority of evidence," WHO and UNAIDS said in a joint statement. The statement also said "unsafe sex is the primary mode of transmission of HIV in Africa."

Authors of the original studies said they stood by their findings, which blamed heterosexual sex for "roughly one-third" of African HIV cases. "The [WHO/UNAIDS] report does not reflect the sense of the meeting and distorts facts," said David Gisselquist, a primary study author. "The report is grossly inaccurate to say there is no evidence. It can be ignored or denied, but it is there, and we talked about it."

An African immunization practices expert agreed that the report's emphasis was a "surprise." "The meeting was balanced. Both sides brought sound arguments. It does not matter if the risk [of HIV infection from needles] is 5 percent or 90 percent; ethically we cannot allow people to get HIV from unsafe practices. This is the feeling we all had and agreed on," said Dr. Jules Millogo, with Virginia-based BASICS, an immunization project funded by the U.S. Agency for International Development. Millogo, who attended the Geneva meeting, said it had been his expectation that the WHO/UNAIDS statement would emphasize the need for better medical practices, rather than undermine the credibility of the Gisselquist findings.

Experts in Geneva estimated that "unsafe injection practices" account for about 2.5 percent of HIV infections in sub-Saharan Africa.

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