[afro-nets] Obama on AIDS- debates on needle Exchange programs

This week's edition of SIGN / WHO quotes from the Washington Independent on US contradictions in policies regarding needle exchange program for IVDU. (see below) On that, just coming back from the French national meeting on nosocomial infection, and meeting former WHO experts on the subject of hospital acquired infections, we must add a few comments:
1) It is true that IVDU contract HIV from dirty needles, and that clean needles are essential to save lives,
2) Poor people also contract HIV from sharing syringes throughout Africa and silence on the issue is scandalous. At the ICASA conference in Abuja two years ago, Professor Weinberg agreed and said in substance: We not only need the slogan: clean needles for IVDU, but we also need to say a clean syringe for every African in health care.
3) IVDU contract HIV even when using clean needles when large containers of drugs are contaminated with HIV by unscrupulous dealers using old dirty syringes to mix drugs- This is an important and well identified means of infection for drug users (according to UN report on drug use in Asia)
4) Poor people also contract HIV from multidose vials - or catheters when improper procedures are used (ie changing needle but not the syringe)- Reminder in 1997 it was found that over half of North American use of anesthesia was improper and potentially contaminating patients because of multidose vials. In 2006-2007 over 250 babies were contaminated with HIV that way in Kazakstan and Kirghistan
5) Last but not least, for people who already have contracted HIV -PLWHAs-, clean injection in health care, in dentistry, etc, it a life and death question. PLWHAs should mobilize like hell against dirty injections in LMICs Latest figures show that in SS Africa 20 to 70% of patients contract a hospital acquired infection!!
We need to tell OBAMA: SAY YES TO NEEDLE EXCHANGE PROGRAM *AND* LAUNCH A GLOBAL CLEAN INJECTION CAMPAIGN TO STOP HIV SPREAD IN AFRICA!
By Mike Lillis, The Washington Independent - Washington, DC, USA (29.01.09)

Bush-era envoys to the United Nations are trying to block global efforts to promote HIV/AIDS-prevention programs such as needle exchanges, according to health and human rights advocates who supplied documents of the negotiations. The envoys' opposition runs directly counter to the stated position of President Obama, who supports lifting a ban on clean- syringe programs that's existed in the United States for 20 years. The saga unfolds as the members of the United Nations are busy drafting a non-binding declaration of global drug-policy goals for the next decade. Although a number of countries — many in the European Union — are pushing hard to include language promoting "harm reduction measures," including syringe-exchange programs shown to prevent needle-born illness, the U.S. representatives have already lobbied that provision out, according to health and human rights groups familiar with the negotiations.

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g_upham@club-internet.fr

Friends,

Claudio Shuftan makes good points: We should advocate not only for harm reduction (safe injections for IDUs) but also safe injections in health care.

To ensure safe injections (and more generally safe health care) it is not enough to simply tell or teach health care workers to be safe. The Expanded Program on Immunization began to advocate for safe injections in Africa in 1974 -- injections still are not safe. What more can we do? Here are some suggestions. Are these workable? What else might work?
(1) We can advocate for investigating unexplained HIV infections to find where they have come from -- testing others who attended suspected facilites, as was done in Russia in 1988-89, Kazakhstan in 2006, etc.
(2) We can warn the public that HIV lives in trace amounts of blood on used skin-piercing instruments for hours (dry) and weeks (wet).
(3) We can advise people to demand Patient Observed Sterile Treatment (POST) -- that is, to demand proof that invasive procedures are safe; for example, patients can ask to see syringes and needles come from sealed plastic packages, and to see medicines come from single-dose vials.

What else might work?

David

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David Gisselquist
mailto:david_gisselquist@yahoo.com