An estimated 41 children were infected with HIV in hospitals in Osh province, Kyrgyzstan in a single outbreak in 2007. Mothers are still trying to get the government to pay compensation after an investigation found that the infections were a result of negligence. The women are also demanding further investigations in case there were other undiscovered infections, in Osh province or elsewhere. Another 200 hospital transmitted infections have already been identified throughout the country and 17 new cases have been identified this year alone.
Unfortunately they are also demanding punishment for the health personnel involved. Of course, health professionals must behave professionally, and they should face the consequences when they are negligent.
But HIV prevalence in Kyrgyzstan is low, at about 0.1%. Where prevalence is high and conditions in health facilities are poor there could be a lot of similar outbreaks. However, in countries where skilled health personnel are scarce, systematic punishment of those found not to be complying with infection control procedures might have a lot of highly undesirable consequences. Many countries may even lack written procedures, training in their application or supplies required to do so adequately.
The children were infected as a result of receiving contaminated blood transfusions. In countries like Tanzania, up to 90% of transfused blood comes directly from family members and other donors, without going through the blood transfusion service. It is tested for HIV and syphilis once, but the risk of contaminated blood being passed in such conditions is very high. The blood is not tested for hepatitis.
In Kyrgyzstan, a sizable percentage of HIV transmission has been shown to result from unsafe healthcare. In Tanzania, where HIV prevalence is about 60 times higher, no such investigation has ever been carried out. Rather than carrying out such an investigation, UNAIDS estimates that the relative contribution of unsafe healthcare to be 1-2.5%, several times lower than the figure for Kyrgyzstan would suggest. And Tanzania has far lower standards of healthcare, as well.
Many Tanzanians and other East Africans may be protected from hospital transmitted HIV because access to health facilities is relatively low. However, you don’t improve the quality of health services by ensuring that as few people as possible receive healthcare. So, if UNAIDS want more people to avail of health services, including HIV related services, they should first check that health facilities are not risking transmitting HIV and other diseases.