Bloodborne HIV: Don't Get Stuck!

Protect yourself from bloodborne HIV during healthcare and cosmetic services

Geologists can’t find sand in Saudi Arabia!


OK, that’s not so. Geologists know there’s sand in Saudi Arabia. But what about health experts not finding HIV infections from health care in Africa?

All the best evidence says blood exposures in health care and possibly also cosmetic services – not sex — have been driving Africa’s HIV epidemics all along. (Yes, this is a controversial statement; so here are details and references[1].) But just like geologists who don’t know there’s sand in Saudi Arabia, health experts have only rarely identified HIV infections from health care in Africa. And when they have found evidence pointing to HIV from health care, they have mostly ignored and/or denied that happened. For example:

  • A self-declared virgin is HIV-positive? Experts say she lied (administering a double stigma – she’s a liar and a slut).
  • Baby is infected but mother not? Experts can’t deny that, so they ignore it.

I post this blog on the 40th anniversary of the first report of AIDS on 5 June 1981.[2] As soon as AIDS cases were discovered in the US, doctors recognized similar cases in Africa. In the 40 years from 1981 to 2021, medical researchers could have found and stopped HIV transmission through hospitals and clinics in Africa. But that hasn’t happened. No government in sub-Sahara Africa has investigated any unexplained HIV infection to find others infected from the same clinics and to find and stop the risks. Just let it happen, in other words.

When HIV transmission through health care has been so common for so long, how can health experts miss it? To miss it, experts have to be either naturally incompetent (simply not up to the job) or professionally incompetent (keeping quiet so as to keep their jobs).

Such consistent and widespread incompetence requires bad international leadership – discouraging people from finding and/or talking about HIV from health care. WHO, UNAIDS, CDC, and leading US and European universities and journals have helped to organize and enforce deliberate incompetence. Too many people have accepted bad leadership. As a consequence, Africans have suffered tens of millions of unnecessary HIV infections.

Finally, to avoid misunderstanding: sex is a risk. But it’s a secondary risk – people who got HIV from unsafe health care can infect unsuspecting sex partners. So: test sex partners for HIV, because you can’t tell from their sexual behavior if they might be infected. But don’t just worry about sex – blood exposures may be your biggest risk.

References

1. See chapter 6 in: Gisselquist D. Stopping Bloodborne HIV: investigating unexplained infections. London: Adonis & Abbey, 2021. Available at: https://sites.google.com/site/davidgisselquist/stoppingbloodbornehiv

2. Gottleib MS, Schanker HM, Fan PT, et al. Pneumocystis pneumonia – Los Angeles. Morb Mort Weekly Rep 1981; 30: 250-252. Available at: https://www.cdc.gov/mmwr/preview/mmwrhtml/june_5.htm (accessed 5 June 2021).

Who Guards the Guardians?


“Emergency, which service?” 

“The World.” 

“The World, sir?” 

“Precisely. The World must act to stop the collapse of Somalia.” 

“Is that Mr Vava Tampa?” 

“That’s right. This is an emergency.” 

“Sir, you have been calling emergency services a lot. Recently you requested assistance from Africa.” 

“If my memory serves me correctly, I said that Africa needs to rein in Tanzania’s anti-vaxxer president. But that’s old news, he’s dead now.” 

“You want ‘Africa’ to do that? The WHO assured Mr Magufuli that no Covid outbreak in East Africa justifies a lockdown. Look at the mess in Kenya and Uganda, with their ‘emergency’ powers and indefinite curfews.” 

“Africa must intervene. Magufuli is not the only leader who is off message on Covid.” 

“Africa must oppose the WHO? My mistake, I thought the WHO and Africa were working together on this. Oh well, perhaps Africa can turn their attention to Sweden, now. Before that you asked for the global community to intervene in the DRC?” 

“I did, that’s my country.” 

“You also criticized Barak Obama for not delivering for Africa in 2020, having called for him to assist in 2014?” 

“Yes! He’s a son of Africa and he turned his back on us!” 

“So, you now want Joe Biden to sort everything in Africa out?” 

“Well someone has to.” 

“Perhaps I was off the day you called on Donald Trump to help. Shouldn’t Joe check with ‘the global community’, or with ‘Africa’, before sorting everything out? They’ll all work together, right?” 

“I don’t think it’s your place to question headlines that appear in a renowned liberal media outlet.” 

“You’re right. Just to check, did France stop supporting Paul Biya?” 

“Is Africa on its way or not? I mean The World.” 

“Can you confirm that you are based in the UK?” 

“What’s that got to do with it? I’m an Africanist, activist, anti-imperialist, globalist, liberal…eh…journalist!” 

“We had a call from Belgium recently, someone claiming to be the rightful president of Tanzania. He seemed to think we could put him through to the US Embassy in Dar es Salaam.” 

“He got more than 10% of the vote. If it hadn’t been for those nationalists, with their slogans about Tanzanians deciding who to elect as president, he might have got 15%.” 

“Please toe the line, sir.” 

“Besides, Europeans are not able to travel anywhere at the moment. That’s because they CARE!” 

“I’ve been reading some of your articles since you started making calls to Emergency Services. You once wrote: ‘Black people are overmedicated, pathologized and overpoliced. The profession needs to work to dismantle racist power structures.’ ‘The profession’ being social workers.”

“And?”

“Would these power structures include the US, the UK, some parts of ‘The World’, perhaps even certain African countries? In fact, the UN, IMF, World Bank, global media, multinationals and other groups could also be dubbed ‘power structures’.” 

“This is an emergency. How dare you question my credentials! I’d like to speak to your manager, please.” 

“Your Twitter account says you’d like ‘@POTUS to back an International Criminal Tribunal to end violence/famine/impunity in #DRC. Where do you think imperialist oppression comes from?” 

“YOUR MANAGER! NOW!” 

“You have quite a record of calling on non-African people and institutions to overthrow African ones. Yet, you don’t like being questioned. Is it because I’m a woman?” 

“How dare you, I write for The Guardian! No newspaper is more pro-woman than The Guardian. And I’m pro-woman, too, so long as they are not already in the thrall of their oppressors.” 

“Maybe it’s because I’m black, or working in a menial position?” 

“You sound like you’ve got a chip on your shoulder.” 

“Not yet, sir, but there are plans for that.” 

“If you came from a country that had been oppressed for centuries you would have more respect for the work I do. Besides, you sound like you’re from Ireland.” 

“Give the man a cigar! What do you get for this, a bounty?” 

“History will judge you for the time you tried to frustrate the attempts of a true African to find fit leaders for each great African nation.” 

“We had another of you journalists on this morning, environmental correspondent. Tried to lurch to the right on a bypass, got stuck on the central reservation. Police blocked the traffic on the other side thinking he wanted to do a U-turn. But no, he wanted to go against the oncoming. Did a lot of damage to the central reservation. Especially considering he wasn’t even driving a car.” 

“I’m not going to ask AGAIN…!” 

“I may have forgotten to say earlier, calls are recorded for quality and training purposes. With the help of @God you’ll be a great leader, one day. Just putting you through, now.” 

“Good morning, Guardian Global Development Desk, how may I help you?” 

Global Health Tears the World a New One


The Felicific Calculus used by international institutions and global media has decreed that all the bad things in the world, whomever or whatever may have been blamed for them in the past, are now almost entirely accounted for by Covid-19. The world of ordinary people knows that the calculus is a hoax, and that poverty, sickness, disability, economic and environmental collapse, anything that is getting worse since the pandemic started, are a result of the response to it, not the pandemic. 

The English Guardian churns out another clickbait article, deeply concerned about the effects of Covid-19, seemingly oblivious to the fact that every item ticked off in their spreadsheet predates the virus by decades, even centuries. Other media have jumped in with organ trafficking, persecution of people with HIV, family planning provision, availability of sanitary pads, teen pregnancy, child abuse, domestic abuse, female genital mutilation (sic), child marriage, orphans and much else, striving to update their advocacy with the latest hashtags. 

And the universal solution to all these problems is technology! There are vaccines, masks, hand sanitizers, handheld computers and anything else that can be sold to people who have lived their whole lives without access to running water, an adequate and varied diet, in environments that have been depleted, to a large extent, by the same countries that produce all the technology and the purported solutions and their array of placebo suppositories. 

For the Guardian, decades of progress on extreme poverty is now in reverse due to Covid, so the title goes. But much of the ‘evidence’ for this is from a World Bank wonk, who pours out the usual sanctimonious spiel about all the great things that have been achieved, but that are now threatened by a pandemic. They are not threatened by a pandemic, they are threatened by the response to it. 

Bear in mind, this is the institution to which almost every poor country is in debt. Much of those countries’ annual earnings is sent to repay loans they have been persuaded to take over a period of several decades. A handful of international institutions have pushed poor countries to reduce public sector employment, spending on health, education, infrastructure and social services. Indeed, they have ensured the destruction of the very things that they now claim are vital to address Covid-19: hospitals, schools, infrastructure and social services. 

Poor countries are arm-twisted by such international institutions into handing over all resources that are of value to multinationals. Multinationals are not content to rip out everything they can get their hands on, but will happily destroy environments, communities, water supplies, economies and anything else, and leave behind an enormous tab for the host to pay. The very means to survive for most people, fertile land, water, food, employment, agriculture, etc., are denied to those countries in the name of modernization and development. 

The World Bank knows more than most about the conditions in poor countries, because they have spent so long reducing struggling economies to rubble. Countries that had anything worth exploiting were, effectively, colonized by poverty profiteers, people who were paid to take what they wanted, and often took a lot more. Media, like the Guardian, dutifully cover ‘disasters’ as if the damage they wreak on increasingly vulnerable populations is entirely unforeseen, unpredictable, an ‘act of God’. 

Since when has the World Bank been the go-to source of ideas for reducing poverty, or for improving the conditions that most people in the world live in? The countries that have followed their ideologies, as they gradually moved from the vile and despotic policies of 40 years ago to the most comprehensive and widespread enslavement and subjugation of people living in poor countries that we see today, are the ones suffering the most now. 

The only thing more disgusting than promulgating this kind of poverty porn is the pretence that the English Guardian, the World Bank or any of the other big players in the media, international financial institutions and the development industry have the slightest sympathy for those who suffer most from the conditions that underlie this veneer of humanitarianism and philanthropy.  

If these prognostications from the media are correct, and many things really have improved over the past 30-40 years, then we must return to where we were before the pandemic, and identify what we were doing right, and do more of that. Many things will need to be done differently, and the big players of the past will be reluctant to do anything not in their interest. But these lockdowns are a disaster and must be ended before the damage they are doing becomes irreversible. 

To those who herald in the ‘new normal’, there’s nothing new about poverty, disease, food shortages, droughts and disasters. Lockdowns exacerbate and further institutionalize phenomena that have been around for as long as people in poor countries can remember. There’s nothing new about authoritarianism, but we have been happy to overlook it when it was imposed on distant countries. It now threatens everyone and it’s not something to be encouraged. 

In Memory of Dr Joseph Sonnabend, 6 Jan 1933–24 Jan 2021


Dr Joseph Sonnabend’s first concern was always the welfare of his patients, their families and the people they loved. Before HIV was identified as the virus that caused Aids, Dr Sonnabend was treating people suffering from the shocking illnesses that he and others were discovering among their patients in New York, mostly gay men. Many people infected in the 1980s died. But some survived because of the work of professionals such as Joseph. He pioneered safe sex as a response to HIV and Aids among gay men, and gave his patients the undivided attention that few others were prepared to give.

Joseph set up and ran several institutions to address the epidemic, care for sick people and research the disease. But when some of his colleagues joined with other parties to create a myth about an imminent ‘heterosexual Aids’ pandemic in order to raise funding, he left. Joseph was branded a ‘denialist’ by those who didn’t wish to deal with any of the numerous concerns that he raised. However, Joseph continued to insist that you cannot understand the spread of a disease if you fail to identify the most important circumstances surrounding its transmission. He still held his ‘multi-factorial’ view of HIV a few months ago, in a discussion about the history of the pandemic with Sean Strub and Dr. Stuart Schlossman. When Schlossman claimed that no one held such a view any longer, Joseph disagreed, but did not have the opportunity to defend his position at that time.

Joseph told me later that his ‘multi-factorial’ view of disease transmission is a characterization of epidemiology as the study of pathogen, host and environment, and not an idiosyncratic theory of his own. He said that most people he worked with in immunology and epidemiology held a similar view, and did not reduce the explanation of HIV infection and the development of Aids to an account of the pathogen, alone, independent of host and environment factors. That’s why the multi-factorial view of HIV explains a lot more than its sexual transmission among men who have sex with men. The theory can also be used to understand the extraordinary outbreaks of HIV transmission among people who are neither male, gay, intravenous drug users, nor even sex workers. The worst of these outbreaks are all to be found in a few countries in southern and eastern Africa, including Zimbabwe and South Africa, where Joseph spent several decades of his life.

Joseph confirmed my belief that HIV is not ‘all about sex’ in high prevalence countries, and that the worst epidemics cannot be accounted for by alleged ‘unsafe’ sexual behavior among African people. He often asked how women can transmit HIV to men via sexual intercourse, saying he knew of no causal mechanism to explain it. Something about the host and the environment, African people and the conditions they live in, the experiences they have, the diseases they suffer, their crumbling healthcare facilities, their poverty and their position as former possessions of European powers could turn out to be a part of a credible explanation of the highest rates of HIV transmission in the world.

Joseph was concerned about the way people lived, their welfare, their “complete physical, mental and social well-being and not merely the absence of disease or infirmity” (WHO’s definition of health, not necessarily exemplified by their activities). He was not content with vaccines and cures, treatment regimens and medications, alone. In fact, Joseph was opposed to what he saw as the rapidly increasing ‘medicalization’ of healthcare, and disgusted by the systematic humiliation of African people, who were blamed for their own sickness and told to quietly accept what they were given.

Many people have learned a great deal from Joseph, and benefited from his work. He distanced himself from those who saw HIV and Aids as a launchpad for their own careers and ambitions, and he refused to get involved in the more lucrative side of the pandemic. He will be much missed.

Covid-19: Denialism, Brand of the Cultural Imperialist


The World Peace Foundation should be more circumspect when criticizing a country for its approach to Covid-19. The word ‘denialism’ has a distinctly pejorative use in the selectively diplomatic world of international health. Those using the word see themselves as right, empirically and morally, upholders of the orthodoxy, unassailable. 

The title ‘Tanzania’s Layered Covid Denialism’ is more inciteful than insightful, and calculatedly so. Clearly, the author does not believe there is more than one valid view. If you are not with the orthodoxy, you are against it, an authoritarian, intent on imposing your will on those you lead. 

On the basis of a handful of headline-grabbing titbits, several from Twitter, the author claims that “access to information about Covid-19 has become an elite privilege”.

Let me give you a real example of elite privilege: 

“Use of improperly sterilized syringes and other medical equipment in health-care settings can also result in HIV transmission. We in the UN system are unlikely to become infected this way since the UN-system medical services…use only new or sterilized equipment. Extra precautions should be taken, however, when on travel away from UN approved medical facilities, as the UN cannot ensure the safety of blood supplies or injection equipment obtained elsewhere;…avoid direct exposure to another person’s blood — to avoid not only HIV but also hepatitis and other bloodborne infections.” 

Note, the UN believes that their personnel risk bloodborne infections from healthcare facilities available to the public in Tanzania or South Africa. But they insist that those same facilities are safe for people living in those countries, because they claim that almost all HIV transmission is a result of unsafe sex and only a tiny fraction results from unsafe healthcare. 

For all his faults, Thabo Mbeki questioned the view that ‘unsafe’ sexual behavior could explain massive HIV epidemics in a few African countries, but nowhere else. He questioned that old western prejudice about ‘African’ sexual behavior, employed throughout history to justify numerous and lengthy lapses in ethical research and healthcare. 

Sadly, Mbeki was pushed into rejecting the far better supported view that Aids is caused by a virus, HIV. What he should have rejected was the view that HIV is almost always transmitted via heterosexual sex, because outside Africa, it isn’t. 

Mbeki was punished, branded a ‘denialist’, because he didn’t agree with the orthodox view, and said so. The international health community knows that HIV is not commonly transmitted via heterosexual behavior outside of a few African countries. They should have admitted that this serious anomaly tarnishes the entire orthodoxy. 

President Magufuli of Tanzania is certainly not in the same position as Mbeki, because Covid-19 is expected to kill relatively few people, especially compared to numerous pathogens that cause extremely high morbidity and mortality rates in African countries. 

With the economies of Tanzania’s partners under threat, and the strength of the global economy at stake, Magufuli imposed a less stringent lockdown than most other countries. Thankfully, outbreaks of violence, civil unrest, food insecurity and economic collapse seen in countries with similar economies to Tanzania’s were averted. 

Labelling someone a ‘denialist’, whether it’s about HIV or Covid-19, is an unmistakable piece of cultural imperialism. Magufuli’s initial response was entirely reasonable and sensible, more so than those of Kenya, South Africa and many other countries. Since you can’t shame the country into copying an almost global failure to address the virus, maybe you can learn from them?

The Sound of No Hacks Flapping


Silence may have been the most profound contribution to what we know about the Covid-19 epidemic in Tanzania. In fact, silence is the only truly sustainable measure to reduce the onslaught of questionable information emissions during the current infodemic. I hope to hear more of it. 

I am not referring to silence about cases, deaths, lockdown measures, masks and the like. I’m referring to the silence of the media about the terrifying consequences of extreme and irrational lockdowns. Tanzania didn’t follow other poor countries, so they don’t have to face such consequences. 

But there is silence in the mainstream media about the fact that Tanzania is peaceful, the economy is better than most, people are going to work, buying food in the market, agricultural production is little affected and children are going to school, and all because of their moderate response to Covid-19.

The media was all abuzz about what Tanzania’s President Magufuli said about praying and religious devotion, but not his advice about continuing to work, looking after families, sending kids to school and going to hospital in the event of any illness, including, but not limited to suspected Covid-19.

Negative impacts are reported in local Kenyan and Ugandan media, where rash curfews have been brutally enforced by police. But the mainstream media are not interested in that. We hear less about people persecuted, held in unhygienic and insanitary conditions, exposed to numerous health and other risks than we do about Magufuli questioning the efficacy of tests. 

There have been substantial increases in food prices, shortages of staple foods, with many in Kenya and Uganda facing starvation. Kenyan schools will reopen next year, by which time state school pupils will have missed almost a year of schooling. Both countries struggle to maintain law and order and keep their economies afloat.   

Uganda’s President Museveni is less widely quoted, but his only advice to his people was stay at home and pray, nothing else. There are no mainstream media articles about how astute Magufuli has been, nor mention of the moderate lockdown imposed in March, a more moderate one than their neighbors imposed, and for a few months, not indefinitely.   

Does this selective silence in the mainstream media suggest a tacit admission that they were wrong about how poor countries should best address Covid-19, wrong to sneer at Magufuli for his exemplary response, while ignoring the chaos that resulted from neighboring countries’ slavish obedience to wealthy donors?

Covid19 in Tanzania: Faith and Secular Institutions


The media have been quick to trumpet anything President Magufuli of Tanzania says about faith, or the power of prayer, in defeating Covid19. He has refused to address the epidemic in the manner prescribed by the WHO and numerous ‘experts’. Magufuli is anxious to keep things ticking over, as a developing country must.

Specifically, the president had no wish to risk the kind of economic meltdown or civil unrest that some developing countries are now experiencing. The WHO (Guardian, BBC, NY Times, etc.) had all the answers about Covid19, or so they would have us believe. But they are not responsible for the security and welfare of people who live in poor countries. 

Mainstream stories about Tanzania have come from social media, opposition politicians, NGOs and other parties whose views may not be entirely impartial. No one would claim President Magufuli has only ever made sound decisions during his five-year tenure. But standing up to international institutions, foreign donors and the media is a courageous move, one that most leaders will never make. 

Magufuli can be described as having done the opposite of what most countries have done. Or he can be described as having made the right decisions for a country where the majority depend on the informal economy for their livelihoods. Today’s journey, work, purchases and sales pay for today’s meals. Few pathogens can make staying at home, perhaps indefinitely, the better decision. 

Magufuli is frank in his belief that God will keep Tanzania safe. People want to go about their daily tasks in relative safety and security. Some may have little. But no one needs a lockdown to remind them how close they are to having less. Mafuguli refuses to accept the orthodoxy of institutions urging everyone to cower in their homes, indefinitely. This is far from blind faith.

Covid-19: Love the Sin, Hate the Sinner


If I were working for a UK government health agency, I would be obliged to sign a non-disclosure agreement and would be prohibited from sharing information about the agency. That’s standard, in public and private employment in the UK. 

The BBC and Guardian have been inviting people from government agencies to give them information that would breach such an agreement. Both outlets claim that people working in the public sector have given them confidential information about Covid-19 activities. 

Many, whether working for health agencies or not, will know that certain things published by these media outlets are biased; some of them don’t even sound credible. But who are we to judge the pronouncements of a free press in a democratic country? 

UK media report with glee how horrific things are in Sweden. But a UK doctor posts an article by a Swedish doctor, who writes that Covid-19 has been blown out of proportion. The UK doctor has tried to interest UK media, but only Russia Today ran the article.

Tanzania is reported as taking a ‘faith-based’ approach in an article in the BBC. Like Sweden, Tanzania implemented more moderate measures, sent children home from school, and reassured people that the lockdown was a short-term measure, that no one should panic. 

New Zealand seems to have been lucky, with few confirmed infections. However, a slight rise in cases and the coming election is postponed for a month. It will be in October, like Tanzania’s. 

Australia, in contrast, has announced that Covid-19 vaccination will be mandatory. That’s even before a vaccine, safe and effective for everyone, has been developed. Even people in favor of vaccinations may wish to object to mandatory vaccination against a virus that is not a threat to most people. 

Big social media is being cautious about saying the ‘right’ thing about Covid-19, as if there are true and indisputable things about the virus, and untrue, contemptible things, and moderators who can tell them apart. 

After the 2007 Kenyan election, when the country descended into violence and looting, people said they were told to stay inside, so they did, because there was a curfew. If they went outside for food they risked being shot, and accused of looting. 

This went on for months, there was starvation and displacement, schools, hospitals and other facilities were closed. Banks were closed as food prices rocketed, people tried to move to safer areas, but transport and infrastructure were disrupted. 

President Magufuli warned against scaremongering and advised people to keep working and running their households. He knew that if people panicked, peace would quickly deteriorate. What happened in Kenya in 2008 could happen in Tanzania. Indeed, things in Kenya now look similar to 2008. 

Before ridiculing Tanzania’s leader, accusing him of being irresponsible and undemocratic, implying that he has a naïve belief in religion, check which countries have food security and are at peace, and which are threatened with economic collapse and civil unrest.

With Responses Like These, Who Needs a Pandemic?


The Open Society Initiative has announced a Covid19 Emergency Response Fund. Great to hear, but first key area on their list is health system strengthening. Health systems have been in need of funding for decades.  

Second on the list is mitigating the economic impact of Covid19, but that is far more a matter of the devastating effects of lockdowns, people unable to work, purchase food, tend to food production, sell produce, etc. 

A few headlines highlight some of the emergencies faced by African countries and they seem to be either: 1) caused by the response to Covid19, not the virus itself, or 2) emergencies that go back many decades, and increase the harm that kneejerk lockdowns, curfews and the like can cause. 

Unemployment, nothing new, but exacerbated by global lockdowns: Nigeria Records 21.8 Million Jobless People After Covid-19 Effects 

Female Genital Mutilation, nothing to do with the pandemic, but NGOs need to follow the money: No Christmas for West Pokot Girls 

Economic inclusiveness, again, every cause needs to mention the current focus of the media: Covid-19 – Where to From Here for Efforts to Support Youth Economic Inclusion? 

The number of confirmed deaths from Covid19 in Africa is about a third of the number of people who die of rabies every year: Lessons From a Community-Driven Rabies Vaccination Campaign in Kenya 

Diabetes, a recognized risk factor for many conditions long before Covid19: Covid-19 – Understanding the Increased Risk in People With Diabetes 

Foot and Mouth, like all other health conditions, put on the back burner. If there’s an outbreak of this disease now, countries that have closed their economic and administrative functions down will be able to do little to protect themselves: Mozambique: Foot-and-Mouth Outbreak in Maputo Province 

Tourism, conservation, environmental and other projects, all threatened by lockdowns: In Kenya, Maasai Entrepreneur Moves Conservancy Beyond Tourism Hit By Pandemic 

Hardly surprising that food prices have rocketed. They are unlikely to drop anytime soon. Unlike most articles on the pandemic/response, this one identifies other pressures driving up food prices, all of which were there before Covid19, but are made a lot worse by the response: Food Prices in Nigeria Have Shot Through the Roof 

If countries can’t get food locally, or import it from other countries because they can’t get around restrictions on movement and trade, they may end up depending on illicit trading, black markets and other threats to economic and political stability. The above list is from today’s AllAfrica.com newsletter, not at all exhaustive, unfortunately. 

Many are now questioning the wisdom of rigid Covid19 responses urged on them by international institutions, NGOs, donors and foreign leaders. Tanzania is one of the only one to impose a modest lockdown with a viable exit plan. Other countries could soon follow their example. None can afford the millions shelled out by rich countries. 

Adversarial Public Health is Counterproductive


There’s a familiar feel to the shaming of national leaders, and anyone else who questions the received view of Covid19, in any way. Few dare to do so. There seems to be a lot of fear, and the belief that everyone is at risk is still common.

Back in 2012 there was an article in the Tanzanian Daily News about calls for compulsory HIV testing for all. Thankfully, serious objections were raised, and it never happened. But the received view of HIV remains that it’s almost all a result of unsafe sex, though there is no evidence for this.

One of the numerous objections to mass HIV testing was that poor nations don’t have the capacity to test everyone, even if they would agree to spend the millions such an exercise would require. The same objection could be made about Covid19 testing. How often would mass testing have to happen? Once? Every year?

Writing about HIV in 2012 I suggested that some public health approaches to HIV could be seen as ‘adversarial’. A few years later, the massive Ebola outbreaks in West Africa brought civil unrest, with public health professionals accompanied by armed security personnel hunting down people suspected of being infected.

Colonial era syphilis eradication programs in African countries involved threats, lies and extremely painful injections, which some of the colonial administrators felt made the programs more worthwhile. Unfortunately, it only made it more likely that people wouldn’t turn up for the full course of injections.

Tanzania’s President Magufuli questioned the reliability of tests and this event was widely reported. He said that he had tried out the tests on a goat, a papaya and other non-human subjects, and several of them tested positive for Covid19.

But Magufuli raised an important point about false positives from tests, and there’s a good account of why this is so vital in a blog post entitled ‘Why Covid-19 is Guaranteed to Never End’. The author even mentions that Magufuli’s demonstration is not unprecedented.

International media coupled Magufuli’s tests with Twitter rumors of huge outbreaks and night burials of alleged victims of the virus. But ‘Disco funerals’ were reported to have occurred in Western Kenya in 2014, and it was claimed that there was a risk of unsafe sex (=HIV in African countries, apparently) during these events.

The US Embassy in Tanzania issued a warning against visiting the country because, although they had no evidence, they believed the epidemic was extremely serious. They had Twitter posts to back this up. At the same time, calls were being made to censor Twitter and Facebook posts that disagreed with the received view.

When Magufuli addressed the press about his decision to keep public health measures moderate, and vowed that he would not allow day to day economic activity to be jeopardized, he warned against the dangers of spreading fear and of scaremongering.

Media jeering at and shaming ‘dissenters’ during infectious disease outbreaks, including predicted and alleged outbreaks, may be nothing new. So it’s worth noting that a number of HIV, Ebola, hepatitis C and other serious infectious disease outbreaks have occurred in healthcare facilities, as a result of unsafe healthcare, something you’ll rarely read about in mainstream media.

If global efforts to address infectious disease epidemics propose the continued use of fear, ridicule, shaming and bullying, in collusion with a sycophantic and slavish media, they can expect more responses like Magufuli’s in the future. Everyone needs protection from harm caused by destructive and costly lockdowns.