SIGN Meeting 2003, 18-20 September, Nairobi, Kenya
Executive summary
Unsafe health care practices contribute to the spread of HIV and other bloodborne pathogens
A number of health care procedures may lead to the transmission of HIV to patients, health care workers or the community at large. These include (1) transfusion of infected blood, (2) unsafe injections and (3) other skin-piercing procedures performed in the absence of universal precautions. Thus, safe health care services should offer to their users (1) a selection of blood donors, testing of blood units, appropriate clinical use of blood, and when applicable, viral inactivation of human material for therapeutic use, (2) safe and appropriate use of injections – which includes sharps waste management - and (3) procedures conducted according to universal precautions.
Health care-associated HIV infections and other bloodborne pathogens can be prevented
Interventions to prevent these health care-associated infections are available, effective and highly cost-effective. The transmission of HIV infection in health care settings can be prevented with only a modest shift in the assignment of resources, for two reasons. First, blood safety, reduction of injection overuse and injection safety are not costly interventions. Second, the majority of HIV infections worldwide are caused by unsafe sexual practices. While the emphasis of HIV prevention programmes should remain on preventing sexual transmission, efforts to make health care safer should not be neglected.
Strengthening health systems to prevent HIV infections
HIV prevention and care programmes should participate and spearhead interventions for safer health care within cross-cutting health care-strengthening initiatives. This can be achieved through (1) communication and behaviour change, (2) provision of single use injection devices and infection control supplies and (3) safe health care waste management. Global alliances of stakeholders, including the Safe Injection Global Network (SIGN) can assist in the creation of national infection control coalitions. The Global Fund to fight AIDS, Tuberculosis and Malaria as well as the World Bank “Multi-country AIDS Programmes” (MAP) and other funding partners provide an opportunity for countries to finance and scale up interventions through the provision of essential equipment and supplies. Through that approach, everyone will become involved so that the current initiative for “access to care” can become an initiative for access to safe health care.
The Safe Injection Global Network (SIGN) Secretariat
Department of Essential Health Technologies (EHT)
World Health Organization
20 Avenue Appia, Rm. M 22
CH- 1211 Geneva 27
Switzerland
Tel: +41 (22) 791 12 75 (direct)
Fax: +41 (22) 791 48 36
E-mail: sign@who.int