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Ebola and ‘African’ Sexuality: Life in the Old Fantasy Yet?


“Ebola can be transmitted sexually for weeks after recovery – education is crucial”, blurts the English Guardian headline of an article written by an academic from an English development institution.

Not one single case of sexually transmitted ebola has ever been demonstrated, in nearly 40 years. The presence of the virus in some form in semen has been demonstrated. But the possibility that the virus can be transmitted via that semen has not. And the author is even, to some extent, aware of this.

So why do the media rant on about sexually transmitted ebola? Could it be a continuation of some of the racist views of Africans that date back many decades, perhaps centuries? Several decades (at least) before HIV was identified, it was assumed that prevalence of certain sexually transmitted infections in African countries, such as syphilis and gonnorhea, was a result of ‘promiscuity’.

More enlightened researchers published papers, also decades ago, arguing that there was absolutely no evidence that levels of ‘promiscuity’ were higher in African countries than elsewhere. Some of them also argued that the conditions of health services, along with the living and working conditions to which people in colonial Africa were subjected, were far more significant factors than sexual behavior.

Some of them were reacting to the efforts of the various different eugenics movements to provide ‘scientific’ evidence for their extraordinary views. However, once HIV was identified and found to be more common in some African countries than anywhere else, the myth of ‘African’ promiscuity returned. And it remains, explicitly or implicity, in HIV policy, journalism, and in much of the academic writing.

The characterization of African people as promiscuous goes hand in hand with the characterization of African men as sexually incontinent, animalistic, uncaring about those around them, particularly their own family members, and completely unamenable to change.

African women are seen as being entirely incapable of resisting the will of the men around them. They are mere victims, misused and discarded, to be ‘rescued’ by decent westerners, if they are lucky. They are then subjected to the pity of their rescuers, the journalists who write about them, and others who think this sort of thing ‘just shouldn’t happen’.

The author claims to have met with members of a women’s ‘secret society’. We are informed that such societies are “ancient cultural institutions found all over Sierra Leone”. We can’t gainsay that if we’ve never been to Sierra Leone, after all, they are secret, although we might ask how secret they are if the author could meet with them.

But, far more important than the claim that ebola is transmitted sexually (and it might be, occasionally), is the tone of the article, about how much women suffer, with the strong implication that this is the fault of Sierra Leonean men. But poverty, bad health, low levels of education, poor living conditions and terrible labor conditions are a fact of life for most people in Sierra Leone, male and female.

Education may be, as the headline says, crucial. But whose education is crucial? Whose knowledge? Whose data? Whose research? This academic seems to have recorded the result of decades of racist informed education, and now presents it to us as the unassailable views of Sierra Leonean women, at least, the ones who belong to these common ‘secret’ societies.

However, there are promiscuous people everywhere, but most people are not promiscuous. There are violent and abusive people everywhere, and the perpetrators may well be more likely to be male than female. But most people are not violent or abusive. Most men are not. And most women are not mere victims of everything that goes on around them.

This is not to say that there are not huge imbalances and great injustices, with many women suffering, often at the hands of men. But whatever strategy may bring relief to the suffering of women and men, it will not be one based on a puerile and reductive belief in the incredible baseness of African men, coupled with the complete inability of African women to defend themselves in any way.

Ebola, HIV, hepatitis, TB and many other diseases can be transmitted in various ways. One of the modes of transmission for all of them is unsafe healthcare, believe it or not. In the case of HIV, such transmission has been strenuously but entirely unconvincingly denied. Sex is one of several modes of transmission for HIV, but it is unlikely to be a significant mode of transmission of ebola.

But transmission of ebola through unsafe healthcare practices appears to be slipping through the net, as academics indulge in their fantasies about an assumed ‘African’ sexuality, along with a great love for seeking (female) ‘victims’ that they can rescue, study, and hopefully write scholarly(ish) papers about. These academics are not just deceiving themselves, they are deceiving those they claim to be concerned about.

Medical Costs: Protectionism Harms Children


Originally posted on Blogtivist:

This is reposted from the Watoto Kicheko blog.

One of the big expenses that parents (and orphanages!) face in developing countries like Tanzania is the cost of medicines and treatment. Even healthy children need vaccinations and have lots of other health needs that can only be met using pharmaceutical products. Medical costs run high.

You might think that developing countries would pay less for lifesaving medicines and vaccinations, but you would be wrong. Medical costs are often disproportionately high in poorer countries. Pharmaceutical companies negotiate prices in secret, and countries often have to sign a confidentiality agreement in the process.

Medical costs disproportionately high in developing countries

Apparently “Tunisia pays more than France; South Africa pays almost three times more than Brazil.” But it’s hard to compare what countries like Tanzania pay for medical costs because of the secrecy surrounding this industry, all cloaked by vague claims about ‘commercial sensitivity’.

Medical costs - one of our sick girlsThere’s…

View original 389 more words

US Funded Circumcision ‘Research’ & ‘Interventions': Human Rights Abuses?


The Kenyan Daily Nation newspaper reports that at least 30 boys have been forcibly circumcised, some of them as young as six years old, in Eldoret. It is said that an ‘NGO’ called Impact Research Development Organization was behind these forcible circumcisions.

Impact Research Development Organization (IRDO) is quite secretive, with several websites and Facebook pages that give very little detail about who they are, how they are funded, and to whom they are accountable. One of the latest incarnations, http://www.impact-rdo.org/, is still under construction. The owner of the domain is given as ‘Safaricom’, effectively an anonymous identity.

But one of the Facebook pages may answer some of those questions: in a photograph of about thirty black people, twentynine of whom are male, there is the unmistakable white face of ‘Dr’, ‘Professor’ (of epidemiology) Robert C Bailey, of the School of Public Health, University of Illinois at Chicago.

Aggressively pushing mass male circumcision as an antidote to HIV and a host of other possible ailments for more than twenty years, Bailey’s name has appeared on many of the published papers promoting the operation, with even the wildest of claims remaining unchallenged by most other academics.

His ‘NGOs’ may have undergone several name changes for good reason. He is one of the biggest recipients in Kenya (where about 85% of men are already circumcised) of the hundreds of millions of dollars said to be available for mass male circumcision programs. But the fate of some of those millions of public dollars is not always transparent.

Another of his ‘NGOs’ is called the Nyanza Reproductive Health Society (NHRS). The NHRS is similarly secretive and merely recycles the same sort of publicity blurb as IRDO. Kenya’s Standard newspaper covered the allegations of misuse of funds by NHRS a few years ago.

The Nation author seems impressed with the fact that the children were said to have been ‘lured with sweets’, which is probably the mass male circumcision campaigners’ pediatric version of luring people with bullshit about how circumcision, not only ‘protects’ you from HIV and other STIs, but also ensures greater attractiveness to women, better orgasms and ‘hygiene’ (as if intact men are unable to clean their penises and circumcised men don’t need to!).

Although circumcision is contrary to the cultural practices of the communities that the victims come from, incidents like this don’t appear to have resulted in any greater recognition of how serious a crime this is. In contrast, there is a lot of international money and attention for preventing female genital mutilation, especially where this is in keeping with the cultural practices of the communities where it is practiced.

Is it because those involved are male that this is not really seen as mutilation? It is clearly a denial of the right to bodily integrity. Carrying out an operation that involves removal of healthy flesh without consent is always wrong; it is always mutilation, regardless of the gender of the victim.

Perhaps because the money comes from the US, where male circumcision is very common, it is felt that Kenyan people should just put up and shut up (as they seem to have done so far). This is an issue for Kenyan people of all ethnicities to address themselves, whether they practice circumcision or not.

Kenyan children have a right to be protected from such abuses, as do Kenyan adults, male and female. It’s time to question large amounts of money being made available to carry out dubious ‘research’ projects, with Kenyans being used as cheap research fodder.

Manufacturing Evidence for Sexually Transmitted Ebola?


Ebola researchers are still working furiously to gain recognition for ebola as a sexually transmitted infection (STI). The New York Times has been spearheading the media echo chamber’s support for this desperate attempt to blame African people for their illness. ‘Sexually transmitted ebola’ is the culprit, and must be found at all costs.

The reason for the desperation is that, as yet, there is no evidence ebola has ever been transmitted sexually, in the 40 years since the virus has been recognized. Sexually transmitted ebola remains a mere theoretical possibility. Worse than that, a good deal of evidence suggests that the virus is very easily transmitted through unsafe healthcare practices.

Even the media, in it’s great hindsight, has pointed the finger at healthcare as being a weak point in impoverished African countries when it comes to fighting disease, and dealing with massive outbreaks like the one seen last year in several West African countries. But the media are not so good at following that insight to its logical conclusion.

So the ebola campaign seems to be taking a leaf out of the HIV book: UNAIDS, an institution that has been smearing African people for being ‘sexually promiscuous’ for nearly twenty years, is apparently lending a hand. When HIV positive people say they are not promiscuous, as many are not, they are not believed. If evidence for sexually transmitted ebola can not be found, it must be manufactured.

The tradition of wagging accusing fingers at African people about their sexual behavior goes back many decades, long pre-dating the identification of HIV. Eugenicists (often restyled as ‘family planning’ NGOs) and neo-eugenicists have been at it for at least a century.

Even programs to deal with syphilis and other STIs involved a lot of finger wagging and exhortations to address sexual behavior, although many of the big outbreaks had little to do with with sexual behavior and a lot to do with the conditions that people had to live in during colonial occupations.

Thus with ebola, the husband of a woman who died of the virus was asked for a semen sample, as he had recovered from it some time before. He refused and said he had been impotent since recovering from ebola. The doctor leading the investigation said he didn’t believe the man. The doctor is clearly convinced that he has already found a case of sexually transmitted ebola (one out of many thousands) and just needs evidence, however extreme the measures needed to acquire it.

Not believing patients and adopting a ‘veterinary approach’ is part of a pattern in HIV epidemiology. When it is reported that people had ‘no risks’ for HIV, that doesn’t seem to include risks for healthcare transmitted infection. So saying that the man’s wife had no risks for ebola may not exclude healthcare risks, we just don’t know.

The doctor suggested that the man was afraid he would be implicated in his wife’s death, which is not an unreasonable fear, given the way some of the reported ebola programs have been carried out. Many people seem extremely frightened of ‘officials’, and the ‘space suits’ some of them wear is unlikely to be the only cause of that fear. Now, ebola campaigns seem intent on frightening people about sex, by dangling in front of them the fear of sexually transmitted ebola.

But the story just gets more bizarre. A female UNAIDS ‘counselor’, said to be an expert in human (allegedly) sexuality, was employed to ‘talk’ to the man before he tried, unsuccessfully, to produce the semen sample. The man said that two other men, whom he assumed to be doctors, joined the UNAIDS ‘counselor’ and “tried to manually stimulate him with soap while pornographic videos played on a laptop”.

The history of UNAIDS and the HIV industry’s attempts to stigmatize Africans by insisting that heterosexual sex accounts for almost all HIV transmission in African countries (but not elsewhere) makes that obscene scenario seem quite believable. The doctor leading the investigation claims none of it happened, he just supplied the video and laptop, but working with UNAIDS will not improve his credibility.

The similarities between ebola and HIV programs continue with the steadfast refusal to consider the possibility that unsafe healthcare resulted in both the ebola and HIV epidemics. Why is it not possible to investigate the role of unsafe healthcare and deal with it? There are shortages of equipment, supplies, personnel, skills and the like, vital to ensure good and safe practices: healthcare transmitted ebola and HIV can not be ruled out.

Unsafe healthcare has resulted in massive outbreaks of hepatitis, particularly hepatitis C in Egypt, of tuberculosis (TB), particularly drug resistant TB in South Africa and neighbouring countries, and of ebola in all the outbreaks before the recent ones in West Africa, such as those in the Democratic Republic of the Congo and Sudan.

If healthcare transmitted ebola, HIV, TB, hepatitis and other diseases remain unacknowledged and unaddressed, massive outbreaks like those seen in many African countries will continue. The search for ‘sexually transmitted ebola’, like the search for ‘sexually transmitted HIV’, will deflect attention from the very real, and very deadly problem of unsafe healthcare in Africa.

More about State Sponsored, Gender Based Violence in the US and Africa


Victims of the Guatemala Syphilis Experiment (1945-1956) failed in their attempt to sue the US Government for actions that a presidential bioethics investigation admitted “involved unconscionable basic violations of ethics” in 2010; the judge declared that “the US government cannot be held liable for actions outside the US”.

So the victims have now launched a lawsuit against the Johns Hopkins University over its involvement, something the university has ‘vigorously denied’. The university has expressed ‘profound sympathy’, which I’m sure the victims and their families will appreciate.

These vigorous denials were echoed by the Rockefeller Foundation, who also claim to have had nothing to do with the experiments. Big Pharma giant Bristol-Myers Squibb declined to comment.

This infamous episode in the history of American public health experimentation overlapped with the much longer and more extensive Tuskegee Syphilis Experiment (1932-1972). Although this occurred within the US, the victims were African-Americans, so the vigorous denials and profound sympathies were not deemed necessary until some time after the experiments had been halted.

Carrying out questionable public health programs in non-US countries by US institutions is a lot more common now. Injectible Depo Provera hormonal contraceptive (DMPA) is rarely used among non-white or wealthy populations, inside or outside the US. This is despite the fact that the drug has been shown to double the rate of transmission of HIV from HIV positive men to HIV negative women, and from HIV positive women to HIV negative men.

The vigorous denials continue: just search for #DMPA on Twitter and the same faces come up over and over. The tweeters often attack anyone questioning the use of DMPA, especially among poorer non-white women in the US and among people in African and Asian countries, where it is often the most common form of birth control used.

Those defending DMPA don’t generally deny that it doubles HIV risk, as they are often among the research teams who estimated this risk in the first place. They tend to argue that a doubling of risk is not high enough to warrant issuing proper warnings, and that the risk of being infected with HIV is not as serious as the risk that those using DMPA may have an unplanned pregnancy, as if there are no other contraceptives available!

Spite towards Africans expressed through dangerous ‘public health’ programs was entirely normalized once it was decided, for purely political reasons, that HIV should be marketed as a sexually transmitted infection that heterosexuals were very likely to contract and transmit.

Although the virus mainly infects men who have sex with men (MSM) and intravenous drug users (IDU) in wealthy and middle income countries, it mainly infects people who are neither MSM nor IDUs in Africa. In fact, the largest demographic infected in most African countries is women from their mid teens up to their late forties.

How could this be so?

Well, if you’ve ever had the misfortune of being treated in an African hospital, given birth there, or even just visited someone you know, you will find it very easy to believe that unsafe healthcare constitutes a huge, but under-researched risk. Less of a risk, but also under-researched, are unsafe cosmetic and traditional practices.

Consider this when reading about some of the experiments carried out in Guatemala: “Prostitutes were infected with venereal disease and then provided for sex to subjects for intentional transmission of the disease”, syphilis was injected into the spinal fluid of some victims.

Children were also subjected to these ‘experiments’, as were orphans, prisoners and mental health patients. Some of those involved were worried about what people not involved might think if they found out, but they don’t seem to have worried about their victims; one woman is reported to have had gonnorheal pus from a male subject injected into both her eyes.

But it’s not only African (or African American) women that are so maligned by wealthy western institutions that massive ‘public health’ experiments can be carried out using public money, often resulting in private gain, with total impunity. The English Guardian article notes two ‘experiments’ carried out on men, aiming to infect them with sexually transmitted infections and then watching the effect this had on them, their families and others around them.

For example, “An emulsion containing syphilis or gonorrhoea was spread under the foreskin of the penis in male subjects” and “The penis of male subjects was scraped and scarified and then coated with the emulsion containing syphilis or gonorrhea”.

This obsession with sex, sexuality and sexual organs continues to occupy publicly (and privately) funded western HIV scientists in African countries. Research into non-sexual transmission of HIV is almost unheard of, except in the form of ‘vigorous denial’ that it ever occurs.

The enormous Mass Male Circumcision programs (MMC), which have attracted several billion dollars, are targeting tens of millions of Africans. And yet they are predicated on the view that HIV is almost always transmitted through heterosexual sex, a view that is entirely based on the prejudice of ‘experts’. (There are over 100 posts about mass male circumcision on this blog).

These circumcision programs are targeted, like Tuskegee, Guatemala and the use of Depo Provera, at non-white, poorer people, often African and female (while the MMC programs must target men, the operation has been shown to double transmission from males to females).

Data collected is often published selectively, to promote funded interests, and anything that suggests the programs are harmful is either uncollected, ignored or remains unpublished. Those criticizing such practices are attacked, branded, ridiculed and persecuted by professional (and often very well qualified) trolls.

In years to come, articles in the English Guardian may describe these appalling practices, that occurred in the past, as if they could never happen in the present. But similar phenomena continue to occur, with funding from western governments, ‘philanthropists’, academic institutions and others, while the public (and the media) look the other way.

Instances of State Sponsored Violence Against Women in Kenya and the US


The English Guardian has an article on the decision of a Kenyan court to amend a law that criminalizes certain instances of HIV transmission, potentially including transmission from mother to child. But the author misses the true injustice of the law, which is one of many instances of woman bashing and victim blaming that the HIV industry and the media have made their staple fare.

The true injustice is that many women in African countries are infected with HIV through non-sexual routes, probably through unsafe healthcare, but also possibly through unsafe cosmetic and traditional practices that involve skin piercing. These infections are avoidable: women need to be told that they face such risks, that HIV is not just a sexually transmitted virus, that it is not even predominantly sexually transmitted.

As long as the media continues to spew out the misogynistic rubbish they receive from UNAIDS and the HIV industry’s PR machinery about HIV almost always being transmitted through unsafe heterosexual sex in African countries (but not elsewhere), countries like Kenya will pass unjust laws like this one.

The media also loves rubbish about ‘deliberate’ transmission of HIV, ‘revenge’ transmission, anything extreme, which they depict as normal for Africa. The level of anti-African bigotry to be found in the media is on a par with the kinds of antisemitism that was commonplace in many countries before the second world war.

Of course, extreme levels of misogyny are reserved for African women. In the US, a woman has received a 20 year prison sentence for having an abortion. So state sponsored violence against women doesn’t even raise an eyebrow in the US either? But the difference is that the English Guardian recognizes the injustice in this case, but not in cases of HIV in women in African countries.

Prevention of mother to child transmission of HIV (PMTCT) is a wonderful technology, and has probably saved many lives and averted numerous infections. But what about averting infections in the women first? This would be the best strategy for averting infections in infants.

It is of vital importance for women to know what HIV risks they face, so that they can take measures to protect themselves. The Guardian’s humbug conclusion that “The law also puts women at risk of violence or rejection by their husbands because it allows doctors to disclose the status of patients to their next of kin” needs to be rewritten.

It is the HIV industry and institutions like UNAIDS that insist that women’s biggest risk for infection with the virus, even their only risk, is unsafe sex. Many African women have just one sexual partner, and that person is HIV negative. Many HIV positive women were infected late in their pregnancy, even just after giving birth.

It is unpardonable to insist that all HIV positive mothers must have had sexual intercourse with someone other than their partner. This is what puts the women at risk of stigmatization, violence and rejection, as well as at risk of being infected with HIV, and infecting their fetus or infant.

This kind of victim blaming is a clear instance of violence against women, yet it is promulgated by the very parties who claim to be protecting the rights of women: UNAIDS, WHO, various academic instutions and the enormous, top-heavy HIV industry that they and others constitute. And the media tag along, like poodles doing tricks for the odd pat on the head.

The quote “If we want to reduce the spread of HIV and Aids and put an end to the stigma, violence and discrimination surrounding the disease, our public policies must be based on medical evidence and grounded in human rights” would be spot on if it added that the view that HIV is almost always transmitted through heterosexual sex in African countries is most certainly not based on medical evidence, or any other kind of evidence.

Human Papilloma Virus Vaccine and the Unsafe Sex Canard


A recent study asks ‘Does HPV [Human Papilloma Virus] Vaccination Promote Unsafe Sex in Adolescent Females?‘ and the answer is a resounding ‘no’.

Those who followed similar questions about condom promotion ‘promoting’ unsafe sex, comprehensive sex education ‘promoting’ unsafe sex, and the like, will be unsurprised, because all of these interventions have had positive impacts, and all have been shown not to result in increases in unsafe sex.

On the other hand, the $1.3 billion that PEPFAR, the (US) President’s Emergency Plan for AIDS Relief, spent on abstinence and faithfulness programs “showed no evidence the messages had any impact on behavior or HIV risks“.

I wonder how many billions of non-PEPFAR money went into similarly ineffective programs, and how much is still being spent on programs either destined to fail, or destined to do more harm than good, such as the massive male circumcision programs currently underway.

One piece of research found that “[T]here was no evidence of a reduction of [HIV] incidence in women as a consequence of the reduction in HIV prevalence in men due to circumcision“. And that’s after nearly seven years of circumcising people and assuring them that incidence among women will also drop.

They now say it could take ten years to see any impact on women, something I don’t remember hearing when the programs were being aggressively promoted. So we should see results in three years time in Rakai, then? Of course, it will be difficult to tell which were the effective programs in a place where so many HIV activities are taking place at the same time.

The only evidence about the effect of mass male circumcision on male to female transmission of HIV is that it increases it by 50%, yet women are a lot more likely to be infected than men already, and this is being aggressively marketed to women as well as men.

HPV is vaccine preventable, yet in the US an estimated 25% of females between age 14-19 are infected. HPV causes cancer and genital warts. But “vaccination rates are low, partly because of a perception that vaccination may promote unsafe sexual activity among recipients.”

This irrational fear of ‘unsafe sex’ appears to increase the risk of HPV and its consequences, also the risk of HIV, unplanned pregnancy and various other avoidable conditions. Advances in public health appear to evoke the most extraordinary reactions in some people.

Hepatitis C Virus: Revenge of the Killer Icebergs


The comments following an article about hepatitis C (HCV) appearing in the English Guardian suggest that some people still associate the virus with illicit drug taking, illicit sexual practices and those who engage in such activities. Sadly, the article doesn’t make much effort to dispel such views.

Several of the people commenting who have been infected with HCV sound as if they don’t quite understand how this came about, although they know that they have never engaged in any of the well publicized activities that are said to constitute the most serious and the most common risks.

We shouldn’t be facing this problem with HCV; it’s much too like the problem we still face with HIV, the view that it mainly infects people who engage in illicit activities of some kind, their partners and even, sometimes, their children. Trying to scare people about heterosexual HIV being the tip of an iceberg, when public health authorities knew perfectly that that wasn’t true, backfired.

It will backfire with HCV too. Many people are still afraid to be tested for HIV, to be frank about their status, to discuss it with people with whom they may become sexually involved, etc. So why are we risking the same sort of stigmatization with HCV?

The article says: “Only in recent years have doctors realised that the hepatitis C virus (HCV) can be sexually transmitted. As it is carried in the blood but not present in significant amounts in semen and other bodily fluids, the risk of transmission during sex was presumed to be negligible. That was until patients who had never injected drugs started testing positive.”

But patients who had never injected drugs, nor had any other identifiable risks, may have had an endoscopy, colonic irrigation, treatment with contaminated vials (generally multi-dose vials), been exposed to insulin pens, fingerprick lances, been circumcised in a non-sterile setting, received certain beauty treatments (eg, blackhead removal), complementary therapies, or skin-piercing and other invasive traditional practices, shared certain types of haircutting equipment, including machinery, donated blood (donors can face a risk from reused equipment), served time in prison, had anything inserted into a mucus membrane (including hands wearing reused surgical gloves), etc.

The article mentions sharing toothbrushes and razors as if that’s the end of it. The research that the article refers to makes it clear that the relative contributions of various risk factors, whether sexual or non-sexual, have not yet been established.

Mentioning that “Rougher sex, anal sex and the sharing of sex toys, especially among people who are also infected with HIV, make sexual transmission possible” may spice up the article a bit, but it could also deflect attention from other risks. These other risks may well be a lot less likely to transmit HCV (or HIV) than certain sexual practices or intervenous drug use, but the list includes things that many people do many times a year.

We need accurate and comprehensive information about hepatitis C, not scare tactics resembling the ones that failed so devastatingly with HIV. In addition to common skin-piercing and invasive healthcare, cosmetic and traditional practices, it is possible that ordinary, everyday sex, transmits HIV; it may not be as risky as the spicy kinds journalists like to report on, but it is likely to be a damn sight more common.

Syringe Reuse – HIV Industry to Revise Finger Pointing Strategy in Africa?


The news that the World Health Organization (WHO) is calling for exclusive use of auto-disable syringes, which are designed to break if reused, is probably the most significant advance in the reduction of HIV transmission in developing countries to be announced in many years. It should also reduce transmission of other blood-borne viruses, such as hepatitis B and C, also ebola and MERS.

The WHO has started their global campaign to increase awareness of the dangers of unsafe healthcare, especially through reused syringes, needles and other skin piercing equipment, and have issued a brochure on injection safety.

It’s lucky that the inventor of the K1 auto-disable syringe, Marc Koska, heard about the problem of reused injecting equipment in 1984. Only a few years later attention was drawn away from unsafe healthcare to unsafe sexual behavior as the main route of transmission for HIV.

Although HIV in wealthy countries now mainly infects men who have sex with men and people who inject illicit drugs, and this was already clear in the late 1980s, public health institutions decided to emphasize the risks people face from heterosexual sex.

Perhaps these institutions had their reasons, and the campaign was ‘successful'; many people all around the world still believe that heterosexual sex is the biggest risk for HIV. The risk to heterosexuals was, and is, very low, but few people around in the 1980s could forget the relentless scare campaigns.

But in poorer countries, most people becoming infected with HIV were clearly not men who had sex with men or injecting drug users. They were just ordinary people, many of whom who had never had sex, never had ‘unsafe’ sex, or only had sex with a person who was also HIV negative.

There were also a lot of infants infected by their mothers, and there still are, although the prevention of mother to child programs have been among the most successful in the history of HIV.

The issue of non-sexual transmission of HIV in developing countries remained ignored, even strenuously opposed by what became an enormous HIV industry. And so, those infected with the virus, and whose infants were infected with the virus, were accused of being promiscuous, careless, dishonest and even cruel to their family and those around them.

Perhaps this will herald in a new era, making it possible to raise the issue of non-sexual transmission of HIV through unsafe healthcare without accusations of denialism (although it seems to be the opposite of denial), being anti-scientific (although there is no shortage of evidence) or of diverting attention from the importance of sexual behavior, which was never as important as the massive scare campaigns would have us believe.

One newspaper article cites Koska as saying “I always wanted to be a superhero and save the world”. I don’t know if he really said that, but I’d like to believe he did. Because the benevolence of his motives contrast strongly with the apparent motives of certain parties in the burgeoning HIV industry, for whom HIV transmission is but a route to wealth, power and career advancement.

Cambodia, Unsafe Healthcare, Injections: Time for a Changing of the Guard?


There’s a very succinct set of photographs by Marc Koska of the SafePoint Trust about the HIV outbreak in Cambodia’s Roka Commune. Over 270 people are said to have tested positive so far, several of whom have already died. Unsafe healthcare is thought to have been behind this outbreak, reuse of syringes and other skin piercing equipment by medical practitioners who do not have the knowledge, skills or equipment to avoid such occurrences.

Koska invented an auto-disable syringe many years ago, a syringe that breaks if you try to reuse it, but he has been lobbying health and HIV institutions to promote the use of this simple and cheap technology ever since.

It is highly unusual for the BBC to express the slightest hint of disagreement with the mainstream view of UNAIDS and other institutions, that HIV is almost always transmitted through unsafe sex, and hardly ever through unsafe healthcare. Perhaps because this outbreak was in Cambodia, where HIV prevalence is low, this story flew under the radar.

Sadly, as the article points out, use of auto-disable syringes is too late for those already infected, but it is not too late for other Cambodians, nor for HIV negative people living in countries where HIV and other blood-borne viruses are common and, more importantly, where safe healthcare is uncommon.

UNAIDS and others in the HIV industry have been ranting on about ‘unsafe sex’ and completely avoiding the issue of unsafe healthcare, even denying its possible role in the most serious HIV epidemics in the world, which are all in Africa. Perhaps this will bring various kinds of unsafe healthcare into focus, however belatedly.

Cambodia is not the only Asian country where unlicensed practitioners operate; and even licensed practitioners may reuse needles, syringes and other skin-piercing equipment. The practitioner who has so far been the only scapegoat is unlikely to be the only person to practice healthcare unsafely. The investigation should be global, not confined to a population of a few thousand.

As for African countries, it should be clearer than ever that unsafe healthcare must no longer be denied by UNAIDS and other health agencies as an important mode of transmission of HIV and other viruses in African countries. People shouldn’t have to be Buddhist monks, very young or very old to be believed when they say they have not engaged in ‘unsafe’ sex, or any sex at all.

The UNAIDS view that HIV is almost always transmitted through ‘unsafe’ sex and hardly ever through unsafe healthcare is vehemently expressed in a BBC article from 2003, and these views don’t appear to have changed since (although the UNAIDS official in question, along with some of her senior colleagues have since availed themselves of the revolving door).

The maliciously racist view of Africans that the senior UNAIDS official is, apparently, allowed to make public, doesn’t seem to have changed either.

It’s also worth bearing in mind that UNAIDS are well aware of the risks of healthcare transmitted HIV and other infections in developing countries. They publish a brochure warning UN employees not to use health facilities in such countries; this contrasts very strongly with what the BBC published the year before. Perhaps now they UNAIDS will promote this in Cambodia, and hopefully in Africa too?