Uzbekistan: cases and investigations
In 2007-08, two children’s hospitals in Namangan, Uzbekistan, passed HIV child-to-child by reusing equipment without sterilization to give injections, infusions, etc. An investigation identified more than 140 children infected from procedures at the two hospitals.
In 2009, the Uzbek government made a 21 minute film about the outbreak and subsequent investigation. Then the government suppressed the film. However, someone passed the film to FerghanaNews, which put it on the web in March 2010 (you can find the film and a detailed report of the outbreak at this link). You can find other reports about the Uzbekistan outbreak in the international press, including the New York Times and the The Associated Press.
The Uzbek government did well to test hundreds of children to find the extent of the outbreak and to stop it. The government’s subsequent decision not to tell the public about the outbreak violates medical ethics — doctors should tell people about risks. Also, the government’s decision to prosecute health care workers (12 were sentenced to 5-8 years in jail) may be emotionally satisfying for victims, but increase risks for others. Prosecuting health care workers generates strong incentives to lie and cover-up, so that it can be harder to find and investigate other outbreaks.
When investigations uncover and report similar HIV outbreaks from hospitals and clinics in Africa, I expect health care workers will be shocked and remorseful — and will change to protect patients. Punishment does not have to be part of the solution. But without investigations, how will anyone know what to change?