Human Rights Violations with HIV-tainted Blood

[Guest guest]

Human Rights Violations with HIV-tainted Blood

Kunal Saha, M.D., Ph.D.,

The observation that human rights violations are fuelling the AIDS

epidemic in many parts of the world deserves careful attention from

everybody.1

There is little dispute that human rights abuses in HIV/AIDS are more

prevalent in the developing nations including South Africa and India,

the two countries in the world with the highest number of HIV-

positive populations.

While there can be no argument that wide and complex arrays of social

issues including lack of education, poor economic condition and

cultural stigma play vital role in HIV-related human rights abuses,

other factors that are more directly linked to the medical community

can also contribute to the human rights violations in the developing

nations.

Earlier this year, the World Bank published a detail report of their

investigation of AIDS-related health projects in India with scathing

observations of pervasive fraud and corruption including possible

utilization of sub-standard diagnostic kits by many hospitals and

blood banks during the second national AIDS control project (NACP-

II), potentially resulting in further spread of HIV through tainted

blood or blood products.2

Although the Indian government promptly responded assuring a full

investigation and exemplary punishment for those found culpable for

the poor quality HIV kits, the Indian health secretary was " not very

surprised " with the corruption charges labeled by the World Bank.

Interestingly, in the same report, two-thirds of Indian citizens

found country's efforts to fight corruption as " ineffective " .3

Top health officials were indicted for " criminal negligence " for

their sinister role with deliberate delay in the introduction of a

new HIV test that allegedly resulted in the transmission of HIV to

several Hemophilia patients in the mid-1980s in France.4

While direct scientific evidence for spread of HIV through tainted

blood supply has not been established in India as yet, frequent news

reports in the Indian media have blamed contaminated blood for

transmission of the AIDS virus to unsuspecting patients.5

The government of West Bengal (an eastern Indian state) filed

a " criminal " case in 2006 against Monozyme India Ltd, a kit

manufacturer, for supply of allegedly defective diagnostic kits.6

Direct scientific proof for spread of the AIDS virus through tainted

blood/blood products requires intricate laboratory analysis of the

HIV strains and a close clinical monitoring of the alleged victims.

Transmission of HIV to innocent patients through contaminated

blood/blood products as a result of faulty test kits must be

considered as one of the worst examples of human rights abuses.

Apart from improving public awareness about HIV/AIDS, governments in

the developing countries must act more forcefully to combat human

rights abuses responsible for the spread of AIDS through a flawed

medical system.

REFERENCES:

1. Moszynski P. Human rights abuses are fuelling HIV epidemic,

charities say. BMJ 2008; 337: a900.

2. Detailed Implementation Review: India Health Sector (Vol. II).

http://siteresources.worldbank.org/INTDOII/Resources/WB250_Web_Vol2_01

2408.pdf (accessed June 1, 2008)

3. Solberg K E. India's health sector responds to new corruption

charges. Lancet 2008; 371: 464.

4. Casassus B. French Supreme Court ends tainted blood saga. Science

2003; 300: 2019.

5. First Thalassemia, now AIDS. Times of India (October 19, 2006).

http://timesofindia.indiatimes.com/articleshow/2201319.cms (accessed

July 18, 2008)

6. Dud kit scare for more states. The Telegraph (November 1, 2006).

http://www.telegraphindia.com/1061101/asp/nation/story_6942802.asp

(accessed July 21, 2008)

Thank you.

Sincerely,

Dr. Kunal Saha

3937 Kul Circle S. Hilliard, OH 43026, USA

Email: anku1@...

Competing interests: I was involved (as a medical consultant) with

the World Bank's investigation of the HIV/AIDS projects in India in

2007

[Guest guest]

[An editor's note follows Sumit Bagaria's posting]

Dear Group,

Re: /message/9088

Apart from what Dr. Kunal Saha mentions, I consider the spread of HIV and

Hepatitis B & C from Blood Transfusions not only a human right violation but a

crime akin to murder.

It targets the victims or those who are themselves innocent patients. Most of

those getting transfusion are those who are sick, injured, undergoing surgery or

have other problems. They could be children

and the elderly. Multi-transfused patients including Thallesemics are the worst

affected.

Nucleic Acid Testing (NAT) on Individual Donors, i.e. ID-NAT provides a much

needed extra layer of safety. ID-NAT catches window period

infections, mutants and occult infections. ID-NAT is not cheap, but for an

additional Rs. 300-500, you can get NAT Tested Blood. The value of the Rs. 500

(approximate monthly mobile bill of 30 Crore Indians) is for the person who gets

saved from an HIV infection.

A recent publication in the IJMR by Makroo et al shows that approximately 1 in

1528 units may be infected in India.

Not giving the patient " Safe Blood " or at least the choice is a violation. NAT

is now available at the following:

1. Apollo Hospital Delhi

2. Apollo Hospital Chennai

3. Jeevan Blood Bank Chennai

4. SRMC Chennai

5. Artemis Gurgaon

6. Indu Blood Bank Baroda

Safe Blood for All.

Regards

Sumit Bagaria

President

Hemogenomics Pvt Ltd

551, HAL 2nd Stage,

5th Cross, Indranagar,

Bangalore - 560038, INDIA

Ph: +91-80-25264646 / 25270405

Mobile: +91-9845042005

Fax: +91-80-25270404

e-mail: <bagarias@...>

______________________________________

Editors note: The following is the details and the abstract of Dr. Makroo et

al’s article on the efficacly of NAT testing.

Multicenter evaluation of individual donor nucleic acid testing (NAT) for

simultaneous detection of human immunodeficiency virus -1 & hepatitis B & C

viruses in Indian blood donors

R.N. Makroo, N. Choudhury*, L. Jagannathan**, M. Parihar-Malhotra†, V. Raina††,

R.K. Chaudhary‡, N. Marwaha‡‡, N.K. Bhatiad & A.K. Ganguly

Indian J Med Res 127, February 2008, pp 140-147

Background & objectives: India has a high prevalence of HIV-1, hapatitis C and B

virus (HCV and HBV) in the blood donors but has yet to implement nucleic acid

testing (NAT) in blood screening. We undertook a multicentre evaluation of blood

donor testing by NAT for simultaneous detection of HIV-1, HBV and HCV in a

single tube and also to determine the feasibility of NAT implementation in

India’s low volume setting.

Methods: A total of 12,224 unlinked samples along with their serological results

were obtained from representative eight blood banks in India and were

individually manually tested by the Procleix® Ultrio® Assay (Chiron Corp.

Emeryville, CA) for simultaneous detection of HIV-1, HCV, and HBV.

Results: Of the 12,224 samples tested, 209 (1.71%) were seroreactive. One

hundred thirty three samples (1.09%) were reactive by Ultrio assay, 84 samples

were seroreactive but NAT non reactive. There were eight NAT yield cases: 1 HIV,

1 HIV-HCV co-infection, and 6 HBV.

Interpretation & conclusions: Our observed NAT yield for all three viruses was 1

in 1528 (0.065%). We estimate NAT could interdict 3272 infectious donations a

year among our approximate 5 million annual donations.

A pdf version of the report is available from the following url

http://www.icmr.nic.in/ijmr/2008/february/0206.pdf