HIV Injustice in Libya — Scapegoating Foreign Medical Professionals (NEJM)

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Volume 355:2505-2508 December 14, 2006 Number 24

HIV Injustice in Libya — Scapegoating Foreign Medical Professionals

Elisabeth Rosenthal, M.D.

On December 19, 2006, a Libyan court is scheduled to announce its verdict in the trial of five Bulgarian nurses and one Palestinian doctor who have languished in prison for 8 years on charges that they intentionally injected more than 400 Libyan children with human immunodeficiency virus (HIV) in 1998, while they were guest workers at a children's hospital. In 2004, the six were tried and sentenced to death. A new trial was ordered last year after international protests, but scientists and politicians are worried about the defendants' fate.

The scientific evidence being used against them "is so irrational it's unbelievable," said Vittorio Colizzi, an infectious-disease specialist based at Tor Vergata University in Rome and one of a number of international scientists who have visited Libya to study the case and treat the children. But such scientists have not been called to testify in the current trial, which began in late August.

The HIV outbreak at Al-Fateh Children's Hospital in Benghazi, Libya, that peaked in 1998 has been studied in detail by international experts, who have pored over patient charts, tested hundreds of blood samples to characterize the virus, and observed patient care activities at the hospital. All have concluded that the outbreak was nosocomial, resulting from the reuse of contaminated medical equipment. The efforts to understand the outbreak include a site visit by the World Health Organization (WHO) conducted in December 1998 and January 1999 that resulted in a 1999 report, as well as an investigation by Colizzi and Luc Montagnier,1 a codiscoverer of HIV, who were hired by the Libyan government, were given broad access to the hospital and patients, and completed their report in March 2003.

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Indeed, just months after the nurses and doctor were first jailed, in 1998, WHO compared the outbreak to documented nosocomial HIV outbreaks in Russian and Romanian hospitals. Now, 8 years and many scientific studies later, professionals who sought to provide needed health care to Libyan children may sadly become the scapegoats for another country that is loath to admit to a homegrown HIV problem — derived, in this case, from dismal hygiene practices that are only slowly being corrected. "The court is misusing science," Richard Roberts said in explaining his decision to mobilize his fellow laureates in protest. "So scientists need to speak out."

Source Information
Dr. Rosenthal is a reporter for the International Herald Tribune.

http://content.nejm.org/cgi/content/full/355/24/2505?query=TOC