SIGN meeting report 2003. - World Health Organization

Executive Summary
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 (a) 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, (b) safe and appropriate use of injections –
which includes sharps waste management - and (c) procedures conducted
according to universal precautions.
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.
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.