protecting health workers from occupational exposure to hiv through global campaigns dr. jorge r....
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Protecting health workers from occupational exposure to HIV through global campaigns
Dr. Jorge R. MancillasPublic Services
International6 August 2008International AIDS Conference
Health Worker risk of HIV infection
• Effectively tackling AIDS requires adequate numbers of skilled personnel
• Health workers are at high risk of occupational exposure to HIV
• The incidence of HIV infection amongst health workers is highest where the prevalence of HIV is highest, hampering treatment efforts
Global shortage of health workers
Current global shortage: 4.3 million health workers (WHO)
The infection of a HCW with HIV is not only another human tragedy, but also the loss of vital human resource needed to effectively fight the AIDS epidemic.
Protecting health workers is the forgotten front in the global AIDS campaign
The need for international structuresin the current global architecture of AIDS treatment
■ WHO & other Inter-governmental organizationsDevelop policy. No global enforcement mechanism. National policy implementation
1. GHIs & IFIs (IMF, WB) - De facto instruments for global policy
implementation (GHI:GF,PEPFAR) or
- Set framework for policy
implementation (IMF)
2. MNCs (pharma, medical)-Promote products for diagnosis, ART
-Lobby governments
-Financial beneficiaries
■ Health workers unions &
professional organizations-Unique in having both global and local perspective
-Unique in having capacity for: policy development
advocacy, implementation & monitoring
Tasks
a) Survey, monitor and communicate to
identify universal concerns:
integrate local (frontlines) to global
b) Research & develop solutions:
share resources
c) Plan and implement campaigns
PSI structure: 651 unions - 160 countries / 24 sub-regional & regional networks Congress ► Exec B ► HSTF ► Weblog & publications
Secretariat ► HQ & regional staff ► campaigns
Protecting health workers from AIDS
1. Research solutions and tools (universally applicable)
► set goals, identify partners and targets
■ Sources: PSI affiliates, PSIRU, WHO, ILO, academic sources
2. Develop evidence-based global campaigns:
a. Implementation of preventive measures
► Global tools: AIDS guidelines (WHO/ILO)
b. Ensure treatment of infected health workers: PEP & ART ► Global tools: PEP guidelines (WHO/ILO)
c. Prevent workplace exposure by addressing major mode of transmission of HIV: needlestick injuries
Needlestick injuries
Healthcare workers suffer
2 million exposures to
Hepatitis and HIV/AIDS
per year
due to needle stick injuries
Needle stick injuries are
the mode of transmission
for over 30 other
blood borne pathogens
(Malaria, Ebola, Hep C)
Retractable syringes
Retractable syringes
• Safe for health care workers
• Safe for waste collectors
• Safe for patients: non-reusable (Prevent 1.3 million deaths, $535 million)
Benefits of a campaign to make safe devices the universal standard:
► Protection of both health workers and patients
► Helps retain AIDS work force
WHO strategy
Safe devices campaign
GOAL: Achieve widespread shift to safe devices by building economies of scale, country by country, and eliminating price differential
Retractable syringesa) Develop & disseminate information and materials to affiliates
b) Negotiate with government or employers
Present data, mobilize members, build public support
c) Negotiate lower prices with manufacturer – build sales volume
First successes:a) Democratic Republic of Congo: decreed mandatory standard (Jan 5, 08)
b) Nigeria (large scale purchases)
c) Angola (technical decision)
Protecting health workers: the process
a) Advocate at global bodies (WHO, ILO)
► Contribute professional expertise and view from the frontlines
► HCWs and allies: driving force for policy implementation ► governments & employers
► Involve multiple participants (academicians, patient org., NGOs, private sector)
b) Pursue multiple mechanisms to change policy
► International organizations (WHO, IFIs) Policy, financing and guidelines
► Int. Financial Institutions, GHIs Funding, financing and guidelines
► Regional bodies – EU Directives, agreements
► National DRC, Nigeria, Angola Decrees, agreements, policies
US, UK Legislation
► State/province Brazil: Rio, Santa Catarina Legislation
► Employers Negotiations of CBAs
c) Create conditions: Education of members, public relations (consensus), global policy instruments and financing
Thank you
Dr. Jorge Mancillas
PSI Health Services Officer
+33 450 40 11 50
+33 617 54 38 74