On March 27, the Senate Health, Education, Labor, and Pensions Committee held a hearing to discuss the HIV/AIDS epidemic in Africa. Presiding over the hearing, Sen. Jeff Sessions (R-AL) stated that the purpose of the hearing was to determine “the role of the health care setting in the African AIDS epidemic” and also to determine what Congress can do “to address this problem.”
Sen. Mike Enzi (R-WY) added, “AIDS is one of the main contributors to the deterioration of families and the instability of societies in Africa. If we can reverse the course of this tragedy, we will provide the people of Africa with hope for a better future.”
Claude Allen of the Department of Health and Human Services (HHS) explained the department’s role in combating the spread of HIV/AIDS, tuberculosis (TB) and malaria. He noted that there are three specific divisions at HHS—the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), and the Health Resources and Services Administration (HRSA) that are “most actively involved in fighting” the epidemics.
According to Mr. Allen, the NIH has a “strong portfolio of basic research in the areas of HIV and TB, including vital efforts to develop a vaccine to prevent HIV infection and new treatment technologies and strategies.” He also said that the CDC has “engaged in international applied AIDS research and programmatic efforts since the beginning of the pandemic and supports bilateral and multilateral efforts to address TB and malaria.” Lastly, he said that HRSA along with the CDC, “works to train health care workers internationally to care for people living with HIV/AIDS.”
Speaking before the committee, David Gisselquist, an independent consultant, questioned the scientific evidence asserting that sexual transmission is the primary mode of HIV infection in Africa. Rather, Mr. Gisselquist contended that unsafe health care practices associated with injections, blood transfusions, dental care, and the reuse of gloves and other medical equipment account for a large proportion of HIV transmission in Africa.
Mr. Gisselquist noted that “a number of studies show unexplained high HIV incidence in African women from first antenatal visit to delivery and for the first year postpartum. In 1990 in Malawi, for example, HIV-negative antenatal and postpartum women were observed to contract HIV at the rate of 21 percent per year. This is, notably, double the rate that one would expect if all their husbands were HIV-positive.” He also added that “this evidence suggests possible HIV transmission through blood tests, vaginal exams, tetanus vaccinations, and/or other pregnancy-related health care. If so, this could explain an important proportion of HIV in young women in many African countries.”
Dr. Maria Wawer of the Rakai Project, an HIV/AIDS research organization in Sub-Saharan Africa, said that the World Health Organization estimates that there currently are 29.4 million HIV infected persons living in Africa, and that approximately 3.5 million new infections occurred in 2002. Dr. Wawer also argued that in order to prevent the spread of HIV/AIDS, there must be “continued, concerted efforts to reduce risks of HIV transmission associated with unsafe sex and to improve prevention of mother-to-child HIV transmission.”
