Protecting health workers from occupational exposure to HIV through global campaigns

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Protecting health workers from occupational
exposure to HIV through global campaigns Dr.
Jorge R. Mancillas Public Services
International 6 August 2008 International
AIDS Conference
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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

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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
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The need for international structuresin the
current global architecture of AIDS treatment
WHO  other Inter-governmental
organizations Develop policy. No global
enforcement mechanism. National policy
implementation
1. GHIs IFIs (IMF, WB) - De facto instruments
for global policy implementation (GHIGF,PEPFAR)
or - Set framework for policy implementation
(IMF)

• Health workers unions
• professional organizations
• -Unique in having both global and local
  perspective
• -Unique in having capacity for policy
  development
• advocacy, implementation monitoring
• Tasks
• Survey, monitor and communicate to
• identify universal concerns
• integrate local (frontlines) to global
• b) Research develop solutions
• share resources
• c) Plan and implement campaigns

2. MNCs (pharma, medical) -Promote products for
diagnosis, ART -Lobby governments -Financial
beneficiaries
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PSI structure 651 unions - 160 countries / 24
sub-regional regional networks Congress ?
Exec B ? HSTF ? Weblog publications
Secretariat ? HQ regional staff ? campaigns
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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

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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)
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Retractable syringes
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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

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WHO strategy
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Safe devices campaign
GOAL Achieve widespread shift to safe devices by
building economies of scale, country by country,
and eliminating price differential Retractable
syringes a) 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)
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Protecting health workers the process

• 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
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• c) Create conditions Education of members,
  public relations (consensus), global policy
  instruments and financing

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Thank you
Dr. Jorge Mancillas PSI Health Services
Officer Jorge.mancillas_at_world-psi.org 33 450 40
11 50 33 617 54 38 74