Global Epidemiology

Misinformation ? a virus in the system

Lack of disclosure leads to inaccurate data on the spread of disease

By Abe Konigsberg

We rely on governments worldwide to disclose any health crisis, especially if it could spark an epidemic. An impossible task if some dictatorships are intent on keeping the truth under wraps. Some even go as far as pinning the blame on foreign workers ? biting the hand that feeds, so to speak.

After a trial that dragged on for four years, a Libyan court sentenced a group of five Bulgarian nurses and a Palestinian doctor to death by firing squad for allegedly infecting 400 Libyan children with HIV. The health professionals were accused of intentionally infecting the children with the virus so they could test treatments on them. The trial had many twists and turns, including the reduction of the charges against one Bulgarian doctor ? originally charged with murder as well ? to illegal currency exchange (which carries a four-year jail term) without any explanation.

International opinion has roundly condemned both the Libyans' verdict and the treatment of the medical professionals, who've complained of being tortured and in two cases raped by the their captors.

Dr Luc Montagnier, the co-discoverer of the HIV virus, expressed serious doubt about the veracity of Libya's charges against the medics. Dr Montagnier testified, "There's no doubt that the children were infected because of inadequate hospital sterilization." Also, he estimated it happened in 1997 ? a year before the health providers arrived in Libya. This further discredits the charges.

Romano Prodi, Commission President of the European Union (EU) stated that: "The EU has repeatedly expressed its serious concerns regarding the conduct of the investigations, the treatment of the defendants and the delays in bringing the case to a conclusion. It has also expressed concerns about the lack of compelling evidence of the guilt of the defendants."

US Assistant Secretary of State Richard Boucher made his position clear at a press conference in May saying, "you know we've been very critical of Libyan violations of the legal and human rights of the Bulgarian medics." He added, "we find the verdict that was pronounced in the court to be unacceptable." Secretary of State Colin Powell also gave a brief statement promising on behalf of the US government to "do everything we can to bring pressure on the Libyan Government to resolve this matter so these people are released and can return home."

The Libyan HIV case is just one of a growing number of questionable authoritarian government responses to an epidemic. The Chinese officials' decision to cover-up the incipient SARS problem until it got out of control is another example, and one very reminiscent to the Soviet Union's ill-considered attempt to keep the Chernobyl meltdown a secret.

A potential problem of this nature is also brewing in the Middle East. In Iran, the rate of HIV infection is growing rapidly ? primarily through needle sharing amongst drug-users. Although the spread of infection is off to a slow start, the Iranian government is arguably abetting its spread by throwing many hard drug users in jail. Here the absence of clean needles leads to sharing syringes and, for many, the acquisition of HIV.