HIV in Libya

"HIV is the first disease in history where if you're immune to it, you're gonna die from it"

- Dr Robert Wilner

Correspondence

Nature 448, 992 (30 August 2007) | doi:10.1038/448992a; 
Published online 29 August 2007

Libya should stop denying scientific evidence on HIV

Vittorio Colizzi¹, Tulio de Oliveira² & Richard J. Roberts³

1. University of Rome Tor Vergata, Via della Ricerca Scientifica, 00133 Rome, Italy
2. South African National Bioinformatics Institute, University of Western Cape, Private Bag X17, Bellville 7535, South Africa
3. New England Biolabs, 240 County Road, Ipswich, Massachusetts 01938-2723, USA

Sir

We welcome Libya's recent decision to commute to life imprisonment the death sentences of five Bulgarian nurses and a Palestinian medic. All six were imprisoned for eight years on false charges of deliberately infecting children with HIV in the hospital where they worked. We also applaud the subsequent decision by Bulgaria's president to pardon and release the six immediately upon their extradition to Sofia.

We cannot accept, however, the Libyan government's continued denial of the scientific evidence in this case. That denial constitutes a barrier to establishing normal relations with the international medical and scientific community, from which assistance is urgently needed to upgrade Libya's health-care system.

The 17 July announcement that Libya's Higher Judicial Council had commuted the death sentence to life imprisonment should have been accompanied by an explicit acknowledgement that the real cause of the outbreak was an accident stemming from insufficient infection controls and hospital safety precautions.

Indeed, the statements from Libya's prime minister and foreign minister, condemning the recent pardon, reiterating the original conspiracy charges and calling for the health workers to be re-imprisoned, shows that the final judicial and political decision-making process had little to do with the accumulated scientific evidence.

Despite pleas from more than 100 Nobel laureates (R. J. Roberts et al.Nature 444, 146; doi:10.1038/444146a 2006), the judiciary refused to allow independent scientific evidence to be heard during the trial.

In particular, the judiciary failed to take into account convincing findings that the HIV infection was present in the hospital before the arrival of the health-care workers (T. de Oliveira et al. Nature 444, 836–837; 2006). Similarly ignored was the concurrent outbreak of hepatitis C among the same population of children — a strong signal that they were picking up other blood-borne infections from the hospital.

Opportunities for contamination of medical materials are frequent in many hospitals in developing countries, and there is an urgent need to redress this situation by improving health-care policies and practices. The Libyan government wants to upgrade the standards of hygiene and care in its hospitals. With the cooperation of the international scientific and medical community, it could make Libyan hospitals a model for health care in the region and in the African continent.

Removing the obstacle of Libya's intransigence on the science in this case is essential to allow such cooperation to move forward. We call on the Libyan authorities to put this affair behind them, and to exonerate the six health-care workers.

This letter was also signed by:
Massimo Amicosante University of Rome Tor Vergata, Italy
Thomas Lehner Guy's Hospital, London, UK
Luc Montagnier World AIDS Foundation for Research and Prevention, Paris, France
David Pauza University of Maryland, Baltimore, USA
Luc Perrin University Hospital, Geneva, Switzerland
Giovanni Rezza Istituto Superiore di Sanità, Rome, Italy

British Medical Journal

Feb 3, 2001; 322(7281): 260.

PMCID: PMC1119524

Doctors face murder charges in Libya

Carl Kovac and Radko Khandjiev

Sixteen doctors, nurses, and managers at the Al-Fateh Hospital in Benghazi, Libya, are standing trial in Tripoli. All are charged with subverting the country's healthcare system, and seven are charged with murder. The trial, which has been adjourned several times, is scheduled to resume next week.

According to an 11 count indictment issued by the People's Claim Bureau, seven of the defendants are charged with murdering 393 children at the Al-Fateh hospital in 1998 by injecting them with HIV. Twenty three of the children had died by 30 October 1999, the indictment says.

The seven accused of murder—a Bulgarian doctor, five Bulgarian nurses, and a Palestinian doctor, all working under contract at the hospital—face the death penalty if convicted.

The Palestinian doctor and three of the nurses are also accused of having sexual relations “outside marriage.” One of the nurses is also charged with providing the Palestinian doctor with liquor, which “made him dependent and put him under her will in order to continue the crime.” The Bulgarian doctor and four of the nurses are also accused of drinking alcohol in violation of Libyan law.

The indictment also charges the Palestinian doctor and one of the nurses with violating Libya's foreign exchange laws through illegal transactions on the black market and illegal exports and imports.

Nine Libyans, including the director of the Al-Fateh Hospital and the undersecretary of Benghazi's Department of Health, are charged with exposing 19 of the mothers of the infected children to HIV. They “hid the fact that the children were already infected” and failed to take prophylactic measures to protect the mothers.

“In their capacity as government employees, they have committed malpractice to achieve illegal material benefit for themselves by concealing the results of laboratory analyses of the infected children,” the indictment says. The hospital director and the health department's undersecretary are specifically charged with having “abused their positions for personal benefit.”

Ironically, according to a UNAIDS report, Libya has not supplied any information on AIDS cases in that country for 1998-2000. Suleiman Al-Gamary, the former head of Libya's health service, has reportedly expressed concern over the deterioration of the country's health services and the shortage of medicines and hospital supplies as a result of the former UN sanctions against Libya.

According to Libyan authorities, the accused staff have been in custody since their arrest on 9 February 1999 after an investigation.