Via David Friedman a paper suggesting that the high rate (>600K cases) of HIV/AIDS among African children results from infections received during visits to the doctor.

The common belief that 90% of HIV transmission in Africa is driven by heterosexual exposure is no longer tenable. Evidence supporting a much larger role for parenteral HIV transmission in medical settings in Africa has recently been painstakingly detailed 9,21. The HSRC report, if confirmed, adds to this evidence. The lessons for all doctors, including obstetricians and gynaecologists are clear: They must educate their patients in the dangers of non-sterile injections and ensure that their own practice is beyond reproach. Patients could be shown the package of a new needle (or bring their own) and single-dose vials used for injections. Similar improvements in the sterility of injections in the informal sector also need to be made. We must protect patients from their own medical care system in all countries with similar epidemiological characteristics

If true, the really shocking part is not that medical care is in large part responsible for this medical nightmare, but that we missed it until now. With all of the attention put on African HIV/AIDS is it really possible that we didn’t see that medical care itself was the problem? Sadly, I believe that it is.

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