The past week passed under the sign of the approaching Day of struggle with HIV infection. The deputies proposed to insure doctors from infection at work and HIV patients treated according to who standards. The head of Rospotrebnadzor Anna Popova demanded to maximize the coverage of testing citizens at risk. And regions with high prevalence of HIV to provide them with targeted Federal money to fight the epidemic. “Mednovosti” present an overview of recent developments in the field of health.
Medical insurance, patients who standards
The state Duma Committee on health protection has proposed to introduce a national insurance doctors from HIV infection at work. “We need legislation to consider measures additional insurance at the expense of the state, especially surgeons. They told how they work”, – said the member of the Duma Committee Alexander Petrov at the meeting on HIV held in Yekaterinburg. The MP said that many doctors have to constantly come into contact with patients ‘ blood. For example, surgeons recognized that medical clothing interferes with their work, and they are forced to remove the masks and gloves.
In addition, according to him, the Committee came to the view that the Russian standards in HIV treatment should be focused on the who standards. “It is impossible to use only those drugs which act on the territory of the Russian Federation. We must have international standards and we will use them. In Russia about 10 drugs importozameschenie. But even today, scientists at the meeting expressed that they are very bad. Therefore, the main task of the Subcommittee (Duma) at the next meeting – to consider what new drugs should be developed in the Russian Federation. And, maybe, will have to do to adopt a law on compulsory licensing,” – said Petrov.
Every year various infectious diseases in the medical manipulation are infected more than two million health care workers. Only for treating physicians who accidentally got infected with the hepatitis b and C, the state spends up to 15 billion rubles. The actual number of wounds with a needle, according to experts, more than 2 million a year, but the exact number of random injections is difficult to determine: often physicians do not report on them to management. The group most at risk include nurses, with more than 47% of all cases of infection occurs in the treatment room.
Risk groups – testing
The head of Rospotrebnadzor Anna Popova demanded to increase the coverage of testing for HIV infection of citizens at risk. In her opinion, for such testing to be effective, it must be targeted. However, while the state spends big money on a survey of individuals who seek medical help with other diseases. “Up to 30% of the population of Russia passes the test for HIV infection. The question is – who do we test? Unfortunately, at-risk groups from the total number of testing accounts for a very small amount. Today in the group “other” includes about 60% of all for HIV testing, so that testing we identified risk groups. The challenge 2017 – proportion of risk groups to increase the maximum,” – said the head of Rospotrebnadzor.
In addition, the official drew attention to cases of HIV infection in health facilities. “This unit, but they are, and unfortunately, the trend is not improving, so the regions should pay attention to it,” – said Popov. She demanded that the health managers require from their subordinates in strict compliance with all rules and regulations. “Every time we have dealt with the situation with hospital-acquired infection, every time we are faced with the fact that someone flagrantly violating these requirements, ignore them. This is a big problem, which I ask to pay attention”, – said Popov.
Meanwhile, according to the President of the National Agency for the safety of patients and independent medical examination Alexei Starchenko, approved October 25, Strategy counter the spread of HIV in Russia nothing is said about the development and implementation of mandatory, universal anti-epidemic measures to destroy the virus in all collected samples of each patient. Instead, it is proposed the same expansion of the persons subjected to mandatory testing for HIV infection.
“So compromised the whole system of providing invasive medical care: this “offer” to citizens of the Russian Federation should be clearly understood that all invasive medical intervention is dangerous for their HIV infection in the Russian Federation there is no system of measures to protect the patient from HIV infection when performing such interventions, – said Starchenko. It’s dangerous because it creates the appearance of lack of HIV infection in a patient in the presence of the reference and enables nurses to neglect preventive measures. (In the patient’s blood may be a virus, but the result of the study the presence of antibodies may be negative). In the end, can start the growth of HIV infection in medical organizations”.
Meanwhile, regional authorities offer their own measures to combat the spread of HIV. So, according to the first Deputy of the Governor of Sverdlovsk region Alexei Orlov, the regions with high prevalence of HIV needs to target Federal money to fight the epidemic. In early November, the health Department of the administration of Yekaterinburg announced that the city was 26693 HIV infection. This amounts to 1,826 100 thousand people, i.e. 1.8% of the population of the metropolis. The Minister of health Veronika Skvortsova said that the country’s 10 regions critical for HIV, and Deputy Minister of health of the Russian Federation Sergey Kraevoy said that the increase in incidence is largely formed by the 22 regions.
Under current law, local authorities can only inform the population on issues of distribution of socially significant diseases. And do not have the capacity to conduct and Fund activities on secondary and tertiary prevention, which involves working with risk group and prevention of recurrence of the disease. “We ask to consider possibility of allocation of targeted Federal transfers to the regions with high prevalence of HIV … for carrying out of actions for modernization of healthcare institutions involved in the delivery of health care: construction, repairs, equipment, transport,” – said Orlov.
According to the head of the Federal scientific and methodological center for prevention and fight against AIDS Vadim Pokrovsky, current measures are insufficient to stop the epidemic. At the same time, reinventing the wheel is not necessary – it is sufficient to use the experience of those countries that show the lowest incidence.He compared the current system “Test and treat” offer in the West the “Treatment as prevention”. “Now what happens? We allow people to get infected, then they are detected and treatments – it turns out preventing second freshness – as “sturgeon second freshness” Bulgakov,” – said Basil.