PARIS, Dec. 19 — A Libyan court again sentenced five Bulgarian nurses and a Palestinian doctor to be shot by a firing squad for deliberately infecting 400 children with H.I.V., further complicating the country’s efforts to improve relations with the West.
Today’s verdict drew expressions of anger and alarm from Bulgaria and its supporters in the nearly eight-year-old case, which now appears likely to drag on for months more, if not years. Lawyers for the medical workers said they would appeal the sentence to Libya’s Supreme Court.
“We are going to urge the Libyan political leadership to engage in the process,” said Bulgaria’s foreign minister, Ivailo Kalfin, from Washington, where he met with Secretary of State Condoleezza Rice hours after the verdict was announced.
Mr. Kalfin said that his country was working through the Libyan foreign ministry to ask the Libyan leader, Col. Muammar el-Qaddafi, and the country’s political institutions to intervene, because Libya’s inefficient and biased judicial system had failed to deal with the case credibly.
The case began in February 1998 when the nurses arrived to work at the Al Fateh Children’s Hospital in Benghazi, the country’s second-largest city. By August 1998, children at the hospital had begun testing positive for H.I.V., the virus that causes AIDS. Health authorities soon realized they had a huge problem.
An official investigation concluded that the infections had been concentrated in the wards where the Bulgarian nurses had been assigned. Dozens of Bulgarian medical workers were arrested, and a videotaped search of one nurse’s apartment turned up vials of H.I.V.-tainted blood.
According to a Libyan intelligence report submitted to the court, the nurse, Kristiyana Vulcheva, later confessed that the vials were given to her by a British friend who was working for the KBR subsidiary of Halliburton at the time. The nurse was quoted in the report as saying that she and her colleagues used the vials to infect the children.
Col. Qaddafi subsequently charged that the health care workers had acted on the orders of the Central Intelligence Agency and Israel’s intelligence agency, Mossad.
KBR is primarily an engineering and construction company, but it undertakes many kinds of contract work for the United States Department of Defense and other agencies, and its activities in Iraq and elsewhere have sometimes been controversial.
A Benghazi court eventually convicted five Bulgarian nurses and a Palestinian doctor of deliberately injecting the children with the virus. But two of the five nurses said they were tortured into confessing, and international AIDS experts — including Luc Montagnier, the French virologist whose team is among those credited with discovering the H.I.V. virus — concluded that the virus predated the nurses’ arrival and was more likely spread through the use of contaminated needles.
The medical workers were sentenced to death in May 2004 in a verdict that was widely condemned in the West. That began a period of difficult negotiations among Libya, Bulgaria, the United States and the European Union to find a solution.
Eventually, the four sides announced in December 2005 that they were setting up an international fund to cover medical care and other costs incurred by the families of the H.I.V.-infected children. Libya’s Supreme Court quashed the death sentences two days later and called for a retrial, this time by a court in the capital, Tripoli.
The families have asked that Bulgaria or other donors provide $10 million for each child, the same amount that Libya agreed to pay each of the families of the 270 people who were killed in the bombing of Pan Am Flight 103 over Lockerbie, Scotland, in 1988. Libya has accepted responsibility for the bombing.
Under Libyan law, crime victims’ families have the power to grant clemency in return for compensation. The families of the infected children have said that they would agree to release the medical workers from the criminal charges if their request was satisfied.
But only a few million dollars in cash, services and equipment has been donated to the fund so far. Talks over further donations stalled while the second trial was underway — apparently, the Libyan families say, because Bulgaria hoped the new court would acquit the nurses.
In a seven-minute court hearing in Tripoli today, the presiding judge, Mahmoud Hawissa, read out the verdict and sentence in the latest trial.
Bulgarian officials and the defense lawyers for the nurses argue that the latest trial was as flawed as the first.
“The whole court case was compromised, and covers up the real cause that sparked the AIDS epidemics in Benghazi,” said a joint statement issued today by Bulgaria’s president, Georgy Parvanov, and prime minister, Sergey Stanishev.
Emmanuel Altit, a French lawyer in Paris who worked on the defense team, said: “The question of torture by electricity, proof that the nurses had been beaten, sexually harassed, kept for six months without contact, the question of fabricated evidence — none of this was discussed at all. The court refused to hear our experts.”
Amnesty International issued a statement condemned the trial as “grossly unfair.” “We deplore these sentences and urge the Libyan authorities to declare immediately that they will never be carried out,” said Malcolm Smart, the director of Amnesty’s Middle East and North Africa program.
Mr. Smart’s statement raised a number of complaints about the fairness of the trial, and noted that the evidence produced by Libyan medical experts was called questionable by international medical experts.
The European Union’s justice commissioner, Franco Frattini, called on Libyan authorities to rethink their handling of the case, calling it “an obstacle to cooperation with the E.U.” Bulgaria will become a member of the union on Jan. 1.
Outside of the Libyan court, families of the children, about 50 of whom have since died, rallied to call for the sentence to be carried out immediately, news agencies reported.
But for the Libyans who believe the nurses are guilty, the verdict was a foregone conclusion, even if their execution is not.
Ramadan al-Faitore, whose 4-year-old stepsister was among the first to die, predicted earlier this month that the medical workers would be sentenced to death.
“But no one will kill the nurses,” Mr. Faitore said in Paris, echoing a statement made by Col. Qaddafi’s son, Seif, two years ago. “After the trial, negotiations will start again.”
Mr. Kalfin, the Bulgarian foreign minister, said today that his country was committed to the making sure that the fund would “provide lifelong medical treatment for the children, and create conditions that would prevent this from ever happening again.”
But he bristled at the suggestion that Bulgaria would pay “blood money” for the release of the nurses, calling such talk “cynical.”
“We feel a great deal of sympathy for the children and the families,” Mr. Kalfin said. “But making a linkage between this tragedy and the work of the Bulgarian nurses has absolutely no foundation.”
Standing in a muddy field across the street from the Libyan Embassy in Sofia, Zorka Anachkova, Ms. Vulcheva’s mother, said she wasn’t surprised by the verdict.
“What kind of negotiations can you have for innocent people?” she asked. “All the evidence proves their innocence. Their innocence is axiomatic. What else is there to talk about?”