Unconventional health workers and new technologies will be a vital part of the ongoing effort to "virtually eliminate" mother-to-child transmission of HIV, says Michél Sidibé, executive director of UNAIDS.
"We cannot wait for the highest cadre of health professionals to be trained before expanding our capacity to prevent mother-to-child transmission," he told a press conference in the Kenyan capital, Nairobi. "We have to tap into non-conventional capacity to help expand access to health services."
Sidibé and Jeffrey Sachs, special adviser to UN Secretary-General Ban Ki-moon on the Millennium Development Goals, have just concluded a visit to the Millennium Village in Sauri, western Kenya, to assess the progress of a joint effort by UNAIDS and the Millennium Villages Project to strengthen PMTCT services at the village level, creating "MTCT-free zones".
The collaboration, launched in September 2009, aims to "virtually eliminate" mother-to-child transmission in 14 Millennium Villages across 10 African countries using the existing infrastructure, human capacity and technical resources in the villages to help rapidly expand family- and community-centred heath services.
"While in Sauri, we witnessed the very efficient use of limited resources, such as SMSs [short message service] being used to identify and help people in need of medical services," Sidibé added. "We will need a combination of such new technologies and task-shifting, where people are equipped with basic health-provision skills, to rapidly scale up PMTCT efforts."
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An ongoing study into the effectiveness of mobile phone technology in the health management of people receiving ARV medication in Kenya has found that the use of SMS communication between patients and health service providers was both acceptable and significantly cheaper than paying for transport to travel to clinics for physical visits.
According to Sachs, the use of community health workers would also be critical in achieving the Millennium Development Goals relating to PMTCT: Goal 4, to reduce child mortality, Goal 5, to improve maternal health, and Goal 6, to combat HIV/AIDS, tuberculosis, malaria and other diseases.
"We are seeing, for example, the incorporation of traditional birth attendants into the PMTCT effort becoming part of the push for the proper application of medicine," he said. "In India, there is now a three-and-a-half year medical degree because they have recognized the need to accelerate the training to raise their human resource potential."
Mother-to-child transmission of HIV remains a leading cause of death among infants and young children in sub-Saharan Africa; in 2008, 390,000 infants in the region became infected with HIV from their mothers.