Eliminate bottlenecks to end mother-to-child HIV transmission

Making services for the prevention of mother-to-child HIV transmission (PMTCT) available without addressing the factors that keep mothers from accessing these services was an exercise in futility, experts told a press briefing in the Kenyan capital, Nairobi.



"There are barriers that stop mothers from accessing prevention of mother-to-child transmission and treatment services, some of which include inadequate involvement of men and communities, and lack of information," said Chewe Luo, senior advisor on HIV/AIDS to the UN Children's Fund, UNICEF. "These challenges, and others, must be addressed."



Women might not be able to afford medical care or transport to a clinic; cultural taboos might discourage them from giving birth in medical facilities or bottle-feeding infants; a lack of access to clean water could prevent the use of infant formula; health facilities that were few and far between, with poorly trained health workers, would hardly encourage them to make the journey.



"We have to expand the scope of what we do to ensure that the burden of prevention does not fall on women's shoulders alone," Luo said. "If facilities do not monitor mothers after their antenatal visits to ensure their good health and that of their babies, then the gains already made will be rolled back."



Virtual elimination of mother-to-child transmission in Africa - where 20 countries share over 85 percent of the global burden of mother-to-child HIV transmission - was possible, she said, but only if HIV counselling and testing services were expanded so that all mothers had access to effective antiretroviral (ARV) prophylaxis and treatment.



In 2008, 430,000 children became infected with HIV, 90 percent of whom lived in sub-Saharan Africa; in the absence of access to ARV treatment, most of them would die within one year of birth, according to UNAIDS.

More on PMTCT:

PMTCT battles missing drugs, missing moms

PMTCT could be key to cutting child mortality

Men take a hands-on approach to pregnancy

Gaps in HIV prevention for pregnant women

Speakers at the briefing, held after a three-day consultation by more than 200 experts on the pros and cons of the PMTCT strategies currently in use, stressed the need for governments to ensure the safe delivery of babies, and to provide mothers with information on infant feeding. The UN World Health Organization is expected to release new guidelines on infant feeding in July 2010.



Fareed Abdullah, unit director for Africa at the Global Fund to Fight AIDS, Tuberculosis and Malaria, promised that "The Global Fund will refocus funding to ensure that priority is given to PMTCT programmes in the recipient countries, and more so in the 20 countries that share the 85 percent of the global burden of mother to child transmission of HIV."



The Global Fund has committed to accelerating the scale-up of PMTCT programmes, and to extend coverage to at least 60 percent of women in need globally by the end of 2010. Abdullah urged "individual countries to allocate more resources to the elimination of mother-to-child transmission of HIV".



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