Meeting Addresses MTCT of HIV in Africa
Health officials recently held a regional consultation in Kenya to examine mother-to-child HIV transmission (MTCT) services and pediatric HIV/AIDS care in nine Eastern and Southern African countries, IRIN/PlusNews reports. The consultation hosted by UNICEF, UNAIDS and the WHO included representatives from Ethiopia, Kenya, Malawi, Mozambique, South Africa, Swaziland, Tanzania, Uganda and Zambia.
The meeting addressed issues in MTCT prevention services including the continued use of single-dose nevirapine instead of more effective combination therapies, as well as delays in diagnosing and initiating treatment that are weakening prevention programs in focus countries. According to IRIN/PlusNews, 70% of pregnant women in Eastern and Southern African countries are seen by a health care provider at least once during pregnancy. However, 43% of HIV-positive pregnant women have a health care worker present during labor who can administer PMTCT treatment.
In Uganda, a national policy calls for all sub-county level health facilities to provide PMTCT services, but only 53% offer such services because of health worker shortages. Janet Kayita, regional PMTCT advisor for UNICEF, said, "We are doing a bad job of testing women for HIV and then following them up, and an even worse job of ensuring that infants receive appropriate prevention and treatment services." She added that national PMTCT guidelines have not reached local levels. "These policies must become a reality for the people they were designed to help," Kayita said, adding that primary health care systems at all levels must be strengthened (IRIN/PlusNews, 5/25).
Some officials at the meeting called for African governments to reach 80% of pregnant women, mothers and children with services; reduce by 50% the number of women and infants who do not receive follow-up care; and double the number of HIV-positive children who receive antiretroviral treatment. Xinhua reports that prevention services currently reach about 50% of pregnant women in all Eastern and Southern African countries.
At the close of the consultation, officials issued a set of recommendations for meeting PMTCT goals, including increased community involvement in prevention programs; reduced workloads for health workers; and increased coverage of and compliance with PMTCT regimens. In addition, the experts urged governments to prioritize regions with high HIV burdens, as well as strengthen data management to better understand trends (Ooko, Xinhua, 5/25).
James Kamau, coordinator of the Kenya Treatment Access Movement, recommended that more women in the country deliver in hospitals in order to ensure that they receive PMTCT services (Mwaniki, Daily Nation, 5/25). David Alnwick, a UNICEF regional adviser, said, "It is critical at this juncture, when many countries are faced with shrinking budgets and competing demands, that we do not lose the momentum of what needs to be done to create an AIDS free generation" (Xinhua, 5/25).