Although antiretroviral drugs known to prolong the life of people living with HIV have been available for more than a decade, two-thirds of HIV-positive pregnant women in the developing world do not receive any medication to prevent mother-to-child transmission (PMTCT) or vertical transmission.
Worse still, most of those who receive drugs are treated with a therapy that is only 40% effective, rather than the triple-dose combination therapy that can prevent almost 98% of newborn HIV infections, according to the research Missing the Target #7: ‘Failing Women, Failing Children: HIV, Vertical transmission and women’s health’ conducted by civil society in Moldova and five other countries.
Why is PMTCT important?
PMTCT of HIV, which can occur during pregnancy, birth or through breastfeeding, accounts for more than 10% of all new HIV infections around the world. The risk of PMTCT can be reduced to less than 2% with a package of interventions including antiretroviral prophylaxis and treatments combined with elective caesarean section and avoidance of breastfeeding.
The ambitious MDGs of reducing child mortality, maternal mortality and the spread of HIV/Aids by 2015 are still some way from being realized.
Challenges in Moldova
There is evidence that exclusive breastfeeding carries a lower risk of HIV transmission than breastfeeding combined with other fluids or foods. In Moldova, knowledge about PMTCT is relatively limited. The choice of deciding on the best infant-feeding option comes up against many challenges, such as stigma and discrimination in healthcare settings, family pressure and limited financial resources to buy alternative food beyond the first year when formula is provided for free. |
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Time to speak out!
 (First left) Liudmila Untura, Director of Childhood for All and other plenary speakers at the session on PMTCT |
Liudmila Untura, director of Childhood for All, made a presentation on PMTCT and research findings at the third National NGO Forum on HIV/TB on June 12 in Chisinau, Moldova, in front of about 120 people– many of which are government representatives, ministries, UN agencies, civil society representatives and media. As well as providing recommendations for improving the effectiveness of prophylaxis and treatment programmes for women and children in Moldova, Untura said that the national PMTCT programme must be made a priority for the New HIV National Strategic Plan 2011-2016: ‘Critical to the success of the PMTCT programme is improved uptake which requires a national community mobilization. Overcoming stigma and discrimination in public health sector can also be challenging. We need the government to provide treatment for pregnant women, help promote testing, appropriate feeding strategies for infants and provide social support such as counselling on family planning, reproductive choices, psychological support and travel subsidies. The new National Strategic Plan must address all these issues.’ |
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Mr O Benes, head of the Centre for Preventive Medicines, commented, “Such a high level of stigma and discrimination towards children and women living with HIV undermines HIV prevention efforts.” In addition, the vice director of this Centre, Mr. Stefan Georgris, decided to invite 10 people living with HIV (PLHIV) as trainers to join the working group of the UNICEF-funded pilot project ‘Decreasing stigma and discrimination against people living with HIV,’ which addresses the issues of stigma and discrimination from health care workers.
In-country civil society partners, who highlighted the importance of PMTCT advocacy and joint efforts in improving the quality of PMTCT services, agreed to sign a civil society memorandum on PMTCT strategies in the near future.
Moving forward
PMTCT was once expected to be the great success story of the HIV pandemic and today’s programmes could be a logical entry point for women and families needing health care. But for those programmes to be successful, they must be women-specific and address gender issues. They must offer comprehensive maternal and child health services, not just protecting the infant from HIV, but testing and treating the mother and her family and providing comprehensive pre- and post-natal care, prevention and reproductive health counseling and services.
Contact: Attapon Ed Ngoksin, editpc@gmail.com
Liudmila Untura, luntura@yahoo.com
www.itpcglobal.org