International Conference calls for the elimination of Mother-to-Child transmission of HIV in West and Central Africa


International Conference calls for the elimination of Mother-to-Child transmission of HIV in West and Central Africa

PARIS, France/ HONG KONG, 16 November 2011 – UNICEF and other organisations committed to the fight against HIV/AIDS are holding a two-day meeting in Paris to mobilise field workers, policymakers and donors to provide access to the means to prevent the transmission of HIV between mothers and children in West and Central Africa.

A health worker holds a bottle of antiretroviral medicine at the Princess Christian Maternity Hospital in Freetown, the capital. The medicine is being dispensed to a 15-year-old HIV-positive girl, for her seven-day-old newborn. The drug is part of a regiment of treatments and tests intended to prevent mother-to-child transmission (PMTCT) of HIV.  In March 2011 in Sierra Leone, the country commemorated the ten year anniversary of the end of its civil war, which left 50,000 dead and 10,000 amputated. Although progress has been made since the wars end, Sierra Leone still ranks at the bottom of the 2010 Human Development Index. Health centres remain under-resourced, and medical care remains too expensive and inaccessible for many people. The countrys under-five mortality rate is fifth highest in the world, maternal mortality is among the worlds worst as well, and over a third of children under age five suffer stunting due to poor nutrition. According to 2008 data, only 49 per cent of the population uses improved drinking water sources, and only 13 per cent have access to improved sanitation facilities. Education systems are also deficient, with an insufficient number of schools and trained teachers. Girls face additional barriers to education, including high rates of early marriage and teen pregnancy, extra fees, and sexual abuse and exploitation in schools. UNICEF is working with the Government and partners to improve conditions for Sierra Leones children, supporting programmes that train teachers and school managers and that strengthen community-based health systems. UNICEF also supports a Government programme, launched in April 2010, that abolishes fees for primary health services for pregnant and lactating women and all children under age five.Reducing 90% of new infections among children and halving the maternal deaths related to AIDS is a target for 2015 under the Millennium Development Goals. The conference at the Pasteur Institute heard appeals for the countries concerned to make this a national priority. In the absence of prophylaxis and treatment, up to 40% of babies born to HIV positive mothers can be infected with HIV. When the means are available, the risk of transmission can be reduced to less than 5%.

In West and Central Africa there is a background of high maternal and infant mortality, and the transmission from mother-to-child remains generally high. Although the number of women receiving ARV treatment to prevent ‘vertical’ transmission has risen from around 4% in 2005 to 23% in 2009 (when the last statistics were available) this is still too low. Too many women and children are excluded from receiving PMTCT assistance (prevention of mother-to-child transmission) and the countries in the region do not receive the attention, commitment or adequate financial support of policymakers and the international community to reverse the trend.

There is no time to lose. The solutions and strategies exist and have been implemented successfully in other African countries. The international conference organised by UNICEF France, the Ministry of European and Foreign Affairs of France, the French Development Agency (AFD), the National Agency for Research on AIDS and Viral Hepatitis (ANRS), Esther, the Pasteur Institute, UNAIDS and UNITAID, will mobilise efforts to bring more pressure to bear and turn around a situation which is unacceptable. Built as a platform for exchange of experience, firmly focused on “what works”, the conference is an opportunity to bring together field workers, policymakers and top experts from 24 countries in West and Central Africa and their international counterparts.

“Experience shows it is possible to prevent children from contracting HIV/AIDS at birth even in poor countries. Protecting babies against the virus is a matter of political will and priority in the allocation of resources and donor states,” said Jacques Hintzy, President of UNICEF France,” so there is no reason to wait. “

An effective PMTCT should be integrated into health care of mother and child. Perinatal monitoring of pregnant women must be strengthened and to mainstream services for HIV testing and counseling to women, early detection in infants, and the mobilisation of fathers around the detection and prevention should be encouraged. Moreover, to be developed nationally, the approach must be based on decentralisation of services, sharing of tasks and improving the support closer to the communities most isolated and vulnerable. Finally, the feasibility and effectiveness of comprehensive strategies must be evaluated in operational research programmes.

Pregnant women listen to a midwife discuss the importance of HIV testing to prevent mother-to-child transmission (PMTCT) of the disease, at the hospital in Kani, a town in Worodougou Region. [#1 IN SEQUENCE OF FOUR]  By 27 January 2011 in Côte dIvoire, some 20,000 people were internally displaced by violence that erupted after the 28 November 2010 presidential election, and an estimated 32,000 others had fled to neighbouring Liberia. Homes have been looted and burned, and many schools have remained closed since the election. The situation has been exacerbated by outbreaks of yellow fever and cholera. Sixty-four cases of suspected yellow fever and 25 related deaths were reported in the districts of Béoumi, Katiola, Séguéla and Mankono, rural areas with low vaccination rates. Yellow fever, a deadly disease transmitted by mosquito, has no known cure, but vaccination provides ten years of immunity. The Ministry of Health, UNICEF and the World Health Organization (WHO) have initiated an emergency immunization campaign against the disease, targeting 840,000 people aged 9 months and older. The Global Alliance for Vaccines and Immunisation (GAVI) is providing the campaigns vaccines. Meanwhile, a cholera epidemic has been declared in Abidjan, the countrys most populous city, with seven deaths out of a reported 35 infections. UNICEF and the WHO are supporting a rapid response to that outbreak as well, including the distribution of soap and chlorine and the promulgation of cholera-prevention messages. UNICEF is also responding to the mass displacement crisis by distributing blankets, sleeping mats, insecticide-treated mosquito nets, high protein biscuits, water treatment supplies, pre-school supplies and recreation equipment for children in displaced communities, and by providing family reunification services. [RELEASE OBTAINED] Natasha Chisenga Simpasa holds her six-week-old daughter, Mutale, in the Chelstone Clinic in Lusaka, the capital. Ms. Simpasa is HIV-positive, and has brought Mutale for her first HIV test. Ms. Simpasa participated in the clinics PMTCT programme for her sons, 20-month-old Fanwick and four-year-old Masonda, both of whom are HIV-negative. She is now participating in PMTCT for Mutale. [#2 IN SEQUENCE OF NINE]  In October 2010 in Zambia, the Chelstone Clinic in Lusaka continues to provide vital programmes to treat HIV-positive pregnant women and to prevent mother-to-child transmission of HIV (PMTCT). Some 95,000 Zambian children under age five are infected with HIV; the vast majority contracted the illness from an HIV-positive mother during pregnancy, delivery or breastfeeding. PMTCT programmes include HIV testing during pregnancy, antiretroviral (ARV) regimens for sick HIV-positive pregnant women, and early diagnosis and treatment for infants exposed to HIV in utero. Participating infants receive prophylactic antibiotics and ARVs in the weeks after they are born, and are administered HIV tests at six weeks. If breastfed by an HIV-positive mother, infants continue to receive prophylactics and are tested again at 12 months and 18 months (and three months after breastfeeding ceases or at any age if they fall ill). HIV-positive infants diagnosed and treated within the first 12 weeks of life are 75 per cent less likely to die from the disease. Zambia has recently made great strides in expanding PMTCT programmes. In the second quarter of 2009, ARVs were administered to approximately half of all children in need and to some 57 per cent of HIV-positive pregnant women. However, many infants still do not receive PMTCT services because their caretakers lack access to properly equipped facilities, or fear the stigma associated with HIV, or find it difficult to adhere to the structured course of required tests and services.

With more resources, the West Africa and Central is able to accelerate its progress towards ETME and improving maternal health by 2015.

Professor Stephen White, Hospital Necker-Sick Children, who led the preparation of the Conference, emphasised that “the means for achieving elimination are: drugs, effective strategies, researchers, donors and aid, an international network that is organised. It is therefore necessary, with a strong political will, for all the actors at each level of responsibility, to push strongly for effective prevention of vertical transmission of HIV. This is the objective of the Conference.”