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Reducing HIV infections among newborns in Malawi and worldwide

Despite the availability of treatments to prevent the transmission of HIV from infected mothers to their babies, hundreds of thousands of children are still being born with HIV according to a senior adviser on HIV/AIDs at UNICEF.

Speaking at the recent International Aids Conference in Washington, Chewe Luo said analysis suggested infections among newborns had dropped by around 10% each year worldwide, but this meant an estimated “330,000 children are acquiring new infections each year”.

Too often, HIV positive mothers are given drugs early on in their pregnancy and also when going into labour, with a short course given to their babies. But this sporadic approach is proving complicated and sometimes ineffective. Experts now believe that levels of infections could be reduced by giving antiretroviral therapy (ART) to all pregnant women, regardless of their viral count, as an alternative to prophylaxis during pregnancy, labour, delivery and birth.

Currently, many pregnant women in sub-Saharan Africa are not receiving ongoing treatment for their HIV condition. Therefore by the time they attend antenatal clinics, they have high levels of the virus in their bodies and are often at such an advanced stage with the disease, they are at risk of dying within two years of giving birth.

In Malawi, for example, there has been a significant drop in HIV prevalence among pregnant women (and also in the general population as a whole). However, among those women infected with HIV, many are not receiving ART. But as awareness rises that ART helps prevent HIV infection among children, Malawi is adopting a new treatment plan called the B+. Under this new programme, the country aims to put all pregnant women with HIV onto antiretroviral drugs continuously and for life. Health clinics are now routinely testing pregnant women for the disease and treating anyone who is HIV-positive. This has meant a sixfold increase in the numbers of pregnant women receiving treatment.

Countries such as Botswana and Rwanda are moving to adopt the B+ model, with others looking into the plan. But despite the reduction in the cost of the two-drug treatment from 180 dollars to 125 dollars (after the Clinton Foundation carried out successful negotiations with drug companies), the extra expense of such programmes is inevitably an issue. However, with the protection of more babies, as well as the partners of HIV-positive women, health experts hope developing countries will see the extra outlay as a good long-term investment.

Laurinda Luffman signature