HEALTH-AFRICA: AIDS Drugs Slowly Reaching the Needy

By IPS Correspondents Reprint | | Print |

Nawaal Deane

JOHANNESBURG, Aug 14 2003 (IPS) - It may seem an impossible task to eradicate AIDS amongst children globally but the staff from the U.S.-based Elizabeth Glaser Paediatric AIDS Foundation appears to be committed to this vision.

On a visit to South Africa this week staff members, together with officials from the U.S. Senate, toured health centres where mother-to-child-prevention programmes have been operating to push back the tide of HIV infections.

"The trip to South Africa is representative of programmes we are funding around the world. We hope to achieve a deepening of understanding amongst these delegates who are helping to shape U.S. laws on the HIV pandemic," said Kate Carr, president and chief executive officer of the Foundation.

In sub-Saharan Africa up to 30 percent of pregnant women are infected with HIV and between 25-35 percent of their children are born infected. More than 2,000 children are infected with HIV world-wide every day.

After dragging its feet for months, South African government has now agreed to roll out a comprehensive treatment plan for the about five million people living with HIV/AIDS – the largest number in any country.

The Treatment Action Campaign (TAC), which has been at the forefront of efforts to force government to make anti-retrovirals freely available, estimates that about 600 South Africans die of AIDS-related illness every day. Anti-retrovirals are drugs which ease the effects of the HIV/AIDS and reduce the spread of the disease.

The Foundation, formed in 1998 by Elizabeth Glaser who lost her own child to AIDS, has been instrumental in reducing the rate of mother-to-child transmission to two percent in the United States.

Three years ago it set its sight on the rest of the world and launched the Call to Action Project, a multi-country campaign to reduce the infection from HIV pregnant mothers to their unborn children in resource-limited nations. The project provides funding for community mobilisation and training of healthcare workers, HIV counselling and testing, anti-retroviral prevention regimens and infant feeding education.

Currently the project supports 46 programmes operating in 17 countries including Rwanda, Zambia, Zimbabwe, Kenya and Cameroon. "Once fully operational these sites will reach more than half a million women per year with voluntary counselling and transitions and inventions to reduce mother-to-child transmission," said Carr.

The Foundation is at the forefront of mother-to-child transmission research and implementation strategies with expertise harnessed from Cathy Wilfert, a leading paediatric doctor.

Speaking at a conference in the South African port city of Durban early this month, Wilfert reconfirmed the need for the anti-retroviral drug, nevirapine, to be used in mother-to-child transmission programmes. The controversy erupted after the South African Medicine Control Council rejected a Ugandan study on nevirapine – which was used as a pivotal for registration of the drug.

She said that a single dose of nevirapine reduces the transmission of HIV from mother to their infant by up to 47 percent and the benefits are sustained in a breastfeeding population for up to 18 months.

Wilfert says the challenge to roll-out the drugs differs in each country. "The major challenges are resources, whether they are human or financial. Most of the clinics that are in the public sector don’t have enough staff to provide care. So when you increase the complexity of the programme by providing mother-to-child transmission you are extending the hours of those healthcare workers," says Wilfert.

Carr says they have had successes with uptake throughout Africa; an example of best practice is in Cameroon, where programmes were expanded with a very small grants. She says the challenges are government leadership and finding people on the ground committed to making the programmes successful.

Last week, South African president, Thabo Mbeki signed a funding agreement with the Global Fund to Fight AIDS, Malaria and Tuberculosis. The agreement, worth R300 million (40 million U.S. dollars), has been held up in bureaucratic wrangling for almost two years.

Nearly 30 million people in Africa are living with HIV/AIDS, including three million children under the age of 15.