Serious about fighting HIV and Aids

Thursday, March 11, 2010

Increased measures aimed at reducing HIV transmission from mother to child by 2015 have been put in place throughout Sub-Saharan Africa and with bold and life changing policies set to come into effect in South Africa as of April this year, this target might very well be within reach, writes Gabi Khumalo.

The 2010 Global Fund report on progress made in fighting HIV and Aids, Tuberculosis (TB) and malaria revealed that the number of children younger than 15 living with HIV increased from 1.6 million in 2001 to 2 million in 2007.

In 2008, around 430 000 children under 15, became infected with HIV, mainly through mother-to-child-transmission (MTCT) and about 90 percent of these infections occurred in Africa, according to the report.

Global Fund Executive Director, Professor Michel Kazatchkine, said South Africa has stepped up its HIV prevention, care and treatment services.

On World Aids Day in 2009, President Jacob Zuma, announced life-changing policies, that would come into effect next month.

Zuma said HIV positive people, with a CD4 count of 350 or less, will now receive anti-retroviral (ARV) treatment. He also said pregnant HIV positive women with a CD4 count of 350 or with symptoms, regardless of their CD4 count, will now have access to treatment. Pregnant women, not falling in this category but who are HIV positive, will be put on treatment at 14 weeks to protect the baby.

Between December 2007 and December 2008, the number of people receiving antiretroviral therapy (ART) in South Africa increased from 458 951 to 700 500. This led to the stabilization of mortality rates.

"We should eradicate the transmission and intensify programmes that address the quality of life of women and in particular to ensure that attainment of MDG 5, which seeks to reduce three quarters [75 percent] of Maternal Mortality Ratio by 2015," said Health Minister Dr Aaron Motsoaledi.

He said over the years, government had instituted inquiries into maternal deaths to find specific causes, especially those that can be avoided so that action could be taken.

Successive reports by the committee that assess maternal deaths found common challenges including the need for training for healthcare workers, late presentation at hospitals [poor antenatal care] and inadequate availability of supporting infrastructure particularly in rural areas.

"The reports have made several recommendations to address these challenges. By the end of March 2007, 85 percent of our health institutions were implementing the recommendations from the Saving Mothers Report.

"We have revised the Maternal Health Strategy and one of the major interventions that this strategy seeks to strengthen is the community-based response, which will assist us in ensuring that avoidable causes of maternal deaths are detected early and referrals to health institutions done in time," Motsoaledi said.

At least 95 percent of health facilities provide Prevention of Mother-To-Child-Transmission (PMTCT) services and the country is beginning to see the impact of the interventions.

Government has expanded its ART programme for people living with HIV and AIDS to about 920 000 patients.

"These achievements were possible because of our partnership with our development partners including the Global Fund.

"Through our partnership with Global Fund and other development partners, we have trained thousands of healthcare workers to provide these services and have increased access to these facilities," said Motsoaledi.

The Fund has increased its funding to broaden the coverage of programmes to prevent mother to child transmission to specifically accelerate the transition to more efficacious and quality programming in high burden countries.

The target is that at least 80 percent of Global Fund supported PMTCT programmes meet the requisite levels of efficacy and quality.

"The aim is to support country efforts to reduce MTCT to less than 5 percent by 2015, the year of the Millennium Development Goals (MDGs) deadline," said Kazatchkine.

Currently, 790 000 HIV positive pregnant women in low and middle income countries received antiretroviral prophylaxis to prevent mother to child transmission, which represents 45 percent of coverage of women in need.

Kazatchkine stressed that 2010 is a pivotal year to finance the final stretch of the effort to reach the MDGs.

"We have made unprecedented progress but it is fragile, if we lose momentum now, there will be a heavy price to pay.

"A failure to continue the scale up of investments in health will betray the trust of millions," warned Kazatchkine, adding that South Africa has had successes in the fight against HIV and AIDS.

The Global Fund disbursed $ 97.2 million for HIV grants and $ 87.2 million for TB and HIV grants by the end of 2009 to support South African efforts to respond to HIV.

Activities focused mainly on behaviour change communication, provision of Antiretroviral Treatment (ART) and TB and HIV collaborative activities.

In October 2010, the Global Fund will hold its third replenishment session, where government will make their financial pledges for 2011 - 2013.

At a replenishment review meeting, to be held at the Hague on 24 March 2010, the Global Fund will present three resources scenarios for consideration to donors, each with an indication of the results that could be expected in terms of achievements on the ground at the end of the replenishment.

The different scenarios range from $13- to $20-billion for the three-year period.