Tasila, a young woman from Zambia, was expecting her first child when she visited a local clinic for an antenatal examination. What happened next changed not just her life, but the life of the child she carried.
A routine test revealed that Tasila was living with HIV. Her own life was in jeopardy, and so was the life of her child.
Just a few years ago, an HIV diagnosis would have left Tasila with poor prospects for a normal lifespan — and would have meant a 30 to 40 per cent chance that her baby would also be infected. But Tasila’s clinic offered a programme to prevent mother-to-child HIV transmission, or PMTCT. It made all the difference. Her little boy, Felix, did not acquire the HIV virus, and with her treatment, Tasila will live to see him grow into adulthood.
Far too many women living with HIV in sub-Saharan Africa are not so fortunate. Everyday, more than 1,000 babies like Felix do acquire the infection. Virtually all of them are born in Africa. More than half of all children living with HIV need life-saving treatment — and only a small minority receive it. Without that care, half of those babies will die before their second birthday.
We should all be anguished at the scope and inequity of this catastrophe. But we should also be outraged — because we have the power, the knowledge, and the means to prevent it. In fact, a generation free from Aids is now possible, but only if we can reach those hardest hit by the epidemic — those who are often the hardest to reach. That means tailoring our efforts to meet their circumstances and working at the community level to build a stronger continuum of care for more mothers and their babies.
It means improving antenatal care, family planning, and routine HIV testing in the most disadvantaged communities. It also means supporting mothers like Tasila with the critical PMTCT medicines they need, and preserve their own health. PMTCT has helped to make paediatric HIV/Aids an exception in most developed countries, but in many developing countries, we are still far from reaching those in greatest need.
UNITAID and UNICEF have worked together to change this. We support an integrated approach, which includes not only testing and access to life-saving drugs, but also care and support for mothers and their babies. Our partnership in 16 countries has supported the delivery of PMTCT drugs and supplies to hundreds of thousands of women living with HIV in the most affected communities.
In fact, with UNITAID’s financial support, UNICEF and partners have developed a promising new innovation which we call the “Mother Baby Pack” — take-home boxes that contain the drugs needed to protect the health of a mother and her infant.
These packs are designed to provide life-saving PMTCT treatment to the most vulnerable mothers, especially those who are least likely to return to clinics for follow-up once they have been diagnosed.
World leaders have committed to virtually eliminating mother-to-child HIV transmission by 2015. Reaching this goal will also help us achieve other critical targets, including Millennium Development Goals such as reducing child mortality (MDG 4), improving maternal health (MDG 5), and fighting Aids, TB, and malaria (MDG 6).
We must all do our part to ensure that HIV prevention, care, and treatment are integrated into national health systems. Prevention of the virus must be part of a larger framework that promotes maternal and child health. And we must commit ourselves to ensuring that our efforts do not leave behind those in greatest need. This is not only the right thing to do; it is the smart thing to do. When a baby is born with HIV, society faces a terrible choice between moral failure — ignoring the child’s needs — and massive expenditure — paying for a lifetime of HIV care and treatment. Either way, the costs are unacceptably high.
But by focusing on the elimination of mother-to-child transmission of HIV, we can achieve a comprehensive victory, measured not only in human lives or fiscal savings, but in more equitable societies and a better future for everyone. That is how we will realise the promise of an Aids-free generation.
Dr Bermudez is executive secretary, UNITAID, Dr Douste-Blazy is the chair of the board of UNITAID, Mr Lake is the UNICEF executive director