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As the 18th ICASA conference continues to highlight one of the key messages, which is, to end AIDS by 2030, one of the sessions on prevention of mother to child transmission (PMTCT) shed light on initiatives that African countries continue to implore in the HIV response.
In this interesting panel discussion, chaired by Deborah Von Zinkernagel Acting Global Coordinator and Principal Deputy Global AIDS Coordinator in the Office of the U.S. Global AIDS Fund, case studies and unique interventions targeting mothers and unborn children were unpacked. Young women, adolescents and youth have been identified as the key change agents in achieving an AIDS free generation by 2030 and thus efforts to thwart the spread of HIV has been identified as key from child delivery.
In this discussion, the key question that probed the panel was on the success models that have been implored in countries to curb mother to child transmission of HIV? One of the panelists, Florence Anam, of the International Committee of Women living with HIV in Nairobi, Kenya discussed how women are key in playing a pivotal role towards this agenda. She emphasised that the community is responsible for coming up with solutions before global agents. She identified that the role of support groups in Kenya, Nairobi provided a hub of care and security to women who are both infected and affected by HIV. Support groups have been key in relaying messages of awareness and have also provided an educational platform on the different ways of prevention of mother to child transmission.
Testimonies of “peer mothers”, that is, those mothers who have delivered healthy and HIV free babies provided a ray of hope to expectant mothers with the virus. Of interest, was also the amount of work being pioneered by the faith community in the fight towards prevention of mother to child transmission. Fr John Okoye a catholic priest in Nigeria challenged the faith community to be proactive in the endeavor to optimize prevention of mother to child transmission. He reveled that some church leaders in his diocese had introduced peer groups within the church that identify expecting mothers and take them through PMTCT counseling at early stages. These leaders become responsible for the care of these mothers and provide emotional and mental support and care.
Zimbabwe as the host country of the 18th ICASA conference presented interesting initiatives that are currently running in the country towards optimizing PMTCT through Dr Angela Mushavi, National Co-ordinator of PMTCT in the Ministry of Health and Child Care. Amidst the various strategies being implemented at community level, she took peculiar attention to the PADARE men’s forum that is spearheaded by man at community level in playing a key role towards PMTCT. Amongst the other scope of activities this forum deals with, include strengthening men’s movement to redefine masculinities, promoting the transformation of cultural institutions and dealing with patriarchy, gender based violence and HIV and AIDS particularly in the rural areas. Man have been identified as being critical in understanding and being active towards PMTCT by ensuring that they do not partake in activities that promote the spread of HIV.
After all was said and done in this discussion, the key question then was where are we lacking in achieving the ultimate zero infection at child bearing? What of those mothers who do not attend pre-natal care and are delivering outside hospitals and clinics where there is no access to sufficient care required during PMTCT? Are these initiatives really achieving what they are set out to do and if so, where are the measurements to show for it?
The global fund is only a 5 year plan being rolled out by the US government towards eliminating HIV infections among children and keeping mothers alive, what happens after the 5years elapse?
These were some of the questions that the delegates presented to the panel in a bid towards achieving the same goal. In response to some of these key questions was the proxy of Dr Sylvere Bukiki the Regional Director at International Treatment Preparedness at the Coalition regional networks for West Africa, who reiterated on the need to invest into research and development at community level. He reiterated that countries need to learn from Cuba. Cuba became the first country in the world to receive validation from the World Health Organization that it has eliminated mother-to-child transmission of HIV and syphilis.
WHO have been working with partners in Cuba and other countries in the Americas since 2010 to implement a regional initiatives to eliminate mother-to-child transmission of HIV and syphilis. As part of the initiative, the country has worked to ensure early access to prenatal care, HIV and syphilis testing for both pregnant women and their partners, treatment for women who test positive and their babies, caesarean deliveries and substitution of breastfeeding. These services are provided as part of a universal health system in which maternal and child health programs are integrated with programs for HIV and sexually transmitted infections.
Cuba’s success demonstrates that universal access and universal health coverage are feasible and indeed is the key to success.
Deborah Von Zinkergal, Acting Global Coordinator and Principal Deputy Global AIDS Fund pledged further assistance through the President’s Emergency Plan for AIDS Relief (PEPFAR). The challenge still remains to broaden these activities and the effectiveness to household level – this can only be done by the social worker who is also a contributor to the value chain.
A consensus of views from the panel was that the community plays an integral role in the cycle towards PTCMT, the medical sector provides the necessary testing and appropriate distribution of drugs but the society embraces the individual. It remains key in fighting stigma and discrimination. The community is the family to the infected to which in its absence stigma and discrimination will continue to creep in, are we playing our part in the bid to end HIV/IDS by 2030