Africa Lagging on Prevention of Mother-to-Child HIV Transmission

In Africa, lack of infrastructure and other obstacles to HIV drugs access continue to hamper efforts to prevent mother-to-child HIV transmission (MTCT), experts said Monday at the start of the 14th International Conference on HIV/AIDS and Sexually Transmitted Infections in Africa. MTCT accounts for 90 percent of the 600,000 annual pediatric infections worldwide, the majority in Africa and South Asia.

"In Africa, the big problem is inadequate health systems and health infrastructure -- there is a lack of structures, a lack of personnel and a lack of medicines," Ngashi Ngongo, an MTCT specialist at UNICEF, told the conference in Abuja, Nigeria.

"Infant feeding in sub-Saharan Africa is a real conundrum," said Ngongo. "In the developed world one would say don't breast-feed. But applying that in Africa is a real challenge because you increase the risk of the baby dying from other diseases such as diarrhea." If a mother combines breast- and bottle-feeding methods, contaminated water could inflame the baby's digestive tract, increasing MTCT risk when she breast-feeds.

Hygiene risks may undercut the benefit of delivering an infected mother's child by cesarean section. "If the setting is not safe you increase the risk of infection and therefore the risk of mortality," said Ngongo.

Many women give birth without ever knowing their serostatus. In sub-Saharan Africa, giving mothers and newborns HIV drugs to prevent MTCT is difficult, since only 41 percent of deliveries are attended by a health professional.

"The important message to get across is that the necessary technology is there," said Ngongo. "The problem is that our governments need to make these services available to all women." "Unless we scale up our efforts to eliminate mother-to-child transmission, the number of deaths among children will continue to increase through 2010," said Terguest Guerma, World Health Organization's deputy head of HIV/AIDS.

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