Mission to Nigeria Spotlights Progress, Challenges in Preventing Mother-to-Child Transmission of HIV

Posted by Eric Goosby
April 30, 2012
Mother Holds HIV Free Daughter in Nigeria

Last year PEPFAR and UNAIDS joined with other partners to launch the Global Plan, an initiative to eliminate new HIV infections among children and keep their mothers alive. Last week I was proud to take part in a two-day mission to Nigeria with Michel Sidibe, UNAIDS Executive Director. (As I described in this post last week, our visit was interrupted by the tragic bombings.)

Each year, nearly 400,000 children are born with HIV globally, and prevention of mother to child transmission (PMTCT) is a particular challenge in sub-Saharan Africa, an area characterized by weak health systems. Incredibly, Nigeria alone bears about one-third of the global burden of new HIV infections among children. It is thus one of 22 priority countries of the Global Plan, which collectively account for nearly 90 percent of all new HIV infections among children annually. The Plan's central goal is to reduce the number of new pediatric infections in these countries by 90 percent.

We know what to do to prevent vertical transmission -- the science is long-established, and many countries (including Botswana) have achieved virtual elimination. PMTCT is a top priority for PEPFAR, and in 2011 alone, we supported programs that tested nearly 10 million pregnant women. Of these, more than 660,000 pregnant women were found to be living with HIV, and antiretrovirals (ARVs) for these women allowed more than 200,000 infants to be born HIV-free. These are the highest PMTCT results of any year in PEPFAR's eight-year history.

During our mission, we met with Nigeria's First Lady, Dame Patience Jonathan, who personally leads the country's PMTCT strategy. We also met with the Nigerian Minister of Health and Governors and Health Commissioners from PMTCT focus states, who play key roles in expanding PMTCT services in the country. We also had dialogue with Nigerian business, faith-based, and community leaders about the critical contributions they can make to achieving the elimination goal. Throughout these interactions, we focused on the main barriers to PMTCT progress at both the national level and in priority states, and began to identify the most effective strategies to address these challenges collectively. We also discussed Nigeria's plans to optimize and increase all available resources in the country, in order to achieve a generation born HIV-free.

As we have learned from the 30-year history and struggle of AIDS, extraordinary things happen when we work together. By uniting around our common humanity in a spirit of shared responsibility, we can give a chance at a full life to children and mothers around the world. Preventing new HIV infections in children is a smart investment that saves lives, and the United States is proud to partner with Nigeria and other countries in this cause.



Anthony O.
May 1, 2012

Anthony Ekene O. in Nigeria writes:

It was very heart-warming reading this.This is not unconnected with the fact I currently work as a drug dispenser(under the National Youth Service Corps) in a Health Centre in rural Benue State,Nigeria.This health centre has a weekly PMTCT clinic and attendance rates are quite high.However,It is clear to see that there are constraints which I have tried to resolve here:

1.Drugs for Opportunistic Infections.Fine,The ARVs come free but what about the other drugs?I know that some of the co-ordinating NGOs have an agreement with the clinics to reimburse the latter for the OI drugs they dispense.Nevertheless,the health facility most times have no stock and worse still the patients have no money to buy them in the medicine stores.

Suggested Solution: As the ARVs are provided gratis,lets also have drugs for oppportunistic ingections provided free.It is true to say that there is a strong possibity of diversion and arbitrage but these can be kept in check through routine audit checks.

2. Distance to Clinics and Economic Implications. Many of the women who attend these clinics are rural farmers and the time spent at the clinics is a big worry for them.Some of them comes as far as 30km and have to spend quite a lot interms of time and money in the course of attennding the clinic and they do complain pathetically about this.

Suggested Solution: How about engaging the community health workers to visit clinic defaulters and those who live faraway at home if its okay with them.This wiil really help.

Alongside these,there is need for a lot more aggressive advocacy to reach people in the very hinter rural areas.Many women e.g in Logo Local Government Area of Benue have not been reached and would transmit the infection to their babies when born if they do not start attending the clinic.

In conclusion, much more HIV advocacy needs to be done in high burden states like Benue.This will enhance PMTCT success and also prevent lateral transmission.



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