It's no secret that maternal health and HIV are closely linked: In fact, mothers living with HIV are eight times more likely to die during pregnancy or childbirth than other pregnant women. And, in sub-Saharan Africa, the link is even clearer: A newly published study in the Lancet estimates that a quarter of all deaths among pregnant and postpartum women in sub-Saharan Africa are due to HIV. That's one reason why I am so encouraged by new results from an innovative public-private partnership in which the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) plays a critical role in Uganda and Zambia. In one year alone, this partnership helped to cut maternal deaths due to childbirth in areas of these two countries by 30-35 percent -- a truly remarkable achievement.
Saving Mothers, Giving Life, launched in June 2012 in eight districts in Uganda and Zambia, is a public-private partnership, which includes the U.S. government (PEPFAR, through its implementing partners the U.S. Agency for International Development (USAID), the U.S. Centers for Disease Control and Prevention (CDC), Peace Corps, and Department of Defense); the governments of Norway, Uganda and Zambia, Merck for Mothers, the American College of Obstetricians and Gynecologists, Every Mother Counts and Project CURE. The driving force behind this partnership is a shared commitment to increase the number of pregnant women reached with HIV services, reduce maternal mortality and improve health systems that impact maternal health and build on the platform for care that PEPFAR's decade of investments have helped to strengthen significantly.
"Saving Mothers, Giving Life started with audacious targets and, in short order, turned them into remarkable results," said PEPFAR Senior Advisor for Policy, Tracy Carson, at an event held last Thursday to launch the partnership's first Annual Report. In the first year of this five-year initiative, the report found that maternal deaths dropped by 30 percent in the districts in Uganda and by 35 percent in the facilities in Zambia where the partnership has been implemented.
PEPFAR's investment in Saving Mothers, Giving Life is also an investment in HIV prevention, treatment, and care. According to the Annual Report, phase one results for the districts were the partnership is present have shown:
- A 62 percent increase in facility-based deliveries in Uganda and 33 percent increase in Zambia. Facility-based deliveries make it far easier to provide antiretroviral medication to mothers living with HIV -- both for their own health and prevention of mother-to-children transmission (PMTCT) -- as well as education regarding exclusive breastfeeding.
- A 28 percent increase (Uganda) and an 18 percent increase (Zambia) in the number of mothers living with HIV that received antiretroviral medication for PMTCT and to protect their own health.
- A 27 percent increase (Uganda) and 29 percent increase (Zambia) in the number of infants receiving both antiretroviral medication for PMTCT and cotrimoxazole for prevention of infectious complications such as pneumonia.
PEPFAR's engagement in Saving Mothers, Giving Life is a natural extension of our commitment to helping achieve an AIDS-free generation, and realize the goals of the Global Plan towards the Elimination of New HIV Infections among Children by 2015 and Keeping their Mothers Alive, which include a 90 percent reduction in new pediatric HIV infections and a 50 percent reduction of AIDS-related maternal mortality by the end of 2015. PEPFAR's extensive investments in PMTCT strengthen the same community- and facility-based health platforms that are needed to deliver maternal and child health services -- so, an investment in one is an investment in both. Moreover, Saving Mothers, Giving Life is a natural extension of PEPFAR's substantial investments to strengthen health systems through the training and mentoring of nurses and midwives; improving supply chain management; bolstering blood safety systems for HIV as well as for women with complications of hemorrhage; and supporting strategic information systems.
Through our holistic approach to serving mothers and families, PEPFAR is playing an important role not only in advancing progress toward Millennium Development Goal (MDG) 6, which aims to reduce new HIV infections and AIDS-related deaths, but also MDGs 4 and 5, which aim to reduce child mortality and improve maternal health. As the 2015 deadline for achieving the MDGs approaches, the tremendous strides made through "Saving Mothers, Giving Life" in just one year give me -- and all those who work with and support PEPFAR -- great hope for our collective ability to improve maternal health as a critical component of achieving an AIDS-free generation.
About the Author: Deborah von Zinkernagel serves as Principal Deputy Global AIDS Coordinator in the Office of the U.S. Global AIDS Coordinator.