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Capitol Hill Panel Discusses Increasing Momentum Toward Elimination of Pediatric HIV/AIDS

Posted by Dr. Laura Guay
Washington, D.C.
February 2, 2011


This week I had the pleasure of joining an esteemed panel on Capitol Hill, which was organized by amfAR (The American Foundation for AIDS Research) and sponsored by Senator Kirsten Gillibrand, to talk about global efforts to eliminate new HIV infections in children.

Click here to read an article about the panel in the Science Speaks blog.

The discussion focused on the importance of preventing mother-to-child transmission of HIV (PMTCT), and the future of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), which provides so much of the global funding for HIV prevention and treatment.

(Photo: Georgina Goodwin/EGPAF)
As I was preparing to speak, I started to think about my pre-PEPFAR days in Uganda in the 1990s. I was fresh out of my pediatric training, and working on the issue of PMTCT as an HIV researcher. Uganda was one of the first countries in Africa that not only recognized that HIV/AIDS was a real threat, but also tried to bring in resources to fight the worsening pandemic.

In the early days of AIDS in sub-Saharan Africa, women were just learning that they could be infected with HIV, and could pass the virus on to their babies. They were begging for help for their children, just like Elizabeth Glaser did in the 1980s. Unfortunately, we didn’t yet have the tools and know-how that we do today.

We often talk at the Foundation about what a hero Elizabeth Glaser was, doing everything she could to save her children. I have seen that same spirit in the women throughout Africa, who are willing to enter clinical trials to help all women and children confronting the virus. These women are often unsung heroes in our fight against HIV/AIDS.

Thanks to this research, we were able to find more simple and cost-effective ways to not only treat women and children living with HIV, but to prevent babies from being born with the virus, even in the remotest communities.

If a woman in rural Africa is able to buy a bottle of Coke, she should be able to access PMTCT services as well.

It was also out of this early research in 2002 that the first major U.S. government-supported PMTCT program was born – The International Mother and Child HIV Prevention Initiative – which showed that it was possible to rapidly roll-out HIV prevention and treatment services throughout Africa, and laid the groundwork for PEPFAR.

Watching how PEPFAR has progressed and grown since 2003, it is amazing to see the momentum we have built toward eliminating pediatric HIV and AIDS.

According to the UN, in 2009 53 percent of HIV-positive pregnant women in low- and middle-income countries received medicines that can prevent mother-to-child transmission of HIV. That’s up from 45 percent in 2008, and just 15 percent in 2005.

Much of that increase can be attributed to PEPFAR and the Foundation’s own work.

I was pleased to hear other panelists discuss their own successful HIV programs, made possible with PEPFAR support. One point of agreement was the need for greater community-level engagement in PMTCT programs.

As Dr. Elaine Abrams – from Columbia University’s International Center for AIDS Care & Treatment Programs (ICAP) – noted, PMTCT services are inextricably linked with maternal and child health (MCH) services. Reaching women at the community level to encourage antenatal care attendance, facility deliveries, and regular postnatal care are all key to increasing maternal and child survival. Applying new lessons learned and building on this PMTCT/MCH platform can help us not only combat HIV/AIDS, but many other diseases affecting the health of mothers and children.

But just because the numbers are improving does not mean we can ease up on our battle against HIV. With more than 1,000 babies still being infected each day, there is clearly still much work to be done.

The Foundation is leveraging our success through PEPFAR to also encourage the generosity of private donors to enhance and expand our efforts throughout the countries hardest hit by the pandemic.

The lessons learned from these efforts will help us gain even more momentum, and expand our reach to all women, children, and families facing HIV and AIDS.

They will also provide a road map on how to achieve the virtual eventual elimination of new pediatric HIV infections, in Africa and throughout the world.

Dr. Laura Guay is the Foundation’s Vice President of Research, and also serves as a research professor at The George Washington University (GWU) School of Public Health and Health Services. She worked on the landmark HIVNET 012 trial in Uganda, which was the first study to determine a simple and effective method to prevent mother-to-child transmission of HIV in resource-poor countries.
 

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