Championing The End of Pediatric AIDS: First Lady of Uganda launches Option B+

Children entertain guests at the Option B+ launch in Kampala, Uganda.

Irene Nabusoba/EGPAF

March 22 was a day of promises, recommitments, and pledges to end pediatric HIV infections in Uganda, as the country’s first lady launched Option B+ and a campaign to eliminate mother-to-child transmission of HIV (eMTCT).

Launched under the theme, “Stand out. Participate. Be counted: Have an HIV-free baby,” the national event took place at Itojo Hospital playgrounds in Ntungamo district in southwestern Uganda. The event was organized by the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), in conjunction with the Ministry of Health (MoH) and the First Lady’s Office with guidance from the Organization of African First Ladies against HIV/AIDS (OAFLA)-Uganda Chapter.

With over 3000 people in attendance, the message was clear: male involvement, political leadership, and government ownership to ensure an HIV-free generation.

“I always do not believe that men are all that bad. And that the men are not willing to support their wives,” said UNICEF’s Dr. Richard Oketch, who spoke on behalf of Aid Development Partners (ADPs) in Uganda. “I’m a man and I’m not bad. We the men need to check ourselves. Let’s be supportive, let’s stand out, participate, and be counted.”

The packed meeting included participation from members of OAFLA from the East African region, ADPs, members of Parliament, MoH officials, religious leaders, and pediatric HIV implementation partners countrywide.

Sarah Opendi Achieng, the minister of state for health and primary health care, said the launch marks the beginning of an HIV campaign on eMTCT countrywide. “In 2000, we began a journey to prevent HIV transmission from HIV-infected mothers to their babies using Option A. At the time, a team of researchers in our own country demonstrated that Nevirapine, given to a mother while in labor and to the child after birth, could reduce transmission of mother to child by half.”

She then said that the country had fallen short on its goals to reach all pregnant women with the drugs to prevent mother-to-child transmission. “Thirteen years later, we have only identified and provided drugs to half of the HIV-positive pregnant mothers who need this treatment,” she said. “We can do better than this. Experts know the science, let’s provide the political leadership.”

The transmission of HIV from mothers to their infants kills millions of young children each year. If children born to HIV-positive mothers do not receive treatment, the World Health Organization (WHO) cautions that over half will die before the age of two.

In Uganda, the Ministry of Health AIDS Control Program report from 2012 estimates that nearly 1.4 million Ugandans are living with HIV – including 98,000 pregnant women – contributing to a staggering 16,000 new cases of children infected through mother-to-child transmission of HIV annually.

Since its inception in 2000, the MoH’s national PMTCT program has steadily scaled up to cover over 2,000 (40 percent) of the estimated 5,000 health facilities in Uganda. But despite the success, some pregnant women are not being reached, and many HIV-positive mothers are being lost to treatment because of limited access to diagnostic services, complicated drug regimens, poor adherence, and the start-and-stops associated with the previous guidelines. For instance, only 68 percent of HIV-positive pregnant women received antiretroviral medications (ARVs) for prevention of mother-to-child transmission (PMTCT), and only 38 percent of their babies received treatment to prevent HIV after birth.

‘Maama’ (for mother), as First Lady Janet Kataaha Museveni is fondly known, said that Option B+ will address these gaps. She appealed to Village Healthcare Teams, parents, and community leaders to encourage mothers to attend antenatal care so that if they are HIV positive, they can access the preventive drugs immediately.

“The success of this campaign is dependent on the mothers,” Museveni said, further appealing for male involvement. “Men, go with your wives for HIV testing, encourage them to return for antenatal care and to give birth at the health facility. You can have an HIV-free baby.”

Karen Klimowski, who represented the U.S. government at the event, cautioned that Option B+ is just part of the answer, urging “the government of Uganda to do its part by strengthening the country’s maternal and child health systems, its healthcare supply chain, and its monitoring and evaluation chain for PMTCT.”

“We must increase investments in maternal and child health healthcare in order to improve the healthcare of every Ugandan,” Klimowiski said.

“Through increased access to antenatal care, the safe delivery of babies by skilled health care providers, and improved feeding for infants and young children, we can change the lives of countless women and children.”

Irene Edith Nabusoba is Communication and Outreach Officer for the Foundation, based in Kampala, Uganda.