Q & A with First Lady of Ghana and OAFLA President, H.E. Dr. Nana Lordina Dramani Mahama

The Organization of African First Ladies (OAFLA) was founded by 37 African First Ladies in 2002 as a collective voice for Africa’s most vulnerable people: women and children infected and affected by HIV and AIDS. OAFLA works to enable African First Ladies to advocate for effective policies and strategies toward ending the AIDS epidemic as a public health threat, reducing maternal and child mortality, and empowering women and children through strategic partnerships in the spirit of solidarity.

EGPAF got an opportunity to talk with the First Lady of Ghana and OAFLA President Lordina Dramani Mahama about her experiences with OAFLA, and the progress being made to end AIDS in Ghana and across Africa.

Q: What achievements are you most proud of contributing to as First Lady?

A: I have worked to bring a range of health services to the doorsteps of communities across my country that previously lacked access and resources. We’ve seen tremendous success by using an integrated health approach and reaching populations at the events, festivals, and public spaces where they assemble. There they can access many different services for free including: HIV Testing Services, Syphilis Testing, Breast and Cervical Cancer Screening and Family Planning Services. The services provide more than just health screenings because they are coupled with advocacy, awareness raising and in depth education on HIV prevention and the prevention of mother to child transmission of HIV in particular. These services seek to benefit populations holistically, and long-term.

Q: In your position, what notable progress have you seen in the effort to end paediatric HIV and in the epidemic at large over recent years?

A: Since 2011, global leaders made a historic commitment before the world to end HIV infections among children. My husband was among these leaders as the then Vice President of Ghana. Through this commitment, there were conscious efforts by countries to prioritize the elimination of mother-to-child transmission of HIV through increased allocation of funding and scaling up services to ensure universal access.

Progress has been made, with a couple of countries achieving elimination. Unfortunately West and Central Africa still lag behind, but with continued and accelerated efforts this can change. We must persist in our efforts.

Q: What is the most urgent thing that needs to be done in the next several years in order to continue progress towards ending AIDS in children?

A: To end AIDS in children means we need to stop new infections in children; no child should be born HIV-positive, no child should die as a result of AIDS or related illness.

Countries need to align their national treatment guidelines with the World Health Organization’s (WHO) recommendation for immediate treatment, regardless of viral load, CD4 count, or clinical stage, for HIV-positive children younger than age five.

Q: What actions will you take to make sure these goals are met?

A: As OAFLA President, my colleagues and I, as First Ladies, have been organising side meetings during high-level programs such as UNGA and ICASA to facilitate important partnerships for Maternal, Neonatal and Child Health; and to advocate for early infant diagnoses and availability of medication.

I continue to spearhead the need to empower women and girls to prevent HIV and gender-based violence.

The first ladies and I will continue to embark on high level advocacy with national and community leaders to support elimination of mother-to-child transmission (eMTCT) and other interventions and also challenge stigma by engaging celebrities and people living with HIV as ambassadors.

However, we cannot achieve this without government commitment. There must be country owned efforts to eliminate HIV in women and children. Strong leadership, joint accountability and ownership is critical.

Q: As President of OAFLA, what challenges have you seen when it comes to efforts to address the elimination of mother-to-child transmission of HIV and what are you and other first ladies doing to address them?

A: What we’ve discovered is that lack of information or knowledge about HIV still persists in communities despite efforts being made to educate populations on both prevention and treatment.

Ignorance and Illiteracy

Through my campaigns, I realized that even though PMTCT services were available in the communities, people were not aware of the services. In some cases, many people were unaware that it was possible for an HIV positive pregnant woman to give birth to an HIV negative baby.

As a result, the campaign sought to educate the communities about PMTCT services and we saw an increase in uptake of services after each campaign.

Knowledge of HIV Status

Knowledge of HIV status is important for pregnant women and their partners to access the appropriate treatment and care for themselves and their unborn infants. Not knowing one's HIV status acts as a barrier to PMTCT services. My community-level advocacy and awareness raising is always coupled with opportunities for HIV testing for families.

HIV-related Stigma and Discrimination

HIV-related stigma and discrimination affect a pregnant woman's decision to access services and interrupt adherence to treatment and retention in care.

To combat this, I involve persons living with HIV, “Heart to Heart Ambassadors”, who have publicly made their status known to educate communities about the need to access services, using their life stories as examples.

Q: Why is the elimination of new HIV infections in children a priority for OAFLA?

A: Up to 90% of all infants and children with HIV are infected by their HIV positive mothers. In the absence of any interventions, more than half will die before their second birthday.

The provision of a comprehensive eMTCT services is so important. Unfortunately, many people do not have information about available HIV services and accessibility is a challenge in many parts of Africa. 

OAFLA firmly believes in scaling up effective elimination of mother-to-child transmission of HIV services globally to reduce rates of transmission to less than 5% annually, while at the same time improving overall maternal and family health. 

Eliminating mother-to-child transmission is the surest way to attain a generation free of HIV.