Category Archives: PMTCT

July 22, 2012 · 10:34 pm

Statement on the Importance of Community-Based Organizations in Pediatric HIV/AIDS Fight

By Robert Yule

Following its two-day symposium before IAC, the Coalition for Children Affected by AIDS – of which EGPAF is a member – issued a statement  about the importance of  community organizations in the fight against pediatric HIV and AIDS:

Symposium Calls for Community-Based Organizations to Have Greater Role in Efforts to
Eliminate New Pediatric HIV Infections

Washington, D.C. – Ahead of the XIX International AIDS Conference, 450 delegates from 57 countries participated in a symposium to discuss how community-based programs are central to international efforts to prevent mother-to-child transmission of HIV (PMTCT).

The symposium, “Children with HIV: Closing the Gap – Ending Vertical Transmission through Community Action,” brought together researchers, international NGOs, community organizations, and affected populations to examine how to better connect community organizations and medical service providers in ending pediatric HIV and AIDS.

While the global HIV community has largely focused on the medical needs of HIV-positive children, discussion at the symposium focused on how community-based engagement extends the reach of clinic-based services, addresses the needs of children affected by HIV regardless of their individual HIV status, and ultimately improves the health and well-being of entire families.

“Even if a child is born free of HIV infection, that child is not free of a life affected by HIV – which makes the care and support agenda for children more important now than ever,” said Kate Iorpenda, Chair of the Coalition for Children Affected by AIDS. “We have seen a lot of progress in ending pediatric HIV, but we won’t reach our goals unless communities are involved, and unless we pay attention to the most vulnerable families.”

The meeting also included the launch of a new supplement in the Journal of the International AIDS Society (JIAS) focused specifically on how community action is needed to meet the ambitious targets laid out in the Global Plan Towards the Elimination of New HIV Infections Among Children by 2015 and Keeping their Mothers Alive.

“The Global Plan to eliminate new pediatric HIV infections is changing how we think about the pediatric HIV epidemic,” said Professor Linda Richter, Distinguished Research Fellow at Human Sciences Research Council in South Africa. “We have long known that community action is essential to getting services to children affected by the disease, but the Global Plan is the first time the international community has explicitly stated that funding community organizations is an essential part of getting to the end of AIDS in the pediatric population.”

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About the Coalition for Children Affected by AIDS: The Coalition for Children Affected by AIDS believes that children need to be made a higher priority in the international response to HIV and AIDS. The Coalition brings funders and technical experts together to advocate for the best policy, research, and programs for children because children are a vulnerable population that has too often been overlooked. For more information, visit www.ccaba.org.

Media Contact:
Professor Linda Richter
+27 (82) 412 2589
lrichter@hsrc.ac.za

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Filed under Advocacy, Community, Pediatric Treatment, PMTCT

· 3:22 pm

Michel Sidibe Praises Advocates, Highlights PMTCT at IAC Opening Session

By Jane Coaston

During Sunday’s opening session of the International AIDS Conference, UNAIDS Executive Director Michel Sidibe paid homage to the many Americans who have fought for the end of AIDS, including Elizabeth Glaser. 

“We are indebted to the brave American activists  who gave a birth to the AIDS movement 30 years ago,” he said.

“We are indebted to the people who risk everything to come forward as the face of AIDS in all its diversity, Bobbi Campbell, Ryan White, Elizabeth Glaser, Magic Johnson, my friend Mary Fisher, and so many more.”

He also noted the world’s support of efforts to prevent mother-to-child transmission (PMTCT) of HIV worldwide.

“…The world has taken up my call in Vienna to eliminate mother-to- child transmission and keep mothers alive,” he said. “Since then 100,000 fewer babies have been born without HIV.”

You can watch Executive Director Sidibe’s speech here, and you can read his remarks here.

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Filed under Advocacy, Elizabeth Glaser, IAC 2012, PMTCT

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· 1:11 pm

Upcoming EGPAF Session: Overcoming Barriers to Implementing Global Plan

By Robert Yule

Join EGPAF, mothers2mothers, Johnson & Johnson, and our other partners at this upcoming session on overcoming implementation barriers to the Global Plan.

This fast-paced session – moderated by Global Post’s John Donnelly – will feature people working on the front lines of program implementation from high-burden countries and representing various implementing organizations. Each presenter will raise a specific challenge, explain how it was addressed, describe the result, and share what is being done next.

The audience will have the opportunity to interact with presenters for further discussion of implementation barriers and solutions.

“Eliminating Pediatric AIDS and Keeping Mothers Alive from an Implementation Perspective – Best Practices, Programmatic Barriers, and Bottlenecks in the Field”
Sunday, July 22, 1:30 – 3:30 PM
Mini Room 1

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Filed under Global Plan, Implementation, India, Kenya, Lesotho, Malawi, PMTCT, Rwanda, South Africa, Swaziland, Tanzania, Zambia, Zimbabwe

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July 20, 2012 · 5:00 pm

A Focus on Children before AIDS 2012 Begins

By Robert Yule

In recent years, before International AIDS Society (IAS) conferences even begin, there are two events that place a special focus on the effects of HIV/AIDS on children:

The symposium, Children and HIV: Closing the Gap – Ending Vertical Transmission through Community Action, opened today at the Georgetown University Conference Center, with a keynote address from U.S. Congresswoman Barbara Lee. The symposium brings together service providers, donors, researchers, advocates, and policy leaders – all to share data and discuss best pratices for children and families.

EGPAF, a member of CCABA, is presenting throughout the symposium, including talks by staff from the     U.S., Switzerland, Tanzania, and Zimbabwe. EGPAF topics on preventing mother-to-child transmission of  HIV (PMTCT) include:

  • Country-level efforts to scale up and integrate community support with medical services
  • Improving the continuum of care by promoting male involvement
  • Mobilizing community engagement through capacity building of media practitioners
  • Strengthening district capacity for rapid PMTCT scale up in Zimbabwe using the District Focal Person Approach

CCABA has produced a  great roadmap on pediatric and PMTCT-related sessions at AIDS 2012, and will be hosting their own session on Wed, July 25 on community involvement that EGPAF will be participating in.

EGPAF also has a strong presence at the 4th Annual International Workshop on HIV Pediatrics. The abstract-driven workshop shares the latest scientific data and discusses how to implement advances in PMTCT and pediatric treatment in the field.

Both the symposium and the workshop conclude on Sat, July 21, but will help drive the discussion of HIV and children and families throughout AIDS 2012.

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Filed under Community, Implementation, Pediatric Treatment, PMTCT, Research, Switzerland, Tanzania, U.S., Zimbabwe

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· 3:23 am

CDC’s Kevin De Cock on U.S. Leadership Fighting Pediatric AIDS

In advance of AIDS 2012, EGPAF hosted the following guest blog by Dr. Kevin M. De Cock – the U.S. CDC’s Director of the Center for Global Health - about U.S. leadership in preventing mother-to-child transmission of HIV globally:

Dr. Kevin De Cock, U.S. CDC

By Kevin M. De Cock MD, FRCP (UK), DTM&H

From July 22 to 27, Washington, D.C. will host the XIX International AIDS Conference, welcoming more than 20,000 attendees from around the world, representing hundreds of HIV/AIDS organizations and diverse backgrounds.  

 The U.S. Centers for Disease Control and Prevention (CDC) and the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) partner with many of these organizations combatting HIV/AIDS through PEPFAR, the U.S. President’s Emergency Plan for AIDS Relief. 
 
PEPFAR is the largest public health program ever mounted for an individual disease, and is celebrating almost a decade since it was established. Now more than 7 million people worldwide are receiving antiretroviral therapy (ART) for HIV. The conference offers opportunity to assess progress in the fight against HIV/AIDS, review research advances and priorities, and recommit to meeting HIV/AIDS specific targets that we have collectively endorsed.
 
It was in the late 1980s that research in the U.S. and other countries such as the Democratic Republic of Congo laid the foundation for our understanding of mother-to-child transmission of HIV. Approximately one-quarter of children born to HIV-infected mothers acquired the infection themselves, with other research subsequently showing that prolonged breastfeeding contributed an additional 14% transmission risk.
 
Overall, up to 40% of children born to and breastfed by mothers living with HIV would become infected. And yet, alternatives to breastfeeding were not realistic options for most African mothers for reasons of poverty, stigma, and the fact that lack of breastfeeding exposed infants to higher risk of malnutrition and other lethal infectious diseases. 
 
The history of research on mother-to-child transmission of HIV and its prevention offers the clearest example of how domestic and global HIV/AIDS work have interacted and benefited from integration, and how research has led to specific program implementation. Communicating this relationship is an overarching contribution of International AIDS Conferences. 
 
In the early 1990s, the groundbreaking ACTG 076 trial showed that prophylactic zidovudine given to the mother during

Photo: EGPAF/James Pursey

pregnancy and labor and delivery, and postnatally to the infant, prevented HIV transmission by two-thirds. The trial initiated an avalanche of research on prevention of mother-to-child transmission in and tailored to low-income settings, the benefits of which we are reaping today. 

Opinion is growing that the World Health Organization’s “Option B+” – under which HIV-infected women start combination ART on detection of pregnancy and stay on it for life – will be an important tool to meet our ambitious goal of virtual elimination of mother-to-child transmission of HIV by 2015.
 
In 2010, 35% (42% in sub-Saharan Africa) of pregnant women in low- and middle-income countries received HIV testing and counseling, and the estimated coverage of antiretroviral drugs for prevention of mother-to-child transmission of HIV among pregnant women was 48%.  In 2011, 57% of pregnant women living with HIV in low- and middle-income countries received effective antiretroviral drugs to prevent transmission to the child.
 
Despite this progress, much remains to be done. Only 28% of exposed infants worldwide received an appropriate test for HIV infection in the first two months of life in 2010, with 22% coverage of ART for infected children. In 2011, treatment coverage for ART in infected children rose to 28%, yet treatment coverage among children is still substantially lower than the estimated 57% coverage among adults living with HIV.
 
The U.S. Administration’s Global Health Initiative has refocused attention on the health of women and children. Now we have unrivalled opportunity for synergy and integration – harmonizing programs for maternal and child health, HIV/AIDS, and family planning for the greater good of women and children’s well-being. 
 

Photo: EGPAF/Jon Hrusa

Re-commitment to the worthy goals of an AIDS-free generation would be a good outcome of the XIX International AIDS Conference. The targets are to reduce the number of children newly infected with HIV by 90% by 2015, reduce mother-to-child transmission of HIV to below 5% everywhere, and reduce maternal mortality related to HIV by 50%. 

 
Looking back to the dark days – when AIDS was a death sentence, life expectancy was declining in southern Africa, under-five mortality was rising because of AIDS, and hopelessness prevailed – the 2012 International AIDS Conference should be an occasion of pride, re-engagement, and forceful determination to achieve what was once thought impossible: an AIDS-free generation
 
To learn more about EGPAF’s collaboration with the CDC on global HIV treatment and PMTCT programs, click here.

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Filed under Countries, Democratic Republic of Congo, IAC 2012, Implementation, Pediatric Treatment, PEPFAR, PMTCT, Research, U.S.

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July 18, 2012 · 12:15 pm

EGPAF’s Statement on UNAIDS Report on HIV/AIDS

By Robert Yule

Today UNAIDS released a new report on the global AIDS epidemic. Read the Foundation’s statement about the progress made preventing and treating new HIV infections in children and their mothers worldwide, and areas of continued need.

Also see below for ten useful facts and statistics taken from UNAIDS’ Global Plan progress report:

Washington, D.C. – On the eve of the XIX International AIDS Conference in Washington, D.C., a new report released by UNAIDS shows significant progress in the battle against pediatric HIV and AIDS. It also highlights some key areas of improvement needed to reach our goal of ending new HIV infections in children and keeping HIV-positive mothers and children alive and healthy.

According to UNAIDS, about 330,000 children were newly infected with HIV in 2011 – a drop of 60,000 from the previous year. Particularly promising was a reported 25% decrease in new pediatric infections since 2009 among the 21 countries in sub-Saharan Africa identified as high priority by the Global Plan to end HIV among children.
“The significant decrease in new pediatric infections in sub-Saharan Africa is clear evidence that global efforts are turning the tide of the epidemic in children in the part of the world where it is needed most,” said Chip Lyons, President and CEO of the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF).
The report also predicts that several countries where EGPAF works – such as Kenya, Swaziland, Zambia, and Zimbabwe – are on track to meet the ambitious 2015 target to eliminate new pediatric HIV infections.
Key to achieving this for all countries is universal access to services to prevent mother-to-child transmission of HIV (PMTCT). The report shows that investments in scaling up PMTCT are bearing fruit. For HIV-positive women living in low- and middle-income countries, PMTCT access has increased significantly – from 48% of in 2010, to 57% in 2011.
“One point of particular concern is that a relatively low percentage of mothers are receiving PMTCT drug regimens in the breastfeeding period, the time in which a significant amount of transmission to infants occurs,” said Lyons. “Too few mothers are also receiving antiretroviral treatment for their own health, which is vital to their survival and for the care of their children.”
For those children living with HIV, testing and treatment remains critical. According to UNAIDS, only 28% of HIV-positive children received antiretroviral treatment in 2011. While this is a slight increase from the previous year, it is still woefully inadequate. Without early identification and treatment, half of children with HIV do not survive to see their fifth birthday.
“As the global health community gathers in Washington for the AIDS 2012 conference, this report shows us where more work is needed, but also where momentum is on our side,” said Lyons. “It should encourage us to rededicate our efforts and our resources to even greater decreases in HIV infections and AIDS-related deaths in children, and to not let up until we get to zero.”
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Filed under Pediatric Treatment, PMTCT, UNAIDS

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