Pilot launched to reduce mother to child HIV spread
Stabroek News
November 6, 2001

A pilot programme for the Prevention of Mother-to-Child Transmission of the dreaded HIV was yesterday launched at the Dorothy Bailey Health Centre and was described as a milestone in the history of the country's fight against the disease.

The project, which would only be piloted in Regions Four and Six, will be done at a cost of some $23 million.

The Campbellville, Dorothy Bailey, David Rose and Festival City health centres in Region Four and Cumberland, Fyrish and Skeldon health centres in Region Six will pilot the programme. And it is expected that once the pilot is successful, it will be expanded to the rest of the country.

Describing the programme, National AIDS Programme Manager, Dr Morris Edwards, said that being a part of the prevention of the transmission programme was voluntary. Pregnant women would be "offered" the opportunity to be tested for HIV. Pre- and post-test counselling would accompany the HIV testing. Women who test positive would be given a single dose of the drug Nevirapine at the onset of labour. The drug, Dr Edwards said, will also be given to the newborn within 72 hours of birth.

The drug company Boehringer Ingelheim has donated the Nevirapine. Dr Edwards said that it has been shown to reduce mother to child transmission of HIV by 50%. It is hoped that when the programme is expanded it will be able to prevent approximately 200 babies a year from becoming infected with the virus. "This will allow us to achieve our goal of reducing mother to child transmission of HIV by 50% by the year 2003," the doctor said.

The programme was initiated through the efforts of the National AIDS Programme Secretariat (NAPS), the Maternal & Child Health Department of the Ministry of Health, Pan-American Health Organisation/World Health Organisation (PAHO/WHO) and the United Nations Children's Education Fund (UNICEF).

Dr Edwards disclosed that the concept of the programme was conceived three years ago during the development of the National Strategic Plan for the virus. According to the implementation plan, the programme was to have commenced in January of 2002. However, he said, with technical support from PAHO and the Caribbean Epidemiology Centre, the ministry endeavored to upscale the implementation process in order to have the programme instituted by June this year. But due to a few setbacks, most notably the inability to have health care workers trained as counsellors, that date passed.

Since then, with the help of UNICEF, training was done with health care workers in Region Four in HIV/AIDS counselling.

Minister of Health, Dr Leslie Ramsammy, said that some 23 health workers from the four centres were trained. He said that a second component had already begun in centres in Region Six.

Additionally, the minister told Stabroek News, there will be training for nurses in the maternity wards of hospitals who will have direct contact with infected mothers.

Pointing out the seriousness of mother to child transmission, Dr Ramsammy asserted that none of the tragedies caused by the virus was as severe as that of a new born contracting the virus from his or her mother.

The minister feels that Guyana has made the right decision in deciding to embark on the programme to stop the transmission process from mother to child. He stated that the programme was the first of the many efforts of the Government of Guyana to deal with the virus.

Most importantly, he said, all the women who become part of the initial programme will continue to receive care and treatment provided by the Ministry of Health. He said that by next month the draft strategic plan for years 2003 to 2006 will be done.

Dr Sreelakshmi Gururaja, assistant representative of UNICEF, described the programme as not just a another preventive programme of public health, but one that places priority on "the most vulnerable to the epidemic, HIV positive pregnant women and their infants." She said that the programmes came with many challenges including, education and behaviour change among men and women, accessibility and sustainability of services, counselling and guidance from both the practical and human rights perspective, keeping close track of new cases and continuous care of the affected mothers and infants.

Dr Gururaja pointed out that the question has been posed on how to deal with orphans of the epidemic, who number 13 million in the world today. According to her, the answer was straightforward: "By keeping the mother alive!" She said that the question of how HIV positive mothers could be empowered should be answered with: "by respecting her rights to information and making a choice for protecting her infant, " and by giving that mother and her family a sense of hope that she and they had a future.

According to her the pilot programme directly addresses the national and global goals to reduce the proportion of pregnant women and infants infected with the virus.

And speaking about the disease itself, Mayor Hamilton Green in his welcome remarks, noted that when the world entered this millennium a few months ago some 34.3 million men, women and children faced a future dominated by a fatal disease not known just 20 years ago. He said that this fact alone made the integration of the programme in the maternal and child health services an important step forward.

He said it was believed that prevention of mother to child transmission of HIV was both a medical and social challenge.

Health Environmental Adviser to PAHO, Wilton Conliffe, also spoke at the launching.