US$3.4M initiative aims to cut mother/child HIV transmission By Nivedta Kowlessar
Guyana Chronicle
September 4, 2003

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Officials witnessing the launching of U.S President George W. Bush's Prevention of Mother-to-Child Transmission programme to combat the spread of HIV/AIDS in Guyana yesterday. (Mike Norville photo)
A US$3.4M initiative to prevent HIV mother-to-child transmissions in Guyana was officially launched yesterday, with a call by President Bharrat Jagdeo for the resources to be used in a multi-purpose way.

The launching coincided with the Government's expansion of a pilot programme from two to all 10 of the country's administrative regions.

"...I hope that in the utilisation of the resources, we pay attention to the little details - if we're going to do state-of-the-art labs to look at this disease...(they) should have the capability of tackling other infectious diseases," the President urged at the launching at the West Demerara Hospital.

Over the next 18 months, the initiative will provide life-prolonging anti-retroviral treatment to 350 persons; expand Prevention of Mother-to-Child Transmission (PMTCT) services with maternal and child health care; arrange voluntary counseling and testing; train healthcare workers; supply medicines and strengthen laboratories.

The initiative is part of a US$500M PMTCT programme announced by United States President George W. Bush last year.

Guyana is among 14 countries benefiting from the support, which will back up national schemes to provide PMTCT services to one million HIV-infected pregnant women and reduce transmission from mothers to children by 40 per cent.

President Bush, in January this year, also announced a five-year US$15Bln emergency plan for the same beneficiaries.

President Jagdeo thanked the world's "only superpower" for putting the disease that has infected 18,000 people here and 42 million worldwide on the international agenda, and helping Guyana expand its PMTCT pilot programme.

He said Bush's initiative has spurred a "demonstration effect" across the world as more and more Third World leaders speak out on the disease, the effects of which were previously kept in the closet for political reasons.

Political and international support can raise awareness and remove more of the stigma attached to HIV/AIDS, the President reasoned. He said the Government's acceptance of the ravaging effects of the disease led to increased budgetary allocations to buy anti-retroviral drugs, among other measures.

But the administration had to fight criticism about spending on other diseases - an issue Mr. Jagdeo said could be addressed if facilities built under the HIV/AIDS initiative are used to trap infections like malaria and tuberculosis.

With some 16,000 people being infected with HIV/AIDS every day, and 11 per minute, the President said the 25 countries hardest hit are those with low per capita income and low life expectancy.

"...even with the best political will in the world, many of these countries may not have the resources to tackle the problem," he pointed out, urging the international community to offer more support.

"This initiative could be supplemented by support for many other initiatives that would enhance growth in the country, that would increase our national capability to tackle these problems...

"in the future, we just don't have to rely on foreign assistance, which we're extremely grateful for, but we need to tackle these issues ourselves; our budget must grow, and (our) capabilities," Mr. Jagdeo stated.

Newly-accredited U.S Ambassador to Guyana, Mr. Ronald Bullen, said the overall goal of his government's support to Guyana's PMTCT strategy is to reduce HIV mother-to-child transmissions by 80 per cent by 2008.

The effort is being led by the United States Agency for International Development and the U.S Centers for Disease Control, whose representatives, Dr. Mike Sarhan and Dr. Okey Nwanyanwu, respectively, witnessed yesterday's launching.

The agencies' key implementing partners are Family Health International and the University of Medicine and Dentistry of New Jersey. In addition, the University of New Jersey's Francois Xavier Bagnoud Center will provide technical aid in management of paediatric HIV/AIDS in Guyana.

Bullen said the expansion of the Government's pilot programme, conducted with the help of international agencies, "must be done in a timely manner" to prevent a next child being born HIV positive in Guyana.

But he noted that the programme is "fraught with cultural and logistical complexities that must be addressed." These include ensuring all pregnant women voluntarily get counseling and a confidential HIV test.

"Challenges to achieving this include the stigma attached to infected persons and the issue of domestic violence that is all too common in Guyana," Bullen said.

To address these, the U.S support will help train counselors, community outreach workers to promote voluntary counseling, testing, community awareness and education on HIV/AIDS. It will also include a communication campaign designed to combat stigma and discrimination.

Health Minister, Dr. Leslie Ramsammy, said the Government hopes to use U.S support to build and maintain the success of its pilot programme, intended to reach every HIV positive woman and any child born to her.

"...we will work diligently to ensure that no mother escapes the network...," he pledged, noting that the tools are now available to cut the rate of transmissions.

Already, the pilot programme, started in November, 2001, has seen more women being administered the anti-retroviral drug Nevirapine - from 67 per cent in 2001-2002 to 90 per cent in the first half of 2003.

This compares with some 51 per cent in other developing countries battling the deadly disease under similar national conditions.

Yesterday's launching ceremony was chaired by Region Three Health Officer, Dr. Holly Alexander.