Mother to child HIV programme making real impact - Bullen
By Samantha Alleyne
Stabroek News
May 25, 2004

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Since the launch of the Prevention of Mother to Child Transmission Programme (PMTCT) in 2001, around 2,300 women have been offered the services; 20 sites have been set up; 100 health workers have been trained and 50 babies of HIV-positive women have received treatment, says US Ambassador, Roland Bullen.

Bullen made this announcement at yesterday's PMTCT programme support materials launch at the Umana Yana. The materials were devised by the United States Agency for International Development/Family Health International (USAID/FHI) and the Ministry of Health.

They will be used at the different PMTCT sites to assist the counsellors to inform their clients better.

According t o Bullen, USAID has also collaborated in developing a commodity distribution planning system in partnership with the Materials Management Unit.

USAID through its implementing partner, FHI, has also received additional funding to extend PMTCT services to women presenting themselves for delivery at five hospitals and this will ensure that additional women of unknown HIV status are reached with ARV treatment and infant- feeding counselling.

Bullen said the support material is aimed at changing social and individual behaviour using targeted, specific messages and different communication approaches.

The ambassador noted that one of the disturbing aspects of the HIV/AIDS pandemic is the number of infants who become HIV positive through maternal transmission of the virus that can occur during pregnancy, birth and breastfeeding.

FHI's Country Director, Kwame Asiedu, said the materials would ensure health care providers have adequate information to share with their clients.

Members of eight non-governmental organisations around the country will assist the PMTCT programme to reach persons in their communities.

Minister of Health Dr Leslie Ramsammy, addressing the initial scepticism towards the programme, said: "We don't have to be perfect to be able to do something, and we have demonstrated that in Guyana. If I had accepted that there was no way to start the [PMTCT] programme because we are not close to perfection, I am not certain we would have had a PMTCT programme in place today."

The minister recalled that he had refused to accept that the programme could not have been started because of the absence of trained counsellors and he pointed out that as a result of his stubbornness, today one third of pregnant women have access to PMTCT. "...And our goal is that by the end of this year more than half of the pregnant women would have access to PMTCT and rapidly move towards ensuring that every pregnant woman has access to PMTCT."

According to Dr Ramsammy, the greatest tragedy of HIV/AIDS is that the infection is passed on from mother to child and he disclosed that between 20 to 30% of the babies who become infected are infected during pregnancy. He said during birth 50% to 70% of the babies are actually infected and about 5% to 15% get infected because of breast-feeding.

"And we know how to stop those transmissions, there are cost-effective simple ways… And if we do not implement those measures then we would have been guilty, guilty in the eyes of man and guilty in the eyes of God."

Dr Ramsammy told the gathering that in a short while Guyana would be able to implement the programme of fundamental rights providing all of the necessary services that the PMTCT programme entails. He said at the very least there should be universal HIV-prevention education, including counselling and family planning.

"We should be able to provide early diagnoses and counselling, using rapid same-day testing to all pregnant women and their partners. We should be able to administer ARV [anti-retroviral] to mothers, pre and post-deliveries, to reduce viral loads and to new-born children to prevent infection."

The minister noted that the programme should not lose touch with the women who are tested positive and their families.

Ramsammy said one of the good aspects of the PMTCT programme is that it is a direct confrontation to stigma and discrimination. "But we need laws, we need laws and regulation... to reinforce this commitment against stigma and discrimination... "

The minister mentioned that Caricom with other partners has been working to formulate laws that would strengthen a country's response to stigma and discrimination. He said very soon the Guyana government would be in a position to introduce legislation to strengthen the country's HIV/AIDS response.

It was in August 2003 after an 18-month pilot programme at eight ante-natal clinic sites, that the ministry took a decision to expand the programme to 32 sites. In January the programme added a focus on strengthening PMTCT service delivery at maternity facilities in the four districts where more than 80% of all births in Guyana take place.

Also speaking at the launching was the SeniorVice-President of FHI/Arlington, Sheila Mitchell and Mission Director USAID/Guyana, Mike Sarhan.