ETHIOPIA: Feature - Tackling HIV/AIDS
[ This report does not necessarily reflect the views of the United Nations]
© IRIN/Anthony Mitchell
Mother receiving counselling in Dilla
DILLA, 1 December (PLUSNEWS) - As a mother leans over to breastfeed her hungry newborn baby, doctors look on anxiously knowing she could infect her child with the HIV virus.
It is a dilemma medics in rural Ethiopia say they are facing almost daily, as the country launches a campaign to prevent mothers infecting their children with the virus.
The US-funded programme attempts to prevent transmission of HIV during the birth of a baby, through provision of the one-dose drug Neviropine.
But some doctors argue the countrywide scheme is flawed because it does not protect mothers, and ultimately children too can become infected through breastfeeding.
“There is still a one-in-five chance that HIV can be passed on through breastfeeding,” says Dr Haile Gilcha, head of the anti-AIDS programme in Dilla, some 500 km south of Addis Ababa.
And he says although the baby may survive, the chances are it will be orphaned in a couple of years because anti-AIDS drugs are not being provided to save the mothers.
While Dr Haile says most mothers are pleased to be involved he says the risks are still great. He wants to see mothers given anti-retroviral drugs to ensure their future survival.
Mother to child infection is the second highest cause of the spread of the virus in Ethiopia. Some 60,000 children each year become infected with HIV.
Four medical centres across the country have been chosen for the US $5 million project – which is being run by the UN Children’s Fund (UNICEF).
It aims to provide mothers and children with Neviropine to reduce the risk of HIV. It is administered to the mother just before she gives birth, and then to her newly-born child.
The funding is part of US President George W Bush’s five year US $15 billion global fight against the pandemic that is sweeping Africa.
Some 2.2 million people – 200,000 of them are children - are living with the virus in Ethiopia making it the third largest infected population in the world.
The Ethiopian government – whose annual health budget for the entire country is in the region of US $100 million – simply cannot afford to buy the much-needed drugs.
But around US $200 million is currently being earmarked for Ethiopia to help fight AIDS – and government officials are keen to expand the use of anti-retroviral drugs.
Using the mother to child treatment centres would be a logical place to start to distribution of anti-retroviral drugs, say doctors involved in the programme.
Pregnant women receive counselling on the risks and dangers before they have an HIV test at the hospital in Dilla.
Since the programme began in May - more than 300 mothers have come forward for counselling and testing - about 10 percent have tested positive.
CUTTING TRANSMISSION RATES
The UNICEF programme aims to cut transmission rates by a quarter within five years. Without it, 80 percent of children infected with HIV would be dead before they reach two.
Bjorn Ljungqvist, head of UNICEF in Ethiopia, argues that preventing breastfeeding is not a viable option to help mums in Dilla – whether or not they are infected.
“There is even greater risk if the mother doesn’t breastfeed so you have to find a way to balance these risks,” he adds. “In Ethiopia there is probably a higher risk than anywhere.”
“We are afraid that if people think breastfeeding can transmit HIV/AIDS there will be a public scare,” Ljungqvist said from his office in Addis Ababa. “And that would have a tremendous impact on child survival and health in this country, and that is what we are afraid of.”
He says the UN is looking at anti-retroviral drugs as additional funding comes in or as life-saving drugs get cheaper, but admits dilemmas like those in Dilla must be faced.
“We have to find all kinds of ways to contain this terrible threat to children. We face dilemmas in so many cases, who do you choose, where do you put your money?,” he asks. “It is a pure issue of affordability.”
For Dr Haile, working at the frontline, explaining the economics to mothers is daunting and depressing.
“The people here are dying because they are poor, that is the problem. The support being given is not enough,” he says. “This is a cheap solution but it will prove expensive.”