Nigeria shares a great burden of HIV births globally. To reduce that, WINIFRED OGBEBO reports that stakeholders have embarked on strategies to prevent transmission of HIV from mother to child, and to target at least, a million more women and children and reach out to private health facilities in at least a dozen states.
Nigeria has an annual HIV positive births of 70, 000 out of the global 370,000 births.
Globally, the Prevention of Mother To Child Transmission (PMTCT) gap is 80 per cent and Nigeria alone accounts for 32 per cent of the global gap for pregnant women receiving anti retroviral medicines for the prevention of mother-to-child transmission.
According to the Director-General, National Agency for the Control of AIDS (NACA), Prof John Idoko ‘the biggest challenge we have currently in the National Response to HIV, which we are facing and are facing very squarely is the elimination of mother to child transmission”
At last year’s World AIDS Day, Idoko, said the country’s focus was on the elimination of Mother-to-Child Transmission (eMTCT) of HIV in line with the national target of achieving 90 per cent coverage PMTCT for pregnant women as detailed in the National Strategic Plan 2010-2015.
He said the significance of this focus was hinged on;
1) The availability of technology for HIV positive parents to have HIV-free children.
2) The possibility of using pregnant women to generate an interest in HIV testing in their households.
3) Comprehensive post- delivery care for HIV positive mothers and their babies.
4) Integration of PMTCT with other related services such as malaria, tuberculosis, maternal and child health, and family planning.
5) Availability of comprehensive HIV services in communities through primary health care centres.
He told LEADERSHIP that the agency was working to ensure that it expands PMTCT from where it is now which is like 15 per cent or thereabout to 50 per cent coverage by the end of this year and what “we can do differently from what we used to do.”
He explained, “ In the past, we spread ourselves to all the states but what we are doing now is that we have identified a 12-state structure and a 21-state structure. The 12 states are the most burdened states in terms of prevalence and population and then the next states will be another nine states. If you take 21 states in this country, they will be responsible for almost 70 per cent of the gap. So the question is, maybe we should start putting more effort in the 12 states first then we can add on the nine because it is from there we can find most of the women that we need to intervene.”
Speaking further, he said, “That meeting is going on and we are getting the states involved; both the state SACAs and the state ministries so that those various points work. So that is one of our biggest issues.”
Idoko also pointed out what he called the associated problem of testing. “Tied to that is testing; testing of not only pregnant women but adult men and women. We are scaling up that. We are hoping that we will test between five and ten million people this year depending on how much test kits we take delivery of. The Federal Ministry of Health is buying test kits. We are buying with assistance from the World Bank, the Institute of Human Virology of Nigeria, and PEPFAR amongst others. We are hoping that we will be able to increase the number of people on anti retroviral. It is very low now as you know; testing is a very important component of whatever we do whether it’s prevention, treatment or care and support so we need to increase the number of people who have access to testing.”
The NACA DG said the agency was working with all the partners- the Federal Ministry of Health, the various development partners, and the state, to see how to address the issue.
Last week, there was a meeting on strategies to prevent transmission of HIV from mother to child, and to target at least a million more women and children and reach out to private health facilities in at least a dozen states.
The target is to eliminate deaths resulting from HIV/AIDS among maternity age women by 90% before 2015—an increase over the former target of 80%, said Dr Evelyn Ngige, coordinator for National AIDS and STDs Control Programme.
Speaking at the consultative meeting of stakeholders in Abuja, Ngigie noted that the scale-up will also ensure private health centres provide data and record to authorities to make clear how they treat issues of preventing mother-to-child transmission of HIV.
The states in the first phase include Abia, Akwa Ibom, Anambra, Bayelsa, Benue Cross River, FCT, Lagos, Kaduna, Nasarawa and Plateau, chosen on grounds of high prevalence of HIV, high population, high burden of the disease and high fertility rates.
In his contribution,the NACA DG described HIV as an , “embarrassing situation to the country, even more than polio.”
He said the scale-up would address how to get mother to attend antenatal care clinic, how to ensure fathers allow their wives attend antenatal clinics, and ensure that women attend such clinics up to four times before delivery.
Idoko noted that any failure with the scale-up would seriously impact attempts to reach all millennium goals targeting better life for women and children.
Dr Akudo Ikpeazu, director for programme coordination at NACA, said each state would develop plans to tackle their areas of priority as well as reach agreement on mechanisms to enhance local monitoring, tracking and reporting.
The Minister of State for Health, Dr Muhammad Ali Pate said, “what we want is more efforts towards integration of basic services including prevention of mother to child transmission of HIV in all those states. To do that, we will not do it in isolation. It has to be in the context of Primary Health Care system.”
He said that the reality of the people should be integrated. “When a pregnant woman goes into a facility, she doesn’t go in and say, I am going in for HIV and AIDS, TB or malaria but because she has a problem. So to her, that is integrated. So we as providers should come in, in a coordinated and integrated manner. There are some things that can be prevented. No child should be HIV infected because his mother is infected because there is a drug that can be given to the mother when she comes to deliver to prevent that infection from getting to her child. So the mother should get treated and the child should get protected.”