Mother-child transmission slowing Nigeria’s HIV/AIDS fight

Nigeria’s poor coverage of mother-to-child transmission in the HIV/AIDS prevention programme is slowing down the overall progress of HIV prevention in the country, the director general of the National Agency for the Control of AIDS, John Idoko, has said.

A new report, by the Joint United Nations Programme on HIV/AIDS and the World Health Organisation, “2009 AIDS Epidemic Update”, shows that new HIV infections have been reduced by 17 per cent over the past eight years, with most progress observed in sub-Saharan Africa.

In Nigeria, though the new infections rate measured in young people aged 16-24 has reduced from 6 per cent in 2001 to 3.2 per cent in 2008, a UNICEF report shows that there are over 600,000 infants born with HIV every year, with half not reaching their fifth birthday.

“PMTCT is a huge gap in HIV prevention. Only 12 per cent of our women have access to it. And access to this form of healthcare is supposed to be the human right of every woman and every child,” Dr. Idoko says. “Our goal is to cover at least 80 per cent of pregnant women by 2016, and that will be our main campaign of this year’s World AIDS Day.”

Free programme

The Prevention of Mother-to-Child Transmission of HIV is explained as a method of preventing pregnant women who are HIV-positive from transferring the virus to their unborn babies.

Oliver Ezechi, the head of the PMTCT unit of the Nigeria Institute of Medical Research, Yaba (a centre supported by the U.S. President Emergency Programme for AIDS Relief), says the PMTCT begins when a pregnant woman is counselled and screened for HIV as part of the routine antenatal tests. If she is positive, she is enrolled on the PMTCT programme, and it is free of charge in public hospitals.

As part of the programme she is given some drugs such as Nevirapine and Zidovudine, which prevents the transmission. The mother is expected to take the Zidovudine from 34 weeks pregnancy, and will be given Nevirapine when she goes into labour. The medicine reduces the chances of passing the virus from mother to child during delivery. It is also given to the baby within 6-72 hours of birth.

No trained personnel

Health workers say many hospitals, especially private hospitals, don’t have trained personnel competent to administer the technique. Secondly, the drugs are expensive and unless subsidised by the federal government or donor agencies, many hospitals can’t afford it.

Dr. Idoko pointed out that the reason most pregnant women do not have access to the PMTCT is because they do not go for antenatal care.

“Many Nigerian women don’t go for antenatal care, especially in the rural areas. So we are trying to do a community mobilisation to create awareness and imbibe health seeking behaviour in them; we are also trying to take these services to the primary health centres.”

Services unavailable

But Dr. Ezechi doesn’t believe the problem is the women but that the services are not even available in most hospitals. According to him, at the PMTCT centre of the Nigeria Institute of Medical Research, about 1,800 children are currently exposed to HIV through their mothers and 560 out of these are already confirmed positive.

“Amongst these are children born in private hospitals, churches and traditional birth homes where their mothers had no access to PMTCT. They are not our patients here because our patients go through the programme.”

From his experience, Dr. Ezechi says, a lot of women do not even have access to the PMTCT programme, which ought to be free and made mandatory once a pregnant woman is found to be HIV positive. He pointed out that the lack of the involvement of the private hospitals in the national PMTCT programme is also a major setback.

Stemming the rise

Dr. Idoko said that as a result of the mentioned difficulties, this year’s World’s AIDS Day, a day usually commemorated every December 1, will focus on making the PMTCT a human right issue. “It is the right of every child to be born free of HIV; it is the right of every woman to have access to it, so we have to address it; scale up access by providing drugs, personnel, especially to the rural areas.”