TORONTO — Despite all of the discussions of scaling up treatment at the XVI International AIDS Conference in Toronto, pregnant women remain one of the most poorly served of all HIV-positive populations, warn experts with UNFPA, the United Nations Population Fund. “These programmes have been a failure,” says Dr. Arletty Pinel, Chief of UNFPA Reproductive Health Branch. “Despite the fact that the global HIV response is now awash in funding, pregnant women still don’t have access to the drugs that will prevent them from passing the virus on to their children. They risk dying in huge numbers and so do their children.”
In 2001, world leaders, policymakers and activists met at the United Nations General Assembly special session on HIV/AIDS. Among the targets they agreed on in the 2001 Declaration of Commitment on HIV/AIDS, was to increase the percentage of HIV-positive pregnant women receiving antiretroviral prophylaxis to 80 per cent by 2005. Today, global coverage rates remain at 9 per cent and not a single country has reached the 80 per cent target. In the meantime, although still inadequate, overall treatment has increased to 20 per cent, with 21 countries reaching the 50 per cent goal set in the Declaration of Commitment. Indeed, the only global target that was achieved was the amount of money earmarked for HIV.
Dr. Pinel explains why prevention of mother-to-child transmission lags far behind. HIV infection, she asserts, compounds the already existing problem of poor access to reproductive health care in general. “Today, we have a situation of hundreds of thousands of women dying in childbirth each year,“ she says. “If we can’t even address the problem of women dying in childbirth, then it should come as no surprise that we are failing to prevent mother-to-child transmission of HIV.”
Even when women obtain access to the life-saving drugs, many are taken off treatment right after they deliver. This, Dr. Pinel says, leads not only to the eventual death of the mother but also to greater numbers of orphans and higher infant and child death rates. One of the problems, she adds, is that women are still seen by some as reproductive “units”, with male relatives still making the decisions regarding whether their wives, daughters or sisters can seek treatment. Furthermore, in many settings, the woman is the last to learn of her HIV-positive status. Healthcare workers often inform the husband or nearest male relative first. “Needless to say, this does not encourage women to go for testing,” says Dr. Pinel.
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Contact Information:
Abubakar Dungus
Tel.: +1 (212) 297-5031
Email: dungus@unfpa.org
Trygve Olfarnes
Tel.: +52 55 5250-7977
Email: olfarnes@unfpa.org