PMTCT

Ambassador Eric Goosby speaks at the Satellite Session on the Global Plan towards the elimination of new HIV infections among children during International AIDS conference in Washington, on July 24, 2012. Credit: UNAIDS/Y. Gripas

WASHINGTON DC, 24 July 2012— Speaking at a satellite session today at the XIX International AIDS Conference, Ambassador Eric Goosby, the U.S. Global AIDS Coordinator, and Michel Sidibé, Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS), commended countries and their international partners for recent progress in preventing new HIV infections among children and saving mothers’ lives.

“The latest data is encouraging and a testament to the dedication and tireless work under way to virtually eliminate new paediatric infections,” said Ambassador Eric Goosby, who leads the President’s Emergency Plan for AIDS Relief (PEPFAR).  “The United States is committed to working with countries to succeed in this mission and achieve the goal of an AIDS-free generation.”

A steep decline in new HIV infections among children

According to a new report from UNAIDS, there were an estimated 330 000 new HIV infections among children globally in 2011—a 24% reduction since 2009, when about 430 000 children were newly infected with HIV. Among 21 Global Plan priority countries in sub-Saharan Africa, the estimated number of children newly infected with HIV fell by 25%, from 360 000 in 2009 to 270 000 in 2011.

Progress has been made possible through rapid improvement in access to services that prevent mother-to-child transmission of HIV (PMTCT). There was a dramatic increase in coverage of PMTCT services in the 21 priority countries between 2009 and 2011: from 34% to 61%. HIV transmission rates from mother-to child have also declined since 2010 with the introduction of more effective prophylaxis regimens.

“We know how to get to zero—science has shown the way,” said the UNAIDS Executive Director. “The only thing that can stop us now is indecision or a lack of courage. Through strengthened political will and financial resources, we can reach our twin goals of zero new HIV infections among children and zero AIDS-related maternal deaths.”

AIDS-related maternal deaths also on the decline

The estimated number of pregnancy-related deaths among women living with HIV fell from 46 000 in 2005 to 37 000 in 2010—a 20% reduction. Among 21 high-priority countries, pregnancy-related deaths among women living with HIV fell from 41 500 in 2005 to 33 000 in 2010.

Despite significant progress, challenges remain. In sub-Saharan Africa, AIDS continues to be the leading cause of maternal death. And among children born to HIV-positive women, one in five was infected with HIV through pregnancy or breastfeeding in 2011.

The Global Plan

Spearheaded by UNAIDS and the U.S. Office of the Global AIDS Coordinator, the Global Plan towards the elimination of new HIV infections among children and keeping their mothers alive was unveiled in June 2011 at the UN General Assembly High Level Meeting on AIDS. It has two main targets for 2015: a 90% reduction in the number of children newly infected with HIV and a 50% reduction in the number of AIDS-related maternal deaths.

Reaching these targets will require accelerated action across a number of key areas including: preventing HIV infections among women of reproductive age; avoiding unintended pregnancies; reducing HIV transmission from mother to child; and providing treatment, care and support to mothers living with HIV and their families.

The First Lady of Panama and Chair of the CONAVIH, Ms Marta Linares De Martinelli and UNAIDS Deputy Executive Director, Programmes, Dr Paul De Lay. Panama City, Panama. 28 June 2012.
Credit: UNAIDS

The National AIDS Authority of Panama (CONAVIH) held its quarterly session on 26 June 2012. The meeting reviewed the stock out of antiretroviral (ARV) medicines that has been affecting the country in the past months.

The First Lady of Panama and Chair of the CONAVIH, Ms Marta Linares De Martinelli highlighted the need for all partners involved in the national AIDS response to undertake the necessary actions to provide ARV medications regularly and permanently. “It is a matter of life or death,” Ms Linares stressed.   

The meeting brought together high level government representatives from the Ministry of Health, the Ministry of Finance and the Ministry of Education as well as civil society leaders and people living with HIV. UNAIDS Deputy Executive Director, Programmes, Dr Paul De Lay participated in the session at the special invitation from the First Lady.

Dr De Lay commended the authorities on the progress made in scaling up access to antiretroviral treatment but also stressed the need to identify new mechanisms for the distribution of ARVs to avoid stock outs in the future. “Timely and uninterrupted provision of medications to people living with HIV is a matter of commitment to human rights” affirmed Dr De Lay.

The ARV stock outs that occurred in the country were attributed to delays in the ARV purchase due to complex institutional regulations. Participants at the meeting agreed to establish a coordinating committee to identify existing barriers to purchase and provide ARVs. This committee will include representatives from civil society, pharmacists and physicians from health service institutions.

The need for a more precise calculation of annual ARV requirements was also seen as key to avoid stock outs together with a faster process for import, legalization and distribution of medications to the 15 local health facilities where people living with HIV are attended. Currently there are around 11 000 people living with HIV in Panama of which 6 000 are receiving ARV treatment.

Eliminating new HIV infections among children

Dr De Lay congratulated the First Lady´s leadership in the implementation of the national strategy to eliminate new HIV infections among children and keeping their mothers alive. "This country may be one of the first countries in Latin America to achieve the goal of zero new HIV infections among children by 2015," expressed Dr De Lay. “Panama has everything that’s needed to reach this goal even ahead of 2015. However, it is still necessary to expand the current 76% coverage of HIV testing to all pregnant women, especially in rural areas" he added.

The First Lady stressed her commitment as the Chairperson of the National AIDS Commission to scale up the coverage of prevention of mother-to-child transmission services to all women in need throughout the country. “We will increase our efforts in order to achieve the target of zero new HIV infections among children.” concluded the First Lady.

UNAIDS Executive Director Michel Sidibé receives a national honour from the President of Chad, Idriss Deby Itno. L to R: Fritz Lherisson, Acting Director, Regional Support Team for West and Central Africa, Mr Sidibé and President Deby Itno. 30 May 2012. Ndjamena, Chad.
Credit: UNAIDS

UNAIDS Executive Director Michel Sidibé concluded his official visit to Chad on 31 May after meeting with President Idriss Deby Itno, First Lady Hinda Deby Itno, senior government officials and civil society to highlight the country’s progress in the AIDS response.

Mr Sidibé met with President Deby Itno to discuss opportunities and challenges in Chad’s AIDS response. One area of the national AIDS response that has seen progress is access to antiretroviral treatment. Since 2007, the provision of HIV treatment has been offered by the state free of charge. According to the Progress report 2011: Global HIV/AIDS response, issued jointly by UNAIDS, WHO and UNICEF, an estimated 32 000 people were receiving antiretroviral treatment at the end of 2010, covering 39% of people who are eligible for treatment.

President Deby Itno highlighted that Chad finances more than half (53%) of the resources required for treatment. He stressed that the AIDS response has enabled Chad to place people at the centre of the country’s development agenda.

Chad has a national adult HIV prevalence of 3.4%. The rate of HIV infection is particularly high among sex workers, estimated at 25.5% in the capital city of Ndjamena.

Mr Sidibé shared with the President his concern over the high levels of stigma and discrimination in the country, especially among people living in rural areas. He emphasized that stigma and discrimination drive people living with HIV underground, away from much-needed HIV services, and if left unaddressed could undermine the effectiveness of the country’s recent gains.

Promoting national ownership

In view of the upcoming African Union Summit in Malawi, Mr. Sidibé encouraged President Deby Itno to support and promote the agenda for country ownership and shared responsibility among the other African Heads of State. He underscored that Chad has an unprecedented opportunity to contribute greater domestic resources to complement HIV investments from international partners. Currently, Chad relies on external sources to finance more than 85% of its national AIDS programmes.

“Chad has demonstrated remarkable progress in expanding treatment access, in fighting stigma and discrimination and in ensuring the rights of people living with HIV are protected. The AIDS response presents an important opportunity to change the development paradigm,” said Mr Sidibé.

Eliminating new HIV infections among children

In their discussions, President Deby Itno and Mr Sidibé agreed that greater momentum is needed to increase services to prevent mother to child transmission of HIV (PMTCT). Although the number of PMTCT sites across the country has increased from 93 in 2009 to 140 in 2011, coverage remains low, at 10%. One of the main bottlenecks is the lack of coordination and integration between PMTCT and maternal and reproductive health programmes.

Mr Sidibé joined President Deby Into at an event on 31 May to launch the national plan to eliminate new HIV infections among children. Chad is one of 22 countries included in the Global Plan towards the elimination of new HIV infections among children and keeping their mothers alive by 2015.

As part of his visit, Mr Sidibé held bilateral meetings with Chad’s Prime Minister, Emmanuel Nadingar, the Minister of Public Health, Mamouth Nahor Ngawara, and the Minister of Finance, Christian Georges Dinguimbaye.

Before concluding his two-day trip, Mr Sidibé met with the First Lady of Chad, Hinda Deby Itno, to discuss her work with the Campaign for Accelerated Reduction of Maternal Mortality in Africa (CARMMA). He also took the opportunity to interact with the national network of people living with HIV (RNTAP+) and participate in a forum on human rights and HIV, hosted by the Ministry of Foreign Affairs.

During the visit, President Deby Itno awarded Mr Sidibé one of the country’s highest decorations—the Grand Chancelier de l'ordre National du Tchad—in recognition of his commitment and contribution to the global AIDS response.

UNAIDS and PEPFAR bring together Health Ministers and partners from countries with the highest numbers of new HIV infections in children to scale up progress.
Credit: UNAIDS/A.Obeid

Ministers of Health and representatives from the 22* countries with the most new HIV infections in children have come together to report on progress towards achieving zero new HIV infections in children by 2015 and find ways of stepping up action.

In 2010, an estimated 390 000 children were born with HIV. However, with access to comprehensive HIV services the risk of transmission can be reduced to below 5%. In response to this, the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) convened partners to develop a global plan to stop new HIV infections among children by 2015 and keep their mothers alive. The plan focuses on the 22 countries in which 90% of new HIV infections in children occur, 21 of which are in sub-Saharan Africa.

“By uniting our forces across boundaries, institutions and communities, we will leverage this historic opportunity to welcome the first generation born free of HIV by 2015,” said UNAIDS Executive Director, Michel Sidibé. “By building bridges between the movements of AIDS, maternal and child health and women’s movements, we will quicken the pace of this race towards zero.”

Since the launch of the Global Plan at the 2011 High Level Meeting on AIDS, great strides have been made in reducing HIV infections among women of reproductive age and expanding access to antiretroviral therapy for pregnant women living with HIV. However, progress is not being scaled up as quickly on meeting the family planning needs of women living with HIV, preventing maternal mortality and ensuring that all children living with HIV have access to antiretroviral therapy. All of which are key elements in the global plan to achieve zero new HIV infections in children.

“We have the knowledge and the tools to ensure that all children are born HIV-free and that their mothers are healthy,” said United States Global AIDS Coordinator Ambassador Eric Goosby. “Countries are at the forefront of efforts to achieve this vision, and as partners, we are firmly committed to their success.”

During her welcoming remarks, the Director General of the World Health Organization, Margaret Chan emphasized the full commitment of her organization towards the success of the Global Plan. “This is an ambitious, noble and achievable cause,” said Dr Chan. “It is also a great opportunity to make progress towards the integration of health services in countries.”

The President of the 65^th World Health Assembly emphasized the need to raise awareness among communities to ensure that both men and women have access to HIV services for their own health and to prevent HIV infections in children. “Women still face stigma and discrimination when found HIV positive,” said the Health Minister from Côte d’Ivoire, Thérèse N’Dri-Yoman. “Women will not disclose their status and therefore won’t access HIV services unless communities provide them with the support they need.”

Ministers shared their ideas and experiences on four focus areas related to the implementation of the Global Plan: Financing and political ownership; quality of care; community engagement; and human resources.

Speaking about innovative methods of funding, Zimbabwe’s ‘AIDS Levy’ was praised as an example of a sustainable national initiative to mobilize resources for the AIDS response. “Even though no one likes to pay taxes, people are recognizing the utility of the AIDS Levy given the results achieved in the AIDS response,” said Zimbabwean Minister of Health and Child Welfare, Henry Madzorera.

Namibia’s Minister of Health and Social Services, Richard Kamwi, also explained how his country is rapidly increasing its domestic contribution to the overall resources allocated to the AIDS response.   

The integration of services to provide better quality of care for women was also stressed as a key element by several countries. In Tanzania, for example, the Minister of Health and Social Welfare, Hussein Mwinyi, reported that currently all family planning services integrate HIV services and vice versa. Similarly, the Government of Ghana has issued a policy to provide free family planning to all. Botswana, one of the most advanced countries in preventing mother-to-child transmission of HIV, has integrated HIV services in all health settings providing antenatal care to pregnant women. “We are doing everything possible to bring health to people,” said Botswana’s Minister of Health John Seakgosing.

Countries like Burundi, Chad and the Democratic Republic of Congo reported efforts to increase the capacity of health care providers with initiatives such as nurse-driven antiretroviral treatment programmes, expanding service delivery outlets and promoting decentralization.

The importance of community engagement in implementing the Global Plan in countries was stressed by Lucy Ghati from the National Empowerment Network of People Living with HIV/AIDS in Kenya (NEPHAK). “Communities are critical if prevention of mother-to-child services are to be scaled up,” said Ms Ghati. “Women living with HIV must be represented on local and national committees to determine what their needs are as well as to ensure ownership of the response.” Similarly, France’s AIDS Ambassador Mireille Guigaz said, “Every time we look at the problems of women and children we have to get as close as possible to communities. If we don’t give them the opportunity to express how they feel and take their experiences into account, we won’t be able to provide a successful response to AIDS.”

The Deputy General Manager of the Global Fund to Fight AIDS, Tuberculosis and Malaria, Debrework Zewdie, noted that 15% of the funding for HIV prevention goes to the elimination of new HIV infections among children. However, she highlighted that the Global Fund is demand-driven and that countries must request the funds.

Sweden’s AIDS Ambassador Anders Nordström emphasized his country’s commitment to preventing new HIV infections among children and said that Sweden would be allocating US$ 15 million to support Global Plan efforts.

Business Leadership Council for a Generation Born HIV-Free CEO John Megrue reinforced the commitment of the private sector to eliminate new HIV infections among children and keep their mothers alive. He highlighted that the organization will focus its efforts on mobilizing resources among the private sector, advocating for other companies to join the council and to helping countries to accelerate implementation of the Global Plan.

The meeting was the first annual face-to-face gathering of representatives from the 22 focus countries since the launch of the Global Plan towards the Elimination of New HIV Infections among Children by 2015 and Keeping Their Mothers Alive in 2011.

*The 22 priority countries are: Angola, Botswana, Burundi, Cameroon, Chad, Côte d’Ivoire, Democratic Republic of the Congo, Ethiopia, Ghana, India, Kenya, Lesotho, Malawi, Mozambique, Namibia, Nigeria, South Africa, Swaziland, Uganda, United Republic of Tanzania, Zambia and Zimbabwe.

GENEVA, 8 May 2012—The Joint United Nations Programme on HIV/AIDS (UNAIDS) today launched a new campaign, "Believe it. Do it.", aimed at bringing attention and action to the global goal of ending new HIV infections among children by 2015 and ensuring mothers living with HIV remain healthy. 

Each year, about 390 000 children become newly infected with HIV and as many as 42 000 women living with HIV die from complications relating to HIV and pregnancy.

In 2011, world leaders at the United Nations High Level Meeting on AIDS committed to ending new HIV infections among children by 2015 and saving mothers’ lives. A bold new global plan was adopted and action is underway.

“We have an amazing opportunity to change the world,” said Michel Sidibé, Executive Director of UNAIDS. “We have the commitment of world leaders but the clock is ticking and we cannot get from 390 000 to zero without you.” 

UNAIDS Goodwill Ambassadors Naomi Watts and Annie Lennox are among the personalities adding their voices and commitment to “Believe it. Do it.” In addition, UNICEF Goodwill Ambassador Whoopi Goldberg joined Blair Underwood, Denis O’Hare, Alexandra Wentworth, George Stephanopoulos and Sujean Rim to create a public service announcement for the campaign with the message “I believe children everywhere can be born free from HIV—Believe it. Do it.”

Under the premise that ‘every day is Mother’s Day!’ UNAIDS also teamed up with artist Sujean Rim to create a series of e-cards celebrating families. Through public service announcements, an interactive web site and social media outreach, the campaign asks the public to take three simple actions: 

1. Get the facts about ending new HIV infections among children  
2. Send a message about the issue and the actions people can all take
3. Support a mother through one of the great organizations working with families

The campaign will be featured ahead of Mother’s Day on 11 May on the American morning television show Good Morning America and the 30-second public service announcement will appear on CNN International, CNN Domestic (U.S. market) as well as other media outlets.

For more information visit http://www.unaids.org/believeitdoit/

CARMMA aims to accelerate the implementation of activities to stem maternal and child mortality.

The distinctive cry of a new-born baby pierces the air in the labour ward and stops conversation in its tracks. "That’s what we want to hear" remarks Sister Mavimbela, who just hours ago delivered him into the world. “When a baby cries, that’s the sign of a healthy delivery,” she says with the quiet confidence of someone who knows.

Unfortunately, it is not a cry that is heard every time as South Africa struggles with a high rate of maternal and child mortality. The country has a maternal mortality ratio of 310 deaths per 100 000 live births and an under-five mortality rate of 56 deaths per 1 000 live births.  To reduce this, the campaign on Accelerated Reduction of Maternal Mortality in Africa (CARMMA) was launched at Osindisweni Hospital in Ethekwini District, KwaZulu-Natal Province on Friday 4 May.

CARMMA aims to accelerate the implementation of activities to stem maternal and child mortality and meet Africa’s targets for Millennium Development Goals four and five—to reduce by three quarters the maternal mortality rate and to reduce by two thirds the child mortality rate between 1990 and 2015.

Health care workers at Osindisweni Hospital are certain about what is needed to help achieve these targets: reduce the burden of HIV. They are supported by the numbers.  South African data shows that 50% of maternal deaths and 40% of under-five deaths are as a result of HIV infection.

“We didn’t experience problems like this when I started”, says Sister Phumzile Kwitshana, who has been practicing as a midwife for 24 years. “It has gotten worse because of HIV—now mothers are sick.”

Dr. Amina Kajee, a doctor in the maternity ward at Osindisweni agrees.  “The last two cases of maternal deaths under my care were due to clinically advanced HIV. In one case one of the twins survived, the other didn’t. She only weighed 900 grams.”

The policy framework already exists: offer every pregnant woman HIV testing and counselling under the auspices of the national prevention of mother-to-child (PMTCT) programme. If she tests positive for HIV initiate her onto a regime of highly active anti-retroviral therapy to avoid transmitting the virus to her baby and ensure she is offered a continuum of treatment, care and support for herself and her infant.

However, one of the major obstacles to rolling out the policy successfully is that women often present for antenatal care too late in pregnancy for them to be offered the appropriate care. The overriding factor to explain this seems to be fear or lack of information, or a mixture of both.

“Women either don’t know or don’t want to know,” is how Dr. Kagee explains it.

“Women don’t come to the clinic because they don’t want to disclose to their families or partners… Sometimes it is the attitude of health care workers with the young ones,” says Sister Kwitshana, referring to the disapproval that often meets a teenage mother, sometimes discouraging her from returning. “Some of them just hide their pregnancies until late.”

Health care workers cite other challenges—some seemingly minor administrative issues, such as the need for a dedicated ambulance on standby for maternity cases, so that women at risk can get to hospital before the crisis deepens. In resource poor settings, however, minor challenges easily become major obstacles. These are further compounded by substantial health system challenges. For example, more midwives are needed to address understaffing and they require ongoing training and values clarification.

Nevertheless, the conversation returns to the issue of women themselves. “We need to shake up the community” says Sister Kwitshana.

Community mobilization campaigns are needed to encourage women to present early for antenatal care. Communities should be the bearers of information to prevent unintended pregnancies, especially among HIV positive women and teenagers, and to reduce HIV stigma.

The launch was led by South Africa’s Minister of Health, Dr Aaron Motsoaledi and was attended by a number of dignitaries and celebrities, including the Minister of Women, Children and People with Disabilities, Ms Lulama Xingwana, Advocate Bience Gawanas, the African Union Commissioner for Social Affairs, the Premier of KwaZulu-Natal, Dr Zweli Mkhize, musical icon and UNICEF Goodwill Ambassador, Yvonne Chaka Chaka, Mrs Graça Machel  and UNAIDS Regional Director of the Regional Support Team for Eastern and Southern Africa, Professor Sheila Tlou.

“The launch was a stark reminder of the hard work we need to do to achieve the third target of the Political Declaration on HIV/AIDS: Eliminate new HIV infections among children by 2015 and reduce maternal deaths,” says Professor Tlou. “One death is a death too many.”

The UN delegation visited Cama Hospital and the Sir J.J. Hospital—two leading health facilities in the Indian state of Maharashtra that provide health services for pregnant women and children.

On 28 April, United Nations Secretary-General Ban Ki-moon led a high-level mission to Mumbai, India in support of the Every Woman Every Child initiative. During the visit, the Secretary-General commended Indian officials for the progress made in the AIDS response. Mr Ban also encouraged the Government of India to continue efforts to eliminate new paediatric HIV infections by 2015—one of the objectives of the Secretary-General’s five-year action plan.

The Every Woman Every Child initiative is a global effort that was launched in 2010 by Secretary-General Ban Ki-moon to mobilize and intensify global action to save the lives of 16 million women and children and improve the lives of millions more.

Mr Ban was joined by senior UN health officials including the Director-General of the World Health Organization Margaret Chan, the Executive Director of the UN Population Fund Babatunde Osotimehin, the Executive Director of the Joint United Nations Programme on HIV/AIDS, Michel Sidibé, the Deputy Executive Director from the UN Children's Fund, Geeta Rao Gupta and the United Nations Secretary-General’s Special Envoy for Malaria Ray Chambers.

During the visit the Secretary-General, Mrs Ban and his delegation visited Cama Hospital and the Sir J.J. Hospital—two leading health facilities in the Indian state of Maharashtra that provide health services for pregnant women and children.

Mr Ban’s mission concluded with a high level reception hosted by Millennium Development Goals advocates Mukesh Ambani and Ray Chambers, which featured interaction with some of India’s leading AIDS activists, people living with HIV, business and government officials as well as film stars and sports legends. During the reception the Mr Ban announced the appointment of Mr Prasada Rao as his new Special Envoy for HIV/AIDS in the Asia-Pacific region.

L to R: Millennium Development Goals advocate Mukesh Ambani, Kausalya from Positive women network (PWN+), UNAIDS Executive Director Michel Sidibé, Daksha Patel from Gujarat Network of People Living with HIV (GNP+) and United Nations Secretary-General Ban Ki-moon.

The UNAIDS Executive Director Michel Sidibé travelled to India’s capital New Delhi where he met with the Minister of Health and Family Welfare Shri Ghulam Nabi Azad. During their meeting, Mr Sidibé commended India for its new National AIDS Control Programme (NACP-IV) which was developed by national experts and will be funded primarily from domestic sources.

Mr Sidibé paid special attention to India’s role and contribution as a priority country in the implementation of the Global Plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive. It is expected that the national recommendations on the elimination of new HIV infections among children in India will phase-out of single dose nevirapine in the coming months. Mr Sidibé had the opportunity to see first-hand  how services to prevent mother-to-child HIV transmission are being scaled-up at the Ambedkar Hospital, one of Delhi’s largest hospitals.

A high level round table organized by the Federation of Indian Chambers of Commerce and Industry (FICCI) and UNAIDS brought together more than 50 participants including leading representatives from the Indian pharmaceutical industry and the government under the theme “India’s partnership with Africa in pharmaceuticals”. Mr Sidibé encouraged the Indian pharmaceutical industry to seize the opportunities to scale up access to HIV treatment in Africa and engage as strategic partner for the development of pharmaceutical production in Africa.

Front L to R: U.S. Global AIDS Coordinator Ambassador Eric Goosby, UNAIDS Executive Director Michel Sidibé and Nigeria’s First Lady Dame Patience Jonathan.

Preventing new HIV infections among children and saving mothers’ lives were high on the agenda in a two-day mission to Nigeria by Michel Sidibé, UNAIDS Executive Director, and Ambassador Eric Goosby, the U.S. Global AIDS Coordinator. The visit occurred nearly one year after world leaders—including Nigerian President Goodluck Jonathan, Mr Sidibé and Ambassador Goosby—launched The Global Plan towards the elimination of new HIV infections among children and keeping their mothers alive.

Each year, nearly 400 000 children are born with HIV globally. Nigeria carries about one third of the global burden of new HIV infections among children. It is one of 22 priority countries of The Global Plan which, combined, account for nearly 90% of all new HIV infections among children annually.

During the mission, Ambassador Goosby and Mr Sidibé met with Nigeria’s First Lady Dame Patience Jonathan, who leads the country’s prevention of mother-to-child transmission (PMTCT) acceleration strategy, to identify bottlenecks to PMTCT scale up at both the national level and in priority states. Discussions with the First Lady centered on how to optimize and increase all available resources for PMTCT in the country. 

“I will remain steady in my resolve to continue to provide the necessary leadership and support to achieve our national target of eliminating mother to child transmission of HIV in Nigeria,” said the First Lady.

The First Lady also thanked the participants of the mission for their commitment to assisting Nigeria in the critical area of health development, which is a key element of President Jonathan’s “Transformation Agenda.”

“There are no longer technical or scientific barriers preventing us from eliminating the transmission of HIV from mother to child,” said Ambassador Goosby, who heads the President’s Emergency Plan for AIDS Relief (PEPFAR). “Working together, we will address head-on the challenges to achieving elimination in Nigeria and identify the most effective way forward.  Preventing new HIV infections in children is a smart investment that saves lives and gives them a healthy start in life.”

In meetings with leaders from private sector and civil society, including the interfaith community, Ambassador Goosby and Mr Sidibé stressed the importance of working in partnership to accelerate progress in the AIDS response. The delegation also met with members of the Nigerian National Steering Group of The Global Plan, which was launched earlier this month to accelerate and coordinate action on PMTCT by all partners in the country.

While calling for greater global solidarity in the AIDS response, Mr Sidibé also emphasized that country ownership would be essential to accelerate national action around PMTCT. “Our twin goals of zero new HIV infections among children and eliminating AIDS-related maternal deaths can only succeed if countries mobilize the required resources and political will,” he said.

According to government figures, an estimated 16% of pregnant women living with HIV in Nigeria received antiretroviral medicines to prevent mother-to-child transmission of HIV in 2011. There are approximately 3.5 million people living with HIV in Nigeria.

In May 2012, an annual Global Plan progress review will be held on the sidelines of the World Health Assembly in Geneva. Ministers of Health from the 22 priority countries identified in The Global Plan will convene to assess gains made in the first year of the plan’s implementation and to chart a course for continued progress.

UNAIDS Executive Director Michel Sidibé and U.S. Global AIDS Coordinator Ambassador Eric Goosby met with State governors during their visit to Nigeria. 24 April 2012.
Credit: UNAIDS/P.Ekpei

In a round-table discussion on Tuesday, high-level representatives from six Nigerian states committed to working with the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) to eliminate new HIV infections in children. The meeting came at the start of a joint two-day mission to Abuja by UNAIDS Executive Director Mr Sidibé and Ambassador Goosby, the U.S. Global AIDS Coordinator.

The six Nigerian states represented at the discussion were among the priority states identified for urgent implementation of a national scale-up plan to eliminate new HIV infections among children.

“Even though policies are formed at the national level, only if you assume leadership can new HIV infections among infants be eliminated in your states,” said Mr Sidibé, addressing the Governors of Kano, Benue and Nasarawa States as well as the Deputy Governors of Cross River, Akwa-ibom and River States.

Nigeria carries about one third of the global burden of mother-to-child transmission of HIV. It is one of 22 priority countries of The Global Plan towards the elimination of new HIV infections among children and keeping their mothers alive—a roadmap to ending new HIV infections among children worldwide by 2015.

During the meeting, Mr Sidibé saluted Nigerian President Goodluck Jonathan for participating in the launch of The Global Plan last June at the United Nations in New York. Together with Ambassador Goosby, he suggested that a few key Nigerian states, in close collaboration with UNAIDS and PEPFAR, could step up efforts to end mother-to-child transmission of HIV.

Ambassador Goosby acknowledged the importance of the gathering. “These governors recognize the importance of addressing paediatric infections in their respective states. Their leadership will not only help Nigeria reduce the number of infants from being infected by HIV, but it will help advance the overall goals of The Global Plan,” he said.

Benue State in north-central Nigeria has an HIV prevalence of 10.6%—the highest of any state in the country. Calling himself a strong advocate for ending HIV, Benue State Governor Gabriel Suswam said that he often takes HIV tests to encourage others to go for testing.

Nasarawa State Governor, Umaru Tanko Al-Makura, said his State has an agency that supervises the care of people living with HIV and is ready to cooperate with efforts to eliminate mother-to-child HIV transmission.

The discussion ended with a call by Kano State Governor, Rabiu Kwankwaso, to create an event that would shine a spotlight on HIV and ensure that the issue came to the forefront once again in Nigeria.

During the joint mission in Nigeria, Mr Sidibé, Ambassador Goosby and other participants in the delegation—including Peter McDermott of the Children’s Investment Fund, Anil Soni of Business Leadership Council and other members of the steering group for The Global Plan—will meet with high-level government officials, business leaders, and representatives from civil society and the inter-faith community. They will also commemorate victims of last year’s bomb attack on UN House in Abuja.

Members of the West Indies Cricket Team, photographed with children who participated in the Think Wise coaching clinic and Dr Ernest Massiah, Director of the UNAIDS Caribbean Regional Support Team.
Credit: UNAIDS

Hosting a group of local students at the Kensington Oval stadium in Bridgetown, Barbados, the West Indies Cricket Team expressed solidarity with the UNAIDS vision of zero new HIV infections among children. The coaching clinic was held as part of the Think Wise Campaign, a global partnership that uses the power and reach of cricket to address key HIV-related issues.

"We have the medicines, we have the knowledge. There is no need for any Caribbean child to be born with HIV,” said West Indies Captain Darren Sammy, who endorsed the call for preventing mother-to-child transmission (PMTCT) of HIV and ensuring access to life-saving treatment for HIV-positive women. “There is no need to treat anyone any differently because of their HIV status," he added.

The Think Wise Campaign—a partnership between UNAIDS, UNICEF, the International Cricket Council and the Global Media AIDS Initiative—places particular emphasis on HIV prevention as well as on the education and empowerment of children. Engaging young people in the HIV response was the focus of the coaching session in Bridgetown, which included a discussion around HIV.

"Through this event, the children have loved meeting their favourite players and learning some new skills. At the same time, they have gained awareness about HIV and the importance of treating all people with equal respect and compassion,” said Dr Ernest Massiah, Director of the UNAIDS Caribbean Regional Support Team. “Like the cricketers, these children can be agents of change in their families, communities and schools."

A regional Elimination Initiative—led by the Pan American Health Organization—aims to end mother-to-child transmission of HIV in Latin America and the Caribbean by 2015. The Eastern Caribbean, with its smaller disease burden, is expected to reach the target far sooner.

West Indies Cricket Captain, Darren Sammy, participates in media interviews with Dr Ernest Massiah, Director of the UNAIDS Caribbean Regional Support Team, at the Kensington Oval stadium in Barbados.
Credit: UNAIDS

At present, mother-to-child transmission of HIV accounts for between 8 and 10 per cent of all HIV infections in the Caribbean. However, some Caribbean countries have either achieved or are close to achieving elimination targets; between 2007 and 2010, for example, there were no new HIV infections recorded among babies in Barbados.

Widespread stigma and discrimination against people living with HIV remains a challenge for PMTCT programmes across the region. Stigma and the fear of unfair treatment prevent some HIV-positive mothers from accessing early antenatal care, abstaining from breastfeeding or making their babies available for follow-up testing and care.

"The Eastern Caribbean can eliminate mother-to-child transmission because we have the means to prevent it," Dr Massiah stressed. "West Indian people can play a part by addressing the negative attitudes and judgments associated with HIV. This would allow mothers across our region to feel safe and confident about accessing life-saving testing, treatment, care and support."