Aids treatment sends baby infections plunging

2012-05-31 11:48

Soweto - Katakane,1, laughs and coos in the arms of her HIV-positive mother as a doctor tries to examine her at Soweto's Chris Hani Baragwanath Hospital.

But it is only a routine check-up. The little girl is healthy thanks to a treatment that has saved thousands of babies born to mothers with the virus that causes Aids.

"My baby, she's fine! She's playing, and she's saying 'mummy, papa'... Yes, she's good, she's fine," said the beaming 32-year-old Nandi (not her real name), recalling her relief when she learned her daughter was HIV-negative.

Two years ago while she was expecting, Nandi took part in a state health programme designed to prevent HIV-positive mothers from infecting their babies with the virus.

The treatment has saved up to 70 000 children every year, according to officials - a massive success story in a country with almost six million people living with HIV and Aids and a notorious treatment history.

Pregnant women get tested at antenatal clinics, said paediatrician Avi Violari.

Free of charge

"If she is HIV-infected, then we do a lot of intensive counselling ... and we offer to give treatment during pregnancy," she said, as children dangled from blue chairs in the research unit, waiting with parents for testing or treatment.

The HIV mothers are given antiretroviral (ARV) drugs during pregnancy and after birth, and possibly an extra dose during labour depending on the virus' progression - all free of charge.

The medicines reduce the viral load in her body, which in turn reduces the infant's risk of contracting HIV through the umbilical cord or by exposure to the mother's bodily fluids during childbirth or breast feeding.

The newborn also gets a few drops of ARV syrup as an extra boost to fight infection.

While ARV drugs have downgraded Aids from a deadly to a chronic condition in richer countries, allowing sufferers to carry on a decent lifestyle, the same is not true in poorer countries where survival can be a cruel, daily struggle for proper food and medicine.

Infection rates drop

Until a decade ago, South Africa had also notoriously resisted giving anti-Aids drugs to pregnant women.

Former president Thabo Mbeki, in power at the time, drew worldwide criticism for his stance challenging whether HIV causes Aids and questioning Western diagnoses and medicines on how to treat the virus.

In 2002, however, the Constitutional Court ordered that antiretroviral be made available, at no cost, to HIV mothers-to-be.

Today, South Africa's ARV programme has moved beyond pregnant women and now serves 1.3 million people, the largest programme of its kind in the world.

Before the "prevention of mother-to-child-transmission (PMTCT)" programme was launched, almost a third of the country's babies were born with HIV, contracted from their mothers.

Infection rates have now dropped to under 4%, according to official figures released last year.

"It's unbelievable how the transmission rates have come down. It's really dramatic," said Theresa Rossouw, the country's chief HIV doctor in Pretoria.

Success hailed

International health officials have hailed the success.

"PMTCT programme is a flagship of the South African government. It is something of which they can say, 'We lead this programme,'" said Thapelo Maotoe, a doctor with US aid agency USAid, which has put more than $3.3bn into South African HIV and Aids treatment since 2004.

The results signal good news in a country where one in two HIV-positive will still not reach their 5th birthday.

But sometimes the medicines do not work.

The youngest child of Lindiwe (not her real name) was born HIV-negative, but his older brother, 3-year-old Siyabonga, contracted the virus despite administration of the drugs.

"Siyabonga is no longer going to have a better life because he's going to grow with this virus. And he's still young, so it's too painful," said the 22-year-old mother.

At times, children may also develop resistance to the ARVs their mothers took during pregnancy but "the advantages of treatment are dramatically higher than the disadvantages", said Rossouw.

And even after birth, babies can still be exposed to the virus through their mother's breast milk.

Since 2010, however, South Africa has advocated that babies be breast fed exclusively for the first few months of life rather than bottle-fed with infant formula, as the mother's milk protects better against diseases or potentially life-threatening diarrhoea, said Rossouw.

"We know there will be more infections, but there will be more children that survive."

  • Max - 2012-05-31 12:17

    And how is this good news for the clean living tax payer of the country?

      heiku.staude - 2012-05-31 12:44

      What? You want children to die so that your tax can be used on your needs? Damn..

      Eduard - 2012-05-31 12:48

      You are an ignorant idiot Max Do you think anybody wants HIV? Some cannot help, others don't even know they have it, others get it from helping does it help the tax payers, by developing the fight against HIV. Can you imagine if SA finds a cure for HIV, all the money it will bring back to SA? If you wish bad luck onto others, well then Max, bad luck will hunt the saying goes....

      Candice - 2012-05-31 14:49

      wow, my child was born from an hiv infected mother, and thanks to these drugs hes in perfect health, you saying he should of rather died than been helped?

  • Marion - 2012-05-31 12:28

    Good news to hear that they are managing to save so many babies. Find it strange that even though the babies can be exposed to HIV through breast milk the government says it is good to breastfeed. Weird or what?

  • procold2 - 2012-05-31 12:31

    every body has the right to life, but the best cure for this disease is education and safe sex, who is going to looking after all the babies that survive, and i dont only mean the finacial bit but the parenting bit also.

      Henry - 2012-05-31 13:35

      The best cure for this disease is too stop waisting money on it and let the disease take out those too stupid too avoid getting it,natural selection,survival of the fittest and smartest ARV's should only be used on victims of rape or those that got it via a bad blood transfusion. It's like say mr zuma gets the disease because he can't keep it in his pants, then we the taxpayers must pay for him to live.

      Tanya - 2012-05-31 13:38

      Henry - why should an unborn baby be punished for their parents sins? Plus not everyone did this to themselves. That is an extremely narrow-minded comment.

      lotus.river.5 - 2012-05-31 14:14

      Its obvious that henry's comments should be ignored. But to answer on that question about who will look after the babies: arvs work like magic.the mothers themselves have much higher chances of survival on the treatment and lead very productive lives.I alwys tear when seeing such families returning to normal livesn finding employment and leading happy successful lives. People like henry also argue that giving arvs to people will only increase the peoblem,they survive longer and spread the virus futher,but just as a baby born through the blood mess and trauma of delivery has few chances of getting hiv if the mother is on arvs,these people have even less chances of spreading the virus to their sexual partners.and part of the treatment is intensive counselling on lifestyle modifications and condom use, this further reduces the chances of spreading the logically,it goes to show that if we get every single south african tested for hiv and put on treatment if they warrant it, we will reach a stage where the incidence of new infections is plummeting, and the state only has to spend money on the currently infected cohort.100 years later, the possibility of an hiv free society is possible,as they say, it begins with you.

      Rob - 2012-05-31 14:36

      lotus: It is not at all smart to simply ignore Henry's comment...and see my previous one too. What is more to the point is that whilst I agree with allieviation of suffering and reduction of disease (and therefore extension of life) as a set of 'good' things I also fervently believe that such good things must not be considered in isolation and regardless of their impacts. To be harshly realistic, if South Africa is unable to find the money (and the heart) to take effective measures to reduce and prevent HIV it seems to me to be highly unlikely that South Africa will be capable of sustaining the population outgrowth and additional financial burden of maintaining the artificial situations created by donor funding from USAID et al.

      lotus.river.5 - 2012-05-31 14:58

      Funny enough the current government has committed a lot on reducing the hiv pandemic,on not only one level in fact.its probably the only good thing in our health system currently. I'm saying this because I'm currently working in a government hospital. I treat patients with hiv and its really inspiring. The legislation has changed, the qualification criteria for treatment are changing, and honestly the government is really working hard at trying to be one step ahead of the infection. Unfortunately we need to see the stats going up first before they start to come down to know that things are moving forward. Up first due to the higher uptake by the community of the testing campaigns, and down due to the reduced incidence of new infections. Again unfortunately its going to take a while. On the plus side as I said our health system has committed a lot money on the programme.nowadays, nurses are trained very thoroughly and specifically for the programme, so we don't even need a doctor to initiate arvs and monitor the patients, second, the drugs are becoming much cheaper and therefore rolling them out is less expensive, and thirdly people are talking, the stigmas are shifting, and the future looks honestly bright. That's of course if people like henry stop making comments like the above regarding this crippling problem

      Henry - 2012-05-31 14:59

      Tanya. Victims of crime should be helped,but not self inlicted stupidity. I have always made great effort to prevent myself getting infected because I don't want to die from aids,simle. I'm a heavy smoker,there's been lung cancer in my family,there's a chance that i might get it and die,but I enjoy smoking......I won't expect the taxpayer to bail me out one day for something i did too myself. Why should the aids victim(not really a victim) get the helping hand,is it because the vast majority is black? Stuff that. Furthermore,rather pump the money being wasted into a cure instead of treating the symptoms,by treating an incurable disease you run the risk of making it more virulent/resistant ....

      Rob - 2012-05-31 15:14

      lotus: You continue to object to Henry's position. So let me try again: The good things that you list mostly came about because of grants and external support. Arguing that that much of the stuff on the ground is local is a weak argument because it is likely that SA would have done very little without external influence despite local activism (remember the early days with Mark Heywood). Also I am sure that you can recognise the massive gravy train that has been produced by grants etc including the swollen ranks of professionals and academics who feed from the trough both financially and professionally...the cv junkies! So, we have a positive measurable outcome but it is till now highly dependant on the grant system, and even though SUSTAINABILIY was introduced a couple of years ago, with some impact, I think that it is inevitable that we will see 'welfare dependancy' at a national and individual level as funding is reduced (a reality today). So don't avoid Henry's position, it calls for a more critical approach, including waking people up to the fact that they, NOT THE STATE, are responsible for their own health and welfare.

      lotus.river.5 - 2012-05-31 15:18

      Henry I hope you don't get cancer, that will be too easy for you. I hope you get emphysema from your smoking, and live long to see that no medical aid will protect you forever and buy your oxygen tanks indefinately. And while you sit with all the complications of emphysema and\\or chronic bronchitis, I hope you exhaust your medical aid. And come down to earth to your state to bail you will eat those words with maple syrup my dear, life is a b•••h and you need to learn some compassion

      lotus.river.5 - 2012-05-31 15:43

      @criticallyhonest. I'm rejecting henry's approach because it is flawed and it is not the best solution for this problem.the best solution for the hiv pandemic is:in south africa and all over the world: to identify every single infected person, to educate them about the disease, to montior the progress of their infection, to start antiretroviral therapy for those who warrant it, and to moniotr their progress on the therapy.this is the currently what the south african health system is working, very commendibly towards. We also understand that we are looking at at least 6 mil known cases, and probably double that number of undiagnosed cases. Because of the resources implicated, this is also a political problem. Yes south africa has its history, from mbeki,to foreign aiding, to the nhi and so forth. As we speak in 2012, and as a fact and not a speculation,the health department has committed to the above plan on tackling thr problem. So yes I do agree with you that there is corruption, and that yes we as a country, infact continent are some what depending on grants to solve our problems, but I vehemently refuse to give any attention on what henry is saying because it is ignorant and is not constructive to any form of progress towards this battle. However, I do agree that people need to be responsible, but that comes with health education. But leaving people out in the open to die because of their stupidity makes absolutely no sense,and I will never give a seconds attention to such a view is not the only pandemic the world has faced, and people like henry have said the same thinga he is saying now, and history has taught us again and again that we need a different approach to probelm solving

      Rob - 2012-05-31 16:28

      So Henry: you can see that Lotus is dedicated to her beliefs regardless of any other position. She will no doubt have a positive effect on the lives of those she touches. But I have my doubts about how long the world will continue to fund programmes such as SA, and as the resources dry up it is just possible that you will be able to remind everyone that you saw it coming.

      Henry - 2012-05-31 17:17

      Lotus Aids has been known of since the early 80's. Those who got it through ignorance then are mostly 6 feet under now. Our government hospitals have given condoms away for mahala for years now,those getting this self inflicted disease have only themselves to blame. They shouldn't be our problem. Now if aids was purely the result of stupidity,half of the USA would have it(just kidding yankees),this is also a cultural issue. In our patriarchal society,where men take what they want from their woman,regardless of the results,why aren't the woman fighting back. Why is the culture allowed to continue. A culture that cannot or will not adapt to survive,is destined to die out. Now if you insist on giving ARV's to these people,go ahead feel free,but this disease will not have a cure until gene therapy(recoding your genes) becomes a reality.The disease will mutate and things could get worse. Let the disease take it's course and the issue of aids will go away. Stop the waist of resources. Criticlyhonest. I'm sure you don't agree with my view entirely,but thanks.

      lotus.river.5 - 2012-05-31 17:36

      @criticalyhonest;on a different issue, how did you conclude that I'm a she?you're right I am a woman,but my alter ego is a man and I was trying to develop lotus river as one,just wondering?

  • Rob - 2012-05-31 13:06 the level of each family this is as good as it gets. Wonderful indeed. But, consider that is already more than half a million people. Who is going to feed them? Who is going to educate them? Who is going to house them? Who is going to ensure that they become model citizens? Will they vote for liberal democracy or tyranny? And one for the Yankee haters on this site......3.3bil US means that equivalent of every US person, including children, has handed over more than R100 to South Africa. Have you noticed the lifestyle of many newly rich here....and still the US hands out. That is disgraceful. Is that what Ubuntu is about?

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