For years, there has been a battle over the best way to protect babies born to HIV positive mothers living in poor areas from getting the virus which has essentially boiled down to a battle between those who advocate breast feeding and those who advocate bottle-feeding with milk formula. As breastmilk can transmit HIV, global policy was weighted in favour of bottle feeding and HIV positive mothers were discouraged from breastfeeding. But a big study from KwaZulu-Natal led by Professors Jerry Coovadia and Nigel Rollins and published on Friday (30 March) seems to have finally settled the debate in favour of the breast. They found that babies who were exclusively breastfed by their HIV positive mothers were at substantially less risk of becoming infected than babies given both breastmilk and formula milk or solids.
Equity and HIV/AIDS
Oxfam and Médecins Sans Frontières (MSF) welcome Abbott’s decision to offer developing countries a further 55% reduction of its price for Kaletra/Aluvia, a key HIV medicine. However, Oxfam and MSF will continue to support the Thailand government in maintaining its compulsory licenses as an alternative channel for accessing affordable life-saving medicines. As a next step Abbott should publish a comprehensive list of all countries eligible for the price cut.
This letter adresses the World Health Organisation's Director General's meeting with representatives of the International Treatment Preparedness Coalition (ITPC) in March 2007. The letter, written by various representatives of the ITPC, expresses their concern that the world has lost the momentum of the 3 by 5 campaign and that WHO is on the brink of squandering its legacy of leadership role in the battle to bring universal treatment access to people living with HIV/AIDS. In this letter they outline five reasons for concern, make six specific demands to be met before the end of 2007 and give four commitments that ITPC will fulfill to do their part in this most critical global effort.
Food parcels are finally being offered to HIV positive mothers in KwaZulu Natal who want to exclusively breastfeed their babies as part of a new government policy. In the past, positive mothers were advised to either exclusively formula feed or, in cases where there was no supply of clean water, to exclusively breastfeed to protect their babies from getting HIV. But while free formula milk was dished out, no practical support was offered to those who wanted to breastfeed. The mothers, particularly those who were poor, tended to see the formula milk as an incentive. They then tended to opt to get the formula milk and feed their babies both breast and formula milk – the most risky feeding choice for passing on HIV. An exuberant Professor Nigel Rollins, head of the Centre for Maternal and Child Health at the University of KwaZulu-Natal, said he was “delighted” that government had chosen to help HIV positive breastfeeding women meet their increased nutritional needs (of breastfeeding) by offering six months’ worth of food parcels.
South Africa's new five-year AIDS battle plan entered the final stage of a lengthy drafting and consultative process. Government officials and representatives from various sectors met in Johannesburg to debate a draft version of the National Strategic HIV and AIDS Plan for 2007 to 2011, with the goal of hammering out a final version by the end of March. South Africa's HIV/AIDS epidemic is one of the worst in the world and continues to grow by an estimated 1,500 new infections a day, according to a report published this week by the Human Sciences Research Council. Government's past efforts to address the problem have been criticised for lacking the necessary urgency.
The infection rate in Senegal is 0.9 percent; similar to the rate in the U.S. (0.6 percent), and far lower than the soaring tolls in African countries such as Namibia (19.6 percent), South Africa (18.8 percent) and Botswana (24.1 percent). What is Senegal doing right, and can those practices be replicated in other countries?
This report seeks to identify discernible trends through the measurement of new and existing data against a baseline used here for the first time in the areas of preventing mother-to-child transmission of HIV, providing paediatric treatment, preventing infection among adolescents and young people, and protecting and supporting children affected by HIV/AIDS – the ‘Four Ps’. Further, this report reviews progress towards support strategies identified as critical elements of a child-focused response. It seeks to illuminate some of the ways in which Unite for Children, Unite against AIDS has shown relevance and promise, as well as some of the ways it has failed to spur the global, regional and country mobilization required to address the problems facing children affected by AIDS. It will explore how Unite for Children, Unite against AIDS needs to move forward in the next year to achieve its ambitious goals.
Global funds available to combat HIV/AIDS are estimated to reach about US$ 9 billion in 2007. Although this amount will be only about half of what is needed, it is, nevertheless, substantial. Used effectively, such donor financing could help stem the pandemic’s spread and mitigate its effects. In fact, disbursing the balance of such financing early on - ‘front-loading’ it - should be a priority. But there is considerable resistance to doing so. Why is this the case?
The HIV and AIDS epidemic feeds on, and worsens, unacceptable situations of poverty, gender inequity, social insecurity, limited access to healthcare and education, war, debt and macroeconomic and social instability. This paper introduces a series of eight papers from a programme of work reported in this supplement of AIDS Care with an analysis of background evidence of community responses to HIV and AIDS. It explores how interventions from state institutions and non-governmental organizations (NGOs) support and interact with these household, family and community responses. Through review of literature, this background paper sets out the questions that the studies reported in this supplement have, in various settings, sought to explore more deeply.
A trial in Zimbabwe has shown that a programme of integrated peer education, condom distribution, and management of sexually transmitted infections did not reduce the overall incidence of HIV-1. The study, published in PLoS Medicine, by Simon Gregson and colleagues from Imperial College London, randomised different communities in eastern Zimbabwe over a 3 year period. Six pairs of communities in Eastern Zimbabwe were compared, each of which had its own health center. Control communities received the standard government services for preventing HIV. According to the author, the results are disappointing given the urgent need for control measures for HIV-1 in sub-Saharan Africa. The authors conclude that they “emphasise the need for alternative strategies of behaviour change promotion.”