InterPress News Service (IPS); Thursday, 11 July 1996.
Yvette Collymore

Until now, as is the case of with treatment of the disease among adults, the drug therapy that is being advocated is costly and beyond the reach of infected mothers in the developing world which is worst affected by the Acquired Immune Deficiency Syndrome (AIDS).

The Joint United Nations Programme on HIV/AIDS (UNAIDS), which estimates that 90 per cent of all mother-to-child transmissions occur during and right after pregnancy, is coordinating the new research and hopes to develop therapy that would be accessible even to the poor.

Since the virus was first discovered 15 years ago, some three million children -- mostly in sub-Saharan Africa -- have been infected by the virus through their mothers.

Transmission of the HIV virus to newborns is a major social and health problem, made worse by the fact that many mothers are unaware that they themselves are infected.

This is particularly so in the developing world where women are afforded little or no prenatal care and many births are carried out by midwives who are not trained to test for HIV. And even in cases where women can visit clinics before and after giving birth, costs for screening for the virus are prohibitive.

Previous research conducted in the United States and France have shown that mother to child transmission of the AIDS-causing Human Immunodeficiency Virus (HIV) may be reduced through the use of certain drugs, like zidovudine, more popularly known as AZT.

Scientists found through clinical trials, that a regimen of AZT given to infected pregnant women before and during delivery and to the newborn for six weeks after birth, reduced the risk of HIV infection by nearly 70 per cent.

But such therapy is rendered irrelevant to poverty struck developing countries where the poor cannot afford treatment that often runs into thousands of dollars.

"If the treatment of AIDS was one glass of clean water, most people (in the developing world) would not be able to control it...because they don't have access to clean water," Canadian physician Josef Decosas told reporters in Vancouver Wednesday.

The Canadian city is the venue the 11th International Conference on AIDS where scientists and health experts from around the world are debating ways to control the spread of disease.

One of the raging debates centres on breastfeeding and whether pregnant women should be advised to use infant milk formulas as a precaution against transmission to the foetus.

What UNAIDS hopes to do is draw on the gains already made in the research conducted in the industrialised countries, and apply it to clinical trials to be conducted in developing countries with the aim of reducing treatment cost.

The UNAIDS coordinated research, called the Perinatal Transmission (PETRA) study, will test three different treatment regimens among women who breastfeed. The clinical trials will involve 1,900 pregnant, HIV-infected women from South Africa, Tanzania and Uganda.

The entire study is scheduled to take three years at a cost of four million dollars, and according to UNAIDS' clinical research specialist, Dr. Joseph Saba, one of the tasks will be to establish just when the highest risk of breastfeeding occurs.

"This is clearly an intervention beneficial, not just to countries where the trials are being conducted, but to the whole world," said UNAIDS Secretary General Peter Piot in Vancouver.

The research is being sponsored by the National Centre in HIV Epidemiology and Clinical Research in Australia, the National AIDS Therapy Evaluation Centre in the Netherlands, the Swedish Institute for Infectious Disease Control and the Instituto Superiore de Sanita in Italy.(END/IPS/AP-HE-PR/YC/CPG/96)

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