Inter Press Service - November 14, 2000
Anthony Mukwita

It will test some 10,000 pregnant women and put them on a drug that will primarily prevent transmission to the baby and also prolong the woman's life. Director of the government's national secretariat on HIV/AIDS, STD's, Tuberculosis (TB), and Malaria, Dr. Moses Sichone revealed this in an interview, adding that enough drugs were available for the pilot project that would involve 10,000 women.

The reason for testing the women is two-fold: to detect the disease in the mother at an early stage so that the Aids drug, AZT, which has been acquired at an undisclosed cost with the help of donors, can be administered to them with the aim of reducing infection from mother to child commonly referred to as the mother to child transmission (MTCT).

However, the MTCT project has been received with mixed feelings with one school of thought saying it raises lots of ethical and moral issues. One of these is that use of the drug means saving the child and adding to the number of orphans while leaving the mother to die.

"The child will live but the mother will die because she has Aids but also because she will not be able to afford the drug anymore (after the birth). How long will they treat the mother is the big question," says Mulenga Kapwepwe, an anti-Aids campaigner and expert.

She adds that: "This will mean the child shall remain alone as an orphan who will join the ranks of thousands other street children in Zambia, is this correct?"

Kapwepwe says lots of water has been poured on the MTCT campaign because along side it, there is a campaign to promote breast-feeding by the health ministry which, she says, "is the second highest mode of transmission after unprotected sex."

However Dr. Sichone; "It's always a dilemma when you come across such a situation. But the rationale we are using is that there's a problem and if you can do something to help why not do it."

"A woman with HIV/AIDS can live up to 20 years with the proper drug," Dr. Sichone said citing examples of some prominent Zambians who were alive despite having confessed that they were HIV positive several years ago.

He said the money and expertise to screen and treat 10,000 women within an initial period of one year was available and depending on how well the pilot project worked, the number of women to screen and treat would increase to 100,000 eventually.

Presently, between about 35,000 children in Zambia are being born with the deadly virus with seven out of 10 of them dying before they reach the age of five.

The number of mothers dying has also shot up from 200 per 100,000 live births, in the 1980's, to more than 600 per 100,000 presently according to Dr. Sichone. Sichone argues that preventing the children from contracting the disease either in the womb or during breast feeding will save costs of constantly going to the hospital and the accompanying misery and help the child grow with the mother up to a stage where other relatives can adequately take over.

His detractors, and there are many, however, say the AZT drug is too expensive, most pregnant women cannot afford it so giving it to them and leaving them fend for themselves is cruel.

Dr. Sichone, however, says the benefits of testing for a pregnant mother out weigh those of not doing so because drugs are available for pregnant women who voluntarily test.

The disease has killed more than 650,000 Zambians since it became an epidemic in the early 1980's and it has also left more than 700,000 children orphaned according to UN international children's fund (Unicef) studies.

The same studies show that one out of every five Zambian adults are living with the virus that has broken down many a homes as the bread winners die and leave children to take care of other children.

The disease has forced more than 75,000 children on the streets as street children sleeping in trees, shop corridors and under bridges. Most of them do not go to school.

Kenneth Kaunda, the country's first President recently formed a foundation, the Kenneth Kaunda African children's foundation to look after orphans all over Africa and fight against the disease that is leading to the increasing number of orphans.

The foundation's headquarters will be in Johannesburg South Africa where the Zambian President of more than 27 years will also eventually settle after retiring from active politics.

It is given this background that Dr. Sichone feels if the MTCT programme were encouraged, levels of HIV/AIDS incidence in the future would drastically drop like they have in countries such as Uganda where trials were done in 1999.

"We are confident of bringing the levels down and real low," Dr. Sichone said, "this has worked every where trials have been conducted."

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