Integrated Regional Information Networks - July 22, 2002

The newly-launched MTCT (mother-to-child transmission) Plus initiative run by Columbia University's Mailman School of Public Health, recently announced grants of more than US $9 million to 12 hospitals, health centres, and clinics in eight African countries.

Previously, prevention of mother-to-child transmission programmes have focused on infants, but very little has been done for the mothers. AIDS activists have raised concerns that the programmes are saving babies but condemning them to live as orphans.

Mothers in Medecins Sans Frontieres-run clinics in Khayelitsha, Cape Town, and at programmes managed by the universities of Witwatersrand and Natal will for the first time be able to get antiretroviral therapy, care and support services.

"We're anticipating about 300 people in an operational research setting ... but its a very valuable and important step because it will give us information we don't have yet," Dr James McIntyre, of the Perinatal HIV Research Unit of the University of Witwatersrand, told IRIN.

The project will inform future policy by giving an indication of long-term treatment needs and the logistics involved in providing treatment. The initial pilot sites will also assess the response of the mothers to the treatment, as well as any difficulties that might arise.

"The government is saying they don't have enough information yet [to implement a national treatment programme] and this is one way to find that information," he added.

But MTCT-Plus will not be restricted to mothers. "The mother exists within a household, so we are looking at an approach that secures families, not just one person. That is the rationale behind the programme," McIntyre said.

"MTCT-Plus can and will demonstrate that HIV treatment can be done in the poorest countries. Our aim is to save thousands of lives now and develop a family-centred care model that can be replicated by others around the world," Allan Rosenfield, dean of Columbia's Mailman School, said in a press release.

The initiative, which is supported by a coalition of foundations including the Bill and Melinda Gates and Kaiser Family Foundation, will build on existing MTCT programmes by awarding a total of US $50 million to provide care and treatment to more than 10,000 women, children, and other family members.

"MTCT-Plus is a major step towards bridging the gap in access to care, treatment and support. The challenge now is to mobilise the necessary resources so that this programme can be expanded and tens of thousands of mothers, fathers, and children can face the future with hope," Peter Piot, executive director of UNAIDS, said in a press release.

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