Sunday Times (Johannesburg) - July 30, 2008
Tamlyn Stewart

* African gene raises risk of HIV, research finds

* Our children are dying

About 370,000 children younger than 15 years old became infected with HIV last year, bringing the total number of children living with HIV to 2 million.

Steven Whiting, director of HIV SA said: "It's really about the prevention of mother to child transmission programmes. We do have PMTCT programmes but they are only really effective when you have a government that is one hundred percent behind the programmes."

Whiting said the scale of the epidemic in South Africa was a major challenge: "We have been running a PMTC programme in Soweto. We see 30,000 pregnant women, of whom about a third are HIV positive - that's ten thousand women, and that's just in Soweto alone."

Whiting said all PMTCT programmes should be "scaled up enormously".

Andrew Warlick, policy researcher with the Treatment Action Campaign (TAC) said: "The reason why sub-Saharan Africa is falling behind is due to a poorly-functioning prevention of mother to child transmission programme."

The vast majority of children with HIV contract the virus at birth or infanthood through mother to child transmission.

One of the most effective treatment interventions is ædual therapy" whereby the mother is put on a full course of AZT and a single dose of Nevirapine.

"In South Africa we are finally working to the WHO guidelines of dual therapy - it was only introduced in Gauteng in the last eight months," said Whiting.

Using single dose Nevirapine therapy can drop transmission rates to between 6 and 7 percent, compared to a less than 3 percent transmission rate using dual therapy, said Whiting.

"But we are not seeing it implemented on the ground because there is a lack of political will," said Warlick.

"Nurses and healthcare workers need education and training on dual therapy...in some instances they are completely unaware of the dual therapy policy," explained Warlick.

"We have to get very serious about preventative strategies and communication strategies, particularly aimed at the youth," he added.

Another factor hampering the curbing of the HIV epidemic in South Africa is a massive ætreatment gap' in this country.

Last year, an estimated 889,000 South Africans were in need of antiretroviral treatment, but only 371,731 people were actually receiving treatment.

While South Africa's HIV epidemic appears to have stabilised according to the report, South Africa still has by far the largest epidemic in the world, with an estimated 5.7 million people living with HIV.

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