Mother to Child Transmission

A couple weeks ago, I had the privilege of attending the 62nd National Prayer Breakfast in Washington DC. Among all the talk of bi-partisanship and religious freedom, there was a direct and urgent message from USAID Administrator Rajiv Shah asking us to join the fight to end extreme poverty in our lifetime. This young and humble leader has brought great reform to USAID through a relentless focus on investing in strategic, results-oriented, and local development organizations.

After all the notable moments throughout the event, I had multiple people approach me to ask about one comment that Administrator Shah made. He said, “We’re close to eliminating the transmission of HIV/AIDS from mothers to their children.” People came up to me and asked, “Is it true what he said?”

Similarly, I read a great article just a couple weeks ago by Nigel Barker about the realities of pediatric HIV in Africa today:

Both of these experiences reminded me that we need to make more people aware of the advances we are making in this area but communicate that we still have work to do to eliminate mother-to-child transmission of HIV.

– According to the 2013 UNAIDS Global Report, 700 children are still infected with HIV every day.

– According to the WHO, following the 2010 guidelines on mother-to-child transmission can lower the risk of transmission to less than 5% from about 35%.

– According to a UNAIDS report from 2012, half of all HIV-positive children won’t live past the age of 2 and 80% will die before their 5th birthday.

All of these stats remind us that the first line of defense in saving this next generation from HIV/AIDS is by preventing the spread of it from mother to child. Thankfully, CARE for AIDS has done an outstanding job of intervening with these at-risk mothers. To date, we are responsible for over 100 children being born HIV-negative and remaining that way through their 1st birthday.

Here is how we do it:

1. First of all, it is critical that the mother gives birth at a hospital in order to limit the risk that the child will contract HIV during the delivery process. According to Dr. Robert Ayisi, about 40% of Kenyan women still give birth at home, but CARE for AIDS ensures that all mothers give birth in a hospital.

2. Secondly, a special antiretroviral treatment is prescribed to women starting in the second trimester and continuing throughout the breastfeeding period. A prophylaxis is also prescribed for the child after birth. This combination greatly reduces the likelihood of transmission if adhered to properly.

3. When possible, it is recommended for the mother to forgo breastfeeding altogether, but only if she can access an affordable, nutritious, safe, and sustainable food source throughout the breastfeeding period. It is not recommended for the mother to mix breast milk and other foods or formulas during the first 6 months because outside bacteria can weaken the child’s stomach lining making him or her more susceptible to HIV. CARE for AIDS provides a food supply for the children, so mothers have the option not to breastfeed.

4. If it is necessary for the mother to breastfeed, then she must do so exclusively for the first 6 months of the child’s life and then begin introducing mixed feedings after that until 12 months or until the child has a nutritionally adequate diet.

This may sound technical, but these simple interventions have saved more than a hundred children from contracting the virus. Join us in stopping the preventable and pointless infection of children.