New Telegraph

HIV/AIDS: Lack of progress in PMTCT programme worry experts

West and Central African region accounted for 22 per cent of AIDS-related deaths in 2020. Also, available data show that around 200,000 people in the region became newly infected with HIV last year out of a global total of 1.5 million. Experts say pregnant women, unborn children and new born are among vulnerable groups with high risk of exposure to infection, hence the importance of Prevention of Mother To Child Transmission (PMTCT) of HIV services, writes APPOLONIA ADEYEMI

Against the background of lack of progress in the Prevention of Mother to Child Transmission of HIV (PMTCT) of HIV, medical experts that are disturbed over the situation, have called on the three tiers of government to commit adequate fund as well as demonstrate political will to make the PMTCT programme in the country a success. While lamenting the lack of progress in this sphere, a Consultant Paediadric Haematology Oncologist, Prof. Edamisan Temiye said, “The major issue is that governments at all level are not putting in enough efforts to solve the problems.

The governments are waiting for donors to come and help them solve the problems.” “They are unwilling to commit their money; they want people and International agencies to be donating to them. These are major issues for us,” said Temiye who manages children living with HIV and cancers at the Lagos University Teaching Hospital (LUTH), Idiaraba, Lagos. Although new HIV infection rates, and acquired immunodeficiency syndrome (AIDS)-related deaths have been on a steady decline over the past decade, the West and Central African region accounted for 22 per cent of AIDS-related deaths in 2020. Around 200,000 people in the region became newly infected with HIV last year out of a global total of 1.5 million, UNAIDS data shows.

It will be recalled that the PMTCT programmes offer a range of services for women of reproductive age living with or at risk of HIV to maintain their health and stop their infants from acquiring HIV. Although, PMTCT services should be offered before conception, and throughout pregnancy, labour and breastfeeding despite the introduction of the programmes it hasn’t witnessed rapid progress in terms of expected outcome. For instance, Suleiman Akanmu, a Professor of Heamatology and Transfusion Medicine at the College of Medicine, University of Lagos, said when the PMTCT programme started in 2001, the programmes that were domiciled at teaching hospitals, the federal medical centres were available in 25 facilities. He explained that the aim of the Federal Government then was to offer antiretrovirals (ARV) to adults in Nigeria.

The services has since been expanded from 25 to over a thousand service centres and offering comprehensive ARV services. Akannmu lamented that available services could only reach one third of the pregnant women, leaving the other two-third uncared for. While still lamenting the slow pace of progress being recorded in the programme, Temiye said the technology of PMTCT of HIV, has been available since the 1980s and yet the country is not making progress from using this mode of treatment to prevent HIV. According to Temiye, in developed countries today it is like a crime to allow a woman go through pregnancy without knowing her status and then the baby gets infected with HIV. That doctor or that healthcare delivery system that took care of that person will be in trouble because it is possible to completely prevent mother to child transmission of HIV and the means to do it is cheap. Yet the governments in Nigeria are unwilling to drive the system, lamented Temiye.

What is sad about PMTCT of HIV services in the country is that more than 20 years after the programme was introduced in the country, the number of pregnant women benefitting from the programme still has not gone beyond one-third. This came to the fore again during a three-day media dialogue on PMTCT of HIV, which took place in Calabar, Cross River State from October 11 to 13. In his presentation during the programme which was organised by Journalists Alliance for the Prevention of Mother-To-Child Transmission of HIV/AIDS (JAPIN) in partnership with Federal Ministry of Information and Culture and UNICEF, an Assistant Director, National Prevention of Mother-To-Child Transmission (PMTCT) Lead at the National AIDs & STIs Control Programme (NASCP), Federal Ministry of Health (FMoH), Dr. Olugbenga Ijaodola said essential health services that could prevent HIV in unborn children and new born is accessible to only one-third of pregnant women in the country. While lamenting several obstacles hindering PMTCT services from reaching more pregnant women, a Public Health Physician, Dr. Japhet Olugbogi urged pregnant women to avoid risky lifestyles including giving birth at home and in places manned by traditional birth attendants (TBAs) who do not test HIV status of the women, he advised them to adhere to counselling from their health practitioners.

“Pregnant women should also endeavour to attend routine ante-natal clinics (ANCs) and take their routine ANC drugs which help them to prevent malaria, boost immunity and blood level. “They should also be willing to explore the option of ceasarian section when given this option by their obstetricians. This ensures safe delivery and reduces the risk of transmitting HIV to their new born. Olugbogi who is the chairman, Infectious Disease Commit-tee of the Lagos State Branch of the Nigeria Medical Association (NMA), called for continued sensitisation, education and reinforcement of the knowledge of the general population on safe pregnancy, safe delivery and safe motherhood.” While calling for demystifying of rumours, myths, cultural and religious beliefs hindering pregnant women from ANC services, Olugbogi said, “The family including mothersin- laws, grandmothers, among others need to help our women increase their health-seeking behaviour; the governments need to increase the number of primary healthcare centres (PHCs) across the country so that access to health care services can improve.” According to him, many women in remote, rural and hard-to-reach areas do not have ready access to health care, a major factor preventing them from accessing PMTCT services. Olugbogi urged all state governments to train and re-train TBAs so they can know their limits and refer as at when due.

Similarly, he called on pregnant women living with HIV to take their antiretroviral (ARV) drugs as at when due. “This would help them seroconvert, protect them and their unborn child from severe illnesses associated with HIV/AIDS.” On his part, a Consultant Public Health Physician and Epidemiologist, Dr. Oladapo Asiyanbi said the PMTCT of HIV was achievable if all pregnant women in the country have access and avail themselves with the opportunity to get tested for HIV/AIDS to know their status. Subsequently, he added, “Immediately they should begin treatment if they are HIV positive.” Furthermore, he said they should also monitor their treatment such that laboratory tests will show the level of HIV virus in their blood/ system to ensure it is so low so as to minimise the risk of HIV transmission to their unborn child.

Asiyanbi said pregnant women should give birth to their children in a health centre, by a trained health worker to prevent transmission of HIV to their baby during delivery. Similarly, they should ensure that after delivery, for those women who are HIV positive, drug treatment and testing for HIV is done as a necessary routine.

On what can be done to make PMTCT services available to all pregnant women in the country, Asiyanbi said the family and community focused type of care is the best strategy to follow. “The closest, easiest and least expensive type of care for pregnant women should be strengthened and made to provide HIV/AIDS care for pregnant women, their spouses or families. “This simply means we must participate, advocate to establish and make our PHC system work with us and for us.”

Read Previous

Firm launches COVID-19 antibody, immunity test in partnership with UK Lab

Read Next

4 Nigerian startups get NCC’s N20m grant

Leave a Reply

Your email address will not be published. Required fields are marked *