AIDS spreads to infants as most mothers fail to get treatments

By Marilyn Chase. BLOOMBERG NEWS

Tucson, Arizona | Published: 05.21.2009

Drugs that prevent HIV in infants don't get to two-thirds of infected expectant
mothers, leading the virus to spread to 370,000 newborns a year, a treatment
advocacy group said.

Only 33 percent of pregnant women with HIV, the human immunodeficiency virus
that causes AIDS, receive antivirals, a strategy proven 15 years ago to block
mother-to-child transmission of the disease, said a report released today from
the International Treatment Preparedness Coalition. The group blamed governments
and global health groups for poor coordination, funding gaps and valuing
"wealthy women over poor," said Stephen Lewis, founder of AIDS-Free World and
co- author of the report's preface.

Approximately 33 million people in the world have HIV/AIDS and 2.7 million
people a year become infected, according to the United Nations. In the most
hard-hit countries, AIDS has shortened life expectancy by 20 years, plunged
households into poverty and left behind 12 million orphans, the UN said.

"Donors talk the talk, but don't walk the walk," said coalition leader Gregg
Gonsalves in an e-mail. "For millions of women, maternal and child health is
about HIV/AIDS and we have failed them."

A top AIDS official at the UN, a target of criticism in the report, agreed with
many of its findings.

"There has been some progress," said Michel Sidibe, executive director of the
Joint United Nations Program on HIV/AIDS, in an e-mail.

"Overall coverage is still very low for this proven, inexpensive and effective
intervention."

Least Expensive Treatment

Most women with access to prevention get the cheapest possible regimen for
themselves and their babies — a single pill of the Boehringer Ingelheim GmbH
drug nevirapine, according to the report. Nevirapine cuts transmission to babies
by 40 percent and may also spark the rise of drug-resistant strains of the AIDS
virus, the report said.

Boehringer provides the drug free for mother-to-child prevention in developing
countries, and sells the drug for as little as 60 cents a day to treat those in
poor nations who already have the disease, according to the German company’s Web
site.

Triple-drug combination therapy that is more effective and less likely to cause
drug resistance costs less than $100 a year per patient, Gonsalves said. About 8
percent of women in developing countries now get it..

Lacking Preventive Drugs

In Uganda, for example, more than 700,000 women are living with HIV, and there
may be 27,300 babies born with HIV in 2009 for want of the preventive drugs, the
report said.

Affluent countries such as the U.S. commonly provide antiviral drugs to
HIV-positive women and their babies around the time of labor and delivery. The
practice has slashed HIV infection rates in newborns by more than 90 percent,
according to the U.S. Centers for Disease Control and Prevention.

"Today we estimate that less than 150 babies are born with HIV, down from a peak
of nearly 1,700 a year in 1991," the Atlanta-based CDC said in a statement.

The current treatment rate of 33 percent of infected pregnant women is a step
toward better care, said Nicholas Hellmann, executive vice president for medical
and scientific affairs at the Elizabeth Glaser Pediatric AIDS Foundation. The
organization runs prevention programs

in Africa, India and China using funds drawn largely from the President’s
Emergency Plan for AIDS Relief.

"I like to look at the glass as one-third full," Hellmann said in an interview.
"We feel it's best to get women and infants on some regimen, with the intent to
scale up to triple drug combination."

More Services

Hellmann said comprehensive care is needed to reduce the rates of HIV infection
in pregnant women and their children.

"Prevention is more than the dose of a drug," he said. UNAIDS, the World Health
Organization and 20 international partners will convene this week in Nairobi,
Kenya, to launch the "Preventing Mother-to-Child Transmission Push" to improve
the situation, Sidibe said.

"We agree with the report that the combination of stigma, fragmented health
services, inadequate knowledge within the community and insufficient political
leadership are root causes of low coverage," Sidibe said in an e-mail.

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