Geeta, 24, is seven months pregnant and is grossly underweight. She and her husband are HIV positive. Her husband believes he got infected through blood transfusions during a surgery. “I want my child to be HIV negative like my first child,” she says.
It is estimated that 6,500 children are born every year with HIV in India. One-third of them die before their first birthday and half of them do not get to see their second.
National AIDS Control Organisation or NACO’s programme, launched 14 years ago, gives hope to these women.
How Cuba, Thailand eliminated mother to child transmission of HIV
Last year, Cuba became the first country to eliminate mother to child transmission of HIV and Syphilis. In June this year, Thailand joined the brigade. Both countries have received validation by the World Health Organisation.
According to UNAIDS, untreated women living with HIV have a 15-45% chance of transmitting the virus to their children during pregnancy, labour, delivery or breastfeeding. However, that risk drops to just over 1 per cent if anti-retroviral medicines are given to both mothers and children throughout the stages when infection can occur.
To reach this milestone, the Thai Government first focused on preventing new HIV infections. Then it reached quality healthcare services to all and also provided all pregnant women – including immigrant workers – free antenatal care, delivery and services for HIV and syphilis.
According to Thailand’s Ministry of Public Health, 98 per cent of all pregnant women living with HIV have access to anti-retroviral therapy and the rate of mother-to-child transmission of HIV has been reduced to less than 2%. In 2000, an estimated 1000 children became infected with HIV. In 2015, the number of children who became infected with HIV through mother to child transmission was reduced to 85.
Cuba, too, worked to ensure early access to prenatal care, HIV and syphilis testing for both pregnant women and their partners, treatment for women who test positive and their babies and substitution of breastfeeding to combat transmission.
Cuba and Thailand’s success has shown that elimination of mother to child transmission of HIV is possible.
Mother to Child Transmission of HIV – The Indian Scenario
According to some estimates, 38,000 HIV positive women get pregnant every year but only 14,000 of them get diagnosed and treated. Since the rate of transmission is 15 to 45 per cent, it is estimated that 13,000 babies are born with HIV every year and only 6,500 are likely to get diagnosed and treated. To eliminate transmission of HIV from mother to child, India needs to bridge this gap.
The NACO Programme provides utmost care to the women during pregnancy and childbirth. From a blood pin prick screening to counselling to anti-retroviral therapy, tests and drug course, the holistic programme takes good care of mother and child’s health.
The NACO programme is being implemented effectively in the seven states which have high prevalence of HIV — Maharashtra, Tamil Nadu, Karnataka, Andhra Pradesh, Telangana, Manipur and Nagaland.
Experts say while the remaining states have low prevalence of HIV, they contribute 57 per cent of the HIV burden in the country. There is an urgent need to expand the services to the big populous states like Uttar Pradesh and Bihar.
Rajshree has four children. Two of them are HIV positive and two are born HIV negative because of NACO Programme. “I am happy that at least two of my children are HIV negative, but I feel bad about the other two,” she says.