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Malawi’s Approach to Treating Pregnant Women With HIV Shows Success

Posted on by Sundeep Gupta, MD, MPH, CDC Country Director for Malawi, and Beth Tippet-Barr, Division of Global AIDS/HIV and TB
Sundeep Gupta, MD, MPH, CDC Country Director for Malawi
Sundeep Gupta, MD, MPH, CDC Country Director for Malawi

Malawi is a place where good news can be hard to find, especially when the topic is improving people’s health.

Man accompanying wife and child © Robin Wyatt
© Robin Wyatt

That’s why recent news from Malawi, detailed Tuesday at the Conference on Retroviruses and Opportunistic Infections in Boston, is both noteworthy and promising.

As outlined in a paper presented at the prestigious conference by CDC scientists Dr. Beth Tippett Barr, Dr. Sundeep K. Gupta and seven co-authors, Malawi’s bold approach to fighting the rate by which HIV is transmitted from mothers to infants has produced impressive results.

“Coverage of HIV testing and ART (antiretroviral therapy) among HIV-infected pregnant women were found to be very high among those enrolled, and overall early infant transmission was 4.1%,” Barr and Gupta said when asked to summarize their findings.

“This is one-fifth of what would be expected without intervention.  In addition, earlier ART initiation was associated with lower mother to child transmission,” said Gupta, who is CDC country director in Malawi. Barr serves as CDC country director in Zimbabwe. Both have extensive experience in Africa.

The results were the first national outcome results for Option B+ and confirmed the value of Malawi’s policy which was launched in 2011. The study also provided direct evidence on outcomes as well as a dose of optimism.

The results presented by Gupta “represent progress along the path towards achieving the UNAIDS goal of virtual elimination of mother-to-child-transmission (of HIV), which is defined as a transmission rate of less than 5%,” he said.

Mothers with Babies © Robin Wyatt
© Robin Wyatt

“This study will provide final transmission rate results as the infants are followed through until the cessation of breastfeeding, as well as information about other aspects of implementation of Option B+.  Lessons learned from this study may be useful for other countries as efforts to eliminate pediatric HIV continue,” he added.

Option B+ also triggered a collection of larger – and beneficial – effects that have rippled throughout Malawi.

“Roll out of Option B+ immediately led to a transformation of the national health system,” Barr and Gupta reported. The “provision of ART effectively expanded to virtually every health center in the country, and ART is now provided directly in the antenatal care setting, bringing ART much closer to patients.  Also, health worker responsibilities, supply chain and health information systems all underwent a redesign.”

Posted on by Sundeep Gupta, MD, MPH, CDC Country Director for Malawi, and Beth Tippet-Barr, Division of Global AIDS/HIV and TBTags , , , , ,

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