Eliminating mother-to-child transmission of HIV

EGPAF’s 2013 to 2016 three-year study evaluating treatment outcomes for mothers and infants with HIV showed that, with proper interventions, mother-to-child transmission of HIV can be eliminated. / Net

When Angelique Uwizeye, a resident of Nyamirambo, a Kigali suburb, found out that she was HIV positive, the news hit her hard.

She was only 16 years old when she learned about her status. She was born with the virus; her mother, not knowing about HIV mother-to-child prevention, passed the virus onto her unborn child. Her parents, she says, got her medication that they continued to give her as she grew.  She says her parents finally opened up about her condition after going through an uncle as they were too afraid to tell her themselves. Also, there was a chance she would blame them for her sickness, something that made the revelation even harder.

Like many HIV positive people, Uwizeye found herself isolated because of HIV-related stigma and discrimination.  However, with the support of some family members, she joined Kigali Hope Association, along with other minors.

Kigali Hope Association is a local non-government organisation that regroups Rwandan youth infected with and affected by HIV/AIDS. Their main mission is to break the chain of HIV transmission by positive prevention and greater involvement of minors living with HIV.

It’s through this that Uwizeye got to share and listen to stories from other members, something she says motivated her to live positively. 

At the age of 26, she met her husband who was also HIV positive, and they started a family in 2011.

Through the support of doctors, they were advised on how to have HIV negative children.

The couple was blessed with two children, both HIV negative, thanks to Unitaid’s (a global health initiative that is working with partners to end the world’s tuberculosis, HIV/AIDS, malaria and hepatitis C epidemics) funding and support, and innovative HIV testing technologies that were fused into Rwanda’s health services in August 2015.

Uwizeye is a beneficiary of Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), an American NGO whose mission, together with the Ministry of Health of Rwanda, is to curb HIV/AIDS in children.

On June 19, EGPAF celebrated the milestones of the transformational point-of-care early infant diagnosis (POC EID) project in Kigali, while marking the end of their fruitful 19-year partnership. 

Since 2000, the organisation has collaborated with Rwanda’s health ministry to provide early technical assistance to the treatment and research AIDS centre, and to support scale-up of programmes providing services that prevent mother-to-child HIV transmission.

The technologies, according to Dr Angelique Fundi, EGPAF Rwanda’s programme manager, who spoke at the event, allow non-specialised healthcare workers to run tests for HIV in decentralised clinics and can return results within one to two hours.

Earlier, she said, it took 34 days to get infants’ test results back to the caregiver with only 41 per cent receiving results within 30 days.

According to officials, a nagging challenge had been the fact that infants and children, although at risk of death due to faster AIDS progression because of their immature immunity, were subjected to a long waiting period to get their HIV test results, often for three months.

SITUATION IN THE COUNTRY

A presentation by Rwanda Biomedical Centre (RBC) revealed that Rwanda’s mother-to-child transmission of HIV has been reduced to 1.5 per cent, far below the global target of five per cent at the cessation of breastfeeding.

Rwanda has virtually eliminated the mother-to-child transmission of HIV. The country has also surpassed UNAIDS 90-90-90 target; that is, 91 per cent of people with HIV knowing their status and 92 per cent of all people diagnosed with HIV infection receiving sustained antiretroviral therapy, and 91 per cent of all people receiving antiretroviral therapy reducing viral load to undetectable levels, according to Rwanda Biomedical Centre data.

The presentation also showed that 99 per cent of caregivers received infant test results within a day, with 98.2 per cent of those tested HIV-positive being initiated onto life-saving treatment through the project.

More than 140 health facilities across Rwanda were enrolled in POC EID between March 2017 to April 2019 and they tested 3,915 infants.

The technology has been successful in identifying HIV in infants and swiftly linking them to treatment that was integrated into Rwanda’s 2018-2020 HIV/AIDS national strategic plan.

In a press release circulated to media during the event, the point of care, early infant diagnosis technology is key in the elimination of paediatric AIDS.

EGPAF CEO, Charles Lyons, said what Rwanda has accomplished was a dream 10 years ago when the Global Plan to end mother-to-child HIV transmission and keep mothers alive was initiated.

“Virtual elimination of mother-to-child transmission of HIV is a battle within a war. To end AIDS by 2030, we must “first control and sustain the epidemic among children and adolescents,” Lyons said.

EGPAF’s landmark 2013 to 2016 three-year study evaluating treatment outcomes for mothers and infants with HIV showed that, with proper interventions, mother-to-child transmission of HIV can be eliminated. It also showed that high adherence to medicines and positive treatment outcomes among infants and mothers can be achieved.

The Minister of Health, Dr Diane Gashumba, said the integration of HIV services and collaboration with stakeholders has played a critical role in Rwanda’s progress towards the elimination of mother-to-child transmission of HIV.

Rwanda’s focused leadership and strong strategic partnerships have been lauded as having helped it to tilt the scales in the fight to put an end to AIDS in the country.

editorial@newtimesrwanda.com

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