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Malawi, 20 May 2013: The next generation of Malawi's children stay HIV free with Option B+

© UNICEF Malawi/2013/Marinovich
Lexina Lungu and her husband, Frank, at the Kasungu district hospital. The Lungus have both tested positive for HIV. The new treatment plan Option B+ is available for free to expectant mothers in Malawi and includes a simple ‘one pill daily’ treatment.

By Leonie Marinovich

With a new treatment strategy for preventing mother-to-child transmission of HIV in place, there is hope that the next generation of children in Malawi may be born free of the scourge of HIV/AIDS.

KASUNGO, Malawi, 20 May 2013 – On a rainy afternoon in a village on the outskirts of Kasungu, 130 km north of the capital, Lilongwe, Lexina Lungu settles sidesaddle on  the thinly cushioned seat on the back of a bicycle taxi.

Thirty-six weeks pregnant with her second child, Ms. Lungu is determined to keep her appointment at the town clinic for her final antenatal check-up.

A final check-up

Raindrops fall, pitter patter, on the tin roof of the antenatal clinic. Ms. Lungu and her husband Frank, who rode in on a second taxi, appear relaxed.  They have formed a close relationship with the nursing staff at the clinic over the past few months.

Ms. Lungu tested HIV-positive when she came for a routine check-up in the beginning stages of the pregnancy. “It was very painful, very painful indeed,” she recalls. “I didn’t expect to test positive. I rushed home to tell my husband, who immediately returned to have an HIV test.” Mr. Lungu also tested positive.

The Lungus’ story is not uncommon in Malawi. One in every ten people has been found to be HIV-positive.  What has changed, though, is access to the treatment needed to protect children like Ms. Lungu’s baby from the risk of infection during pregnancy.

One pill daily

In 2011, the Government of Malawi developed a new treatment strategy to prevent the next generation of children born to HIV-positive mothers from being infected. The Ministry of Health, in collaboration with UNICEF and other partners, came up with a multi-pronged approached, now known as Option B+. 

This treatment option is available for free to expectant mothers in Malawi and includes a simple ‘one pill daily’ treatment, easier for health workers to prescribe and for pregnant mothers to follow.

The strategy is proving remarkably effective. Clinical officer at the Kasungu district hospital Elton Chavura explains, “If we place women on Option B+, let’s say 100 of them, then by the time the children are 2 years old, we expect that 95 of those children should be HIV free.”

Chief of HIV/AIDS for UNICEF Malawi Dr. Aye Aye Mon puts this figure in context: “Generally, if there is no intervention, approximately 30 of 100 babies born to HIV-positive mothers would have the HIV virus.”

Another pillar of the Option B+ treatment strategy is to reduce the number of new HIV infections among adults.  When an expectant mother tests positive for HIV, she is immediately placed on anti-retroviral treatment. “That alone is also a way of increasing access to [antiretroviral treatment] for so many people in the country,” says Mr. Chavura. In 2008, women in their childbearing years made up 23 per cent of the population.

“An independent and better future”

To assist Mr. Chavura and his staff to deliver life-saving medication and services where they are needed, international donors such as The Global Fund to Fight AIDS, Tuberculosis and Malaria have stepped up to support the government.

Senior advisor for HIV and AIDS at The Global Fund Dr. Ade Fakoya explains, “If you look at the countries where there is the biggest burden for prevention-of-mother-to-child-transmission services, there are 22 countries which account for 90 per cent of the burden. And 20 of them are low-income countries. It costs about US$1 billion a year to maintain those services, and some countries like Malawi need that additional financial support so that they can deliver these services.”

There is hope that the next generation of children born to mothers like Ms. Lungu may be born free of the scourge of HIV/AIDS.

According to Dr. Fakoya, “In 2009, there were 450,000 children born infected with HIV.  In 2010, that figure’s come down to 330,000 globally, so that’s a remarkable achievement.”

For Ms. Lungu, the proof of Option B+ is just a few short weeks away. “I was told by the medical staff that it would be a baby girl,” she says. “I am very happy. I’m looking forward to my kids having an independent and better future.”



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