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South Africa

At South Africa’s third national AIDS conference, all eyes on rising child mortality

© UNICEF video
An unprecedented rise in child mortality in South Africa was the focus of the country’s third national AIDS conference, co-sponsored by Save the Children UK and Child Welfare SA.

By Sarah Crowe

DURBAN KWA ZULU NATAL, South Africa, 8 June 2007 – An unprecedented increase in child mortality in South Africa, one of wealthiest countries on the continent, spurred debate this week at the third national AIDS conference in Durban, Kwa Zulu Natal.

South Africa is already dealing with the second-highest HIV prevalence in the world, but now startling new studies have triggered stepped-up efforts to save babies, who can be exposed to HIV in utero or, after birth, through their mothers’ breast milk.

In large parts of the country, the studies find, child mortality rates are now back where they were during the days of apartheid.

‘Catastrophic’ rise in mortality

“If you look, for example, in the province of Kwa Zulu Natal, an average of 40 per cent of women attending antenatal clinics are HIV-infected,” said Dr. Nigel Rollins, Head of Paediatrics and Child Health at the University of Kwa Zulu Natal.

“In the age group 20 to 29,” he added, “47 per cent are infected, and in [the offspring of] that population we see a trebling of infant mortality in the past 15 years. It’s catastrophic.” Dr. Rollins noted as well that a large number of children are dying in the first year of life.

“The only surprising about these new findings is that anybody should be surprised,” said UNICEF’s Children and AIDS expert for Eastern and Southern Africa, David Alnwick, who suggested that the link between HIV/AIDS and rising child mortality has been apparent for some time.

© UNICEF video
Site of the third national AIDS conference in Durban, South Africa.

The face of AIDS

Not far from the AIDS conference site in Durban and the academic analyses presented there, it wasn’t hard to find stark proof that HIV/AIDS is indeed having a deadly impact on South Africa’s babies.

At the former missionary hospital of St. Mary’s in Marianhill, Kwa Zulu Natal, the face of AIDS is everywhere. In hospital beds and mothers’ arms, babies with patchy, taut skin suffer the ravaging effects of the disease. Many of them are only months old but are fighting to survive.

“Babies are just dying every day. You just have to walk through the paediatric unit and every … second baby is infected,” said Sister Felicity Langhans at the Prevention of Mother-to-Child Transmission section of St. Mary’s Hospital. “Something has to be done, and done very soon.”

ARVs for pregnant women

To help reduce child deaths, UNICEF has increased its support of polymerase chain reaction testing for early detection of HIV in newborn babies. And UNICEF is working to provide antiretroviral (ARV) drug therapy for those who test positive.

Still, too few mothers are being reached on time, and not enough life-saving ARVs such as Nevirapine are reaching pregnant women.

“Nevirapine has worked and worked well for now, but we see an increased number of transmissions, post-partum and inter-partum, and we just really need to bring in this dual therapy urgently,” said Sister Langhans, who advocates for the provision of ARVs both to babies and to their mothers.

Access to prevention services

One of South Africa’s leading HIV/AIDS research scientists, Prof. Glenda Gray, presented a paper at the Durban conference describing the “abysmal” situation of HIV-positive pregnant women who need treatment to prevent transmission of the virus to their babies.

Prof. Gray estimated that prevention services are accessible to only around 17 per cent of these women, though the government puts the figure at more than 80 percent.

“We must look at antiretroviral therapy for mothers, children or both, because it is the only strategy we have to ensure breast milk transmission is minimized,” she concluded in one of many calls made this week for dynamic solutions to South Africa’s HIV/AIDS and child mortality crises.




8 June 2007:
UNICEF correspondent Sarah Crowe reports on the third national AIDS conference in Durban, Kwa Zulu Natal, South Africa.
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