Source: The Citizen
As Tanzania joined the rest of the world to mark this year's World Aids Day on Thursday, some two million women across the country had every reason to celebrate the day.

The HIV positive women are among the 13 million across the world, who have been availed services to prevent transmission of the deadly virus to their children, thanks to the Elizabeth Glaser Paediatric Aids Foundation (EGPAF).

According to its Africa senior regional communications Officer, Mr Eric Kilongi, most of the US-based NGO, which works with international partners, national governments and donors to expand access to services that prevent mother-to-child transmission (PMTCT) of HIV, work is currently in sub-Saharan Africa.

Mr Kilongi said that within the Eastern Africa sub-region, EGPAF has to-date provided nearly 5.6 million HIV-positive women with services to help them deliver HIV-negative babies, and enrolled more than 130,000 on treatment, including more than 12,000 children under the age of 15. Globally, it has enrolled more than 750,000 individuals on antiretroviral treatment, which includes 60,000 children under the age of 15.

"In Tanzania, EGPAF has provided nearly two million women with services to prevent transmission of HIV to their babies, and enrolled more than 80,000 individuals on antiretroviral treatment, including more than 7,500 children under the age of 15," the official told Insight by email this week from the organisation's regional office in Nairobi.

Although prevention of mother- to-child transmission of HIV (PMTCT) has become a crucial intervention in the global fight against the epidemic, the service is still not readily available in sub-Saharan Africa, including Tanzania, where about 1.4 million women become pregnant each year.

Medical experts explain that without proper intervention, about 30 – 40 per cent of MTCT is responsible for about 90 per cent of HIV/Aids infections. And although it has been proved beyond reasonable doubt that mother-to-child transmission is one of the major ways of spreading HIV/Aids to children below the age 15, experts concur that chances of survival for a child infected with HIV/Aids through maternal transmission are rare and thus aggravates the infant mortality rate.

A recent case study undertaken by three dons of the Department of Statistics at the University of Dar es Salaam points out that the severity of the problem of mother-to-child transmission of HIV/Aids in Sub-Saharan Africa is due to high rates of HIV/Aids infection in women of reproductive age, the large total population of women of reproductive age, high birth rates and the lack of effective mother-to-child-transmission (MTCT) prevention interventions.

"In spite of efforts to prevent the spread of HIV/Aids from mother-to-child, existing data in Tanzania reveal that achievement of PMTCT is very little...less than 10 per cent of pregnant women in Africa infected with HIV/Aids receive PMTCT services," the study reads in part.
"It is further noted that even in areas where effective prophylaxis is available to prevent transmission of mother to child, few PMTCT programmes successfully reach mothers and newborns after discharge to provide support for the infant feeding choices or to provide ongoing care and treatment."

In 2009, there were about 370,000 children infected with HIV in Tanzania. And, of the three million orphaned children in the country, 1.3 million have lost one or both of their parents to an Aids-related illness.

Still, more than 90 per cent of child infections occur through mother-to-child-transmission (MTCT), which can be prevented with anti-retroviral drugs and other special measures. Most MTCT infections occur in utero during pregnancy, during delivery or through breastfeeding.

Such treatments have been shown to eliminate MTCT in up to 99 per cent of cases, but today only 45 per cent of HIV positive expecting mothers have access to the medication. Studies show that in Tanzania, approximately 12 per cent of pregnant women attending antenatal clinics are living with HIV/Aids.

"EGPAF believes prevention of mother to child transmission of HIV (PMTCT) is one of the most successful HIV prevention strategies to-date. By making effective PMTCT services available to the women who need them, we are able to protect the health of mothers and dramatically reduce the number of new infections in children, saving lives and a lifelong need for anti-retroviral therapy," Mr Kilongi told Insight.

"Building on the progress made from eight years of HIV/Aids programming to strengthen local health services and ensure access to high-quality care, EGPAF is collaborating with the US Centers for Diseases Control and Prevention (CDC) to transition the largest elements of its CDC-funded work to new local organizations in a bid to build national capacity to execute the high-quality HIV prevention and care and treatment programs originally established and implemented by EGPAF," he added.

Mr Kilongi said that in Tanzania, the affiliate is called Ariel Glaser Paediatric Aids Healthcare Initiative (AGPAHI). According to him, AGPAHI will increase country-based commitments for the elimination of paediatric Aids, and build a Tanzania-led HIV/Aids programme and expand the country partner capacity to lead in creating a generation free of HIV.

Figures provided by Tanzania Commission for AIDS (Tacaids) show that despite progress in specific programmatic terms, at the end of 2007, only 34 per cent (42,595/ 123,738) of HIV positive pregnant women in the country received antiretroviral prophylaxis to reduce MTCT. Tacaids says on its website that a total of 1347 health facilities were providing PMTCT services in the country by 2007.

• Tanzania