Mekong countries join hands in preventing HIV transmission
In Thailand, a programme to reduce mother-to-child
transmission of HIV has helped in halving the number of young children
infected in this way. Today Thailand is providing technical assistance
to other countries in the Mekong region to help them achieve similar
In Thailand, concerted efforts to reduce the rate of
mother-to-child transmission of HIV have helped in achieving a 50%
reduction in the number of children under four infected with the virus.
Launched in 1997, the programme includes voluntary counselling
and testing for women attending antenatal care, a short course of
anti-retroviral drugs during pregnancy for women found to be HIV-positive,
and subsidies for breast-milk substitutes for one year. By 1999, the
number of children under four years old infected during pregnancy,
at birth, or through breastfeeding had been halved -- from over 1200
in 1997 to 600 in 1999.
Mother-to-child transmission of HIV is today a high
priority in East Asia, due to the rapid spread of HIV/AIDS, especially
among women of reproductive age. In Thailand, where the government
launched broad-based efforts to halt the spread of HIV, less than
2% of pregnant women are infected with HIV. In Myanmar, a study in
early 1999 found that 2.6% of pregnant women were HIV-positive -- with
as many as 10%-13% of women testing positive at some test sites.
Today, Thailand is sharing technical assistance and
expertise with Myanmar, Cambodia, and other countries in an effort
to reduce mother-to-child transmission of HIV throughout the region.
Rapid and flexible tools for assessing HIV transmission to children
have been developed.
Results from these assessments in various countries
have underlined the critical importance of continuing primary prevention
of HIV in women and men, and the need to strengthen community-based
efforts to care for and support individuals and families affected
by HIV/AIDS. The Thailand success story has also shown that these
efforts must involve all levels and sectors of government as well
as communities. With assistance from Thailand, a bold programme is
being developed in Myanmar to halt mother-to-child transmission of
HIV. The programme will include training health workers in prevention
issues, encouraging voluntary counselling and confidential testing,
supporting the use of anti-retroviral drugs, assisting mothers in
making the best choices for infant feeding, promotion of birth spacing,
and strengthening existing health care for mothers and infants. The
programme will involve working in partnership with NGOs and community-based
organizations to provide care and support for people affected by HIV/AIDS.
All of these activities will take place within the overall framework
of HIV/AIDS prevention nationwide.
In Myanmar, some of this work has already begun. A working
group has developed voluntary-counselling training manuals for health
care providers, NGOs, and community leaders. And by the end of 2000,
120 participants -- including health staff, NGO representatives, and
community and religious leaders -- from the three pilot townships will
have been trained in various aspects of preventing mother-to-child
transmission of HIV.
The Thailand experience also highlighted the importance
of complementing technical efforts for prevention of mother-to-child
transmission of HIV with a social mobilization campaign. A social
mobilization campaign has been launched in the pilot townships, which
addresses the key role of families, communities, and religious leaders
in building support for HIV prevention efforts. The campaign will
focus on the need to encourage pregnant women to make better use of
antenatal facilities, including services to prevent mother-to-child
transmission of HIV, and to support mothers in making informed choices
about infant feeding. Meanwhile, continuing efforts will also be needed
to reduce the social stigma associated with HIV/AIDS and to provide
assistance to people living with HIV.