With support for HIV and AIDS programs, millions more HIV infections in children can be prevented.

November 2009

By Collins Kaumba, World Vision Zambia, and Shawna Templeton, World Vision U.S.

“I was worried when I became pregnant, knowing that I was HIV positive...” says Violet Nkandu, talking about her most recent pregnancy. “I didn’t know what to do...”

The risk of transmission

As a widow and a mother of six in Zambia, Violet has known many struggles. She had lived with the virus for almost a decade, but only learned of her status in 2007. At times, she was near death.

“So often I would be in and out of hospital feeling very sick, feeling worn out, and I thought, it was the end of my life,” she says.

Now Violet is pregnant again. The father had promised to marry her, but he suddenly disappeared shortly after she became pregnant. She felt very alone.

And her baby is at risk.

Prevention is key

“I shared my burden with World Vision caregivers, who encouraged me to go to Zamtan Prevention of Mother-to-Child Transmission (PMTCT) Clinic,” Violet explains. World Vision funded the construction of this facility, which opened in June 2006.

The clinic staff praised her for her decision to come. They encouraged her not to miss antenatal clinic appointments and strictly follow health guidelines in order to prevent transmission.

Months later, Violet’s healthy baby girl, Mable, was born free of HIV.

“The baby has been breastfeeding, and I stopped the feeding in [six months] as advised at the clinic so that the baby is not exposed to the virus,” Violet explains. Reduced breastfeeding proves to be particularly challenging for mothers who struggle to feed their children. But when faced with the risk of transmission, it’s the wisest choice a HIV-positive mother can make.

“I was really excited and I couldn’t believe it when I took Mable for testing again after six months and she tested HIV negative,” Violet says joyfully.

The Prevention of Mother-to-Child Transmission program

The Zambian Ministry of Health estimates that 40 percent of babies born from HIV-infected mothers in that country are at risk of being infected with the virus.

But transmission can be significantly reduced through prevention. Patricia Mubanga, one of the midwives managing the PMTCT program, says that since June 2008, 42 babies born from HIV-positive mothers have come through the clinic. Of the 42 babies, only four have tested HIV positive.

“The goodness of [the] PMTCT program is that it enables all mothers that come for antenatal and postnatal [care] to be tested, counseled, and monitored easily together with their spouses,” Patricia explains.

“I’m really impressed with [Violet] because she is the best example of mothers that adhere to our instructions for the well-being of the children that are born HIV negative from HIV-positive mothers,” Patricia adds.

More prevention, with global support

Thousands of children each year are infected by HIV through no fault of their own. A majority of pediatric AIDS cases develop as a result of infection during pregnancy, birth, or breastfeeding. While mother-to-child transmission can be prevented, an estimated 2 million children are living with HIV or AIDS today.

With support for HIV and AIDS programs from the United States and other countries, millions more HIV infections in children, like Mable, can be prevented. The United States has made significant contributions to the fight against global AIDS during the past few years — but we are still only skimming the surface.

“The U.S. has been a global leader in the effort to assist people affected by and at risk of HIV and AIDS, particularly in prevention of mother-to-child transmission, where it has supported 16 million women,” says Craig Jaggers, World Vision’s policy advisor for health. “However, we are now facing a crucial moment — will the U.S. continue to lead by maintaining its commitments, or back-track on our promises, accepting the status quo of 1,000 new HIV infections in children each day?”

In honor of World AIDS day, Dec. 1, World Vision is asking Congress to increase the U.S. contribution to programs that aim to prevent mother-to-child transmission of HIV, as well as other HIV and AIDS programs.

We are asking members of Congress to support $7.2 billion for global HIV and AIDS programs and to vote against any efforts to reduce AIDS funding when they vote on a final version of the appropriations bill that impacts AIDS programs.

To put this in perspective, $7.2 billion represents less than 0.2 percent of the president's fiscal year 2010 budget.

World Vision is also asking Congress to ensure the president’s new Global Health Initiative provides direct support for communities and community-based organizations like World Vision.

“As we begin to hear rumblings that AIDS funding may not keep pace with promises, action is desperately needed to demonstrate broad public support for these essential programs,” says Jaggers.

“Lives are literally at stake.”