End of Mother to Child transmission of HIV in Cuba is a ray of hope for Uganda

By Rachael Kentenyingi

In the last week of June, Cuba became the first country to win World Health Organisation (WHO) certification that it had eliminated mother-to-child transmission of both HIV and syphilis.

This calls for not only celebration, but also deep reflection by all of us working towards an AIDS-free generation.

Aptly, the WHO Director-General Dr. Margaret Chan noted that “Eliminating transmission of a virus is one of the greatest public health achievements possible. This is a major victory in our long fight against HIV and sexually transmitted infections, and an important step towards having an AIDS-free generation.”

As partners in the struggle against HIV/AIDS, we are both pleased and challenged, but more importantly, we are now more than ever optimistic that Uganda will sooner than later see a day when no child is born HIV positive.

The Makerere University Joint AIDS Program (MJAP) with funding from PEPFAR and technical support from CDC-Uganda, has been supporting the four prongs as described by WHO, that is; prevention of HIV acquisition in women of child bearing age, prevention of unwanted pregnancies in HIV positive women, provision of highly active Antiretroviral therapy to HIV positive pregnant women and care for HIV positive women, their infants and families. 

Statistics from Uganda AIDS Commission show that Uganda has seen the number of children born with HIV reduce from 28,000 in 2008 to 5,000 in 2014. This is largely attributed to comprehensive interventions from government and NGOs like MJAP.  Whereas the Uganda HIV and AIDS Country Progress report 2013 indicates an estimated 9.2% of HIV positive women delivering HIV positive children in that year, MJAP registered 1.2 % in the same period in all its clinics.

The fact that over 94% of pregnant women who attend antenatal clinics receive counselling and testing for HIV in Uganda is testament that more and more women are aware of prevention of mother to child transmission of HIV/AIDS.

This is tremendous progress that we must celebrate; nonetheless, it is not good enough. That means that every day we still have over 13 children born with HIV in Uganda. We cannot afford to be complacent. Our goal is clear, to achieve zero new HIV infections in babies born to HIV positive mothers. We need to use more aggressive methods to especially reach the large number of mothers who do not deliver from health facilities.

Recently, during the ‘Know your child’s status day’ organised by MJAP, specifically aimed at encouraging  HIV-positive adults  to bring children in their care for HIV testing, Halima, a proud mother and grandmother brought her child and two grandchildren for testing.  Halima tested HIV positive more than 10 years ago and has been receiving treatment from MJAP since.

Halima’s story is no different from that of many Ugandans living with HIV. She has been through the phases of pain, stigma and eventually acceptance by both herself and family- she is now receiving treatment and living a healthy and productive life. Despite her limited means and resources, she is playing her part to ensure that her children and children’s children do not have to go through what she did.

We need more Halimas to finally see the AIDS free generation that we long for. In her own words, “Young people these days are busy chasing the world, looking for money forgetting that it takes more than money to raise a child. These children are the world tomorrow. It’s our responsibility as adults to take care of them,” Halima says.

Halima could have left it to her children, who are much younger than her, better educated, and therefore better placed to take their children for an HIV test; but she took it upon herself because these children stay with her. As parents and as citizens, we cannot afford to be complacent about the health and wellbeing of our children. 

The good news is that all the 20 children tested at the ISS clinic in Mulago during the ‘Know your child status day’ were HIV negative. The successes of Cuba and the success closer to home demonstrate that Uganda can be the next country to receive the World Health Organization certification.

It won’t come easy though. Each and every one of us needs to play our part. I pray we take the children in our care for HIV testing. I hope we work with medical service providers to ensure that mothers receive the right information- whether they are positive or not. I hope we link the HIV positive children to care.  I hope we ensure that our pregnant mothers receive the right prevention of mother to child transmission services.

We owe it to our children, and to ourselves to help them live a much longer, better and healthier life.

The writer is a public relations and communications Officer, MJAP