Thailand Successfully Eliminates Mother to Child Transmission of HIV

Thailand Successfully Eliminates Mother to Child Transmission of HIV

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Highlights:
  • Thailand has become the first Asian country to eliminate mother to child transmission
  • Success attributed to intense political efforts and stringent programs
  • 100% condom use by men and frequent check up for pregnant mothers
Thailand has successfully eliminated mother to child transmission of HIV and become the first Asian country to do so. The success of this program is due to intense political determination as well as an intense response from many sectors, together with investment from the government. A recent study published in the journal Paediatrics and International Child Health reports details the process.
Thailand Successfully Eliminates Mother to Child Transmission of HIV

WHO Elimination Strategy

The country diligently followed the four prongs of the elimination strategy as prescribed by the World Health Organization (WHO).

There is transmission of the virus from the mother to child when a woman who carries the virus transmits the virus during pregnancy, delivery, while in labor or during lactation. In the absence of any preventive medicine
  • About 15-30% of infants born from mothers who carry the virus may become infected with the virus during pregnancy or during delivery.
  • Another 5-15% of infants are infected during breastfeeding.
A child born with the HIV infection would suffer from a lifelong chronic condition which could potentially shorten its lifespan, lead to social stigma and economic burden.

Primary Prevention of HIV

The primary method of prevention of HIV transmission to infants would be to prevent unintended pregnancies, provide easy access to testing, ensure adequate counseling, and utilize infant feeding practices that are low in risk as well as practice safe delivery methods.

Mothers should be counseled about consuming antiretroviral drugs which would prevent transmission to the infants and lower the risk of infant mortality.

The concerted efforts by the WHO has lowered mother to child transmission rates from 20-40% in the mid-1990s to 1.9% in 2015.

Four Prong Strategies of WHO

The focus of the WHO strategy involves
  • Primary prevention of HIV among women who are in the childbearing age
  • Prevention of unintended pregnancies among women with HIV
  • Prevention of transmission from an HIV-positive mother to her child
  • Provision of necessary therapy and care for mother and child with HIV

Initiatives Carried out in Thailand

The initiatives that were carried out in Thailand include
  • Encouraging people to use condoms- 100% condom program encouraged all male patrons of commercial sex workers to use condoms. This was a critical step in lowering HIV risk among women in childbearing age
  • Disbursing information about risk of transmission
  • Introduction of HIV testing during pregnancy and after delivery
These initiatives were successful and were supported by strong government policies which included
  • Thailand's National AIDS policy being transferred to the Office of the Prime Minister from the Ministry of Public Health in 1991 and
  • The Government expenditure for the HIV/AIDS programme increasing from US$684,000(1988) to US$82 million(1997)

Antenatal Care

There is a lot of focus on antenatal care in Thailand which has supported the prevention of transmission from the mother to the child.
  • A voluntary HIV test is routinely conducted with the results provided on the same day.
  • The patients can also re-test to ensure that mothers have remained HIV negative.
  • Among women who test positive for HIV, anti-retroviral drugs are provided.
  • Policies undertaken by the government of permitting production of low-cost generic drugs have resulted in these drugs being more affordable.
  • Extensive counseling about the use of contraceptives is given to women of childbearing age who are at a risk of being infected with HIV.
Dr. Usa Thisyakorn who is the lead author of the study and a Professor of Chulalongkorn University, said that Thailand had achieved WHO elimination of transmission of HIV from the mother to the child. The author further reiterates that there were a lot of lessons that were learnt during the process of preventing transmission from the mother to the child. There is a need to protect children from harm and to ensure that they have a healthy childhood which will form an ideal foundation for adulthood, as children will soon constitute the next generation.

The aim of the governing bodies is not only to prevent transmission to the infant but to also keep the mother alive so that the child enjoys the care and support of the mother. Efforts are thus being focused on providing the necessary treatment and care to support a healthy pregnancy and prevent transmission.

The success of the policies that were undertaken by the Government of Thailand will encourage other Asian countries to emulate the steps taken, to protect the health and interest of infants thus ensuring a healthier generation.

Reference:
  1. Elimination of mother-to-child transmission of HIV and Syphilis - (http://apps.who.int/iris/bitstream/10665/112858/1/9789241505888_eng.pdf)
Source: Medindia

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