- Thailand has
become the first Asian country to eliminate mother to child transmission
attributed to intense political efforts and stringent programs
- 100% condom use
by men and frequent check up for pregnant mothers
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
country diligently followed the four prongs of the elimination strategy as
prescribed by the World Health Organization (WHO).
‘Preventing mother to child transmission of HIV will ensure a healthier generation of children.’
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
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.
should be counseled about consuming antiretroviral
which would prevent transmission to the infants and lower the
risk of infant mortality.
concerted efforts by the WHO has lowered mother to child transmission rates
from 20-40% in the mid-1990s
Four Prong Strategies
focus of the WHO strategy involves
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
out in Thailand
initiatives that were carried out in Thailand include
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
information about risk of transmission
- Introduction of
during pregnancy and after delivery
These initiatives were successful and
were supported by strong government policies which included
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
is a lot of focus on antenatal care
Thailand which has supported the prevention of transmission from the mother to
- 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.
undertaken by the government of permitting production of low-cost generic
drugs have resulted in these drugs being more affordable.
counseling about the use of contraceptives is given to women of
childbearing age who are at a risk of being infected with HIV.
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.
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.
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.
- Elimination of mother-to-child transmission of HIV and Syphilis - (http://apps.who.int/iris/bitstream/10665/112858/1/9789241505888_eng.pdf)