22 May 2009 Today the International Treatment Preparedness Coalition (ITPC) issued its latest report, ’Failing Women, Failing children: HIV, Vertical Transmission and Women’s Health’

Although the drugs have been available for over a decade, two-thirds of HIV-positive pregnant women in the developing world do not receive any antiretroviral drugs (ARVs) to prevent HIV transmission to infants. Worse, most of those who get drugs are treated with a therapy known to be just over 40% effective, rather than the triple-dose combination therapy that successfully prevents almost 98% of newborn HIV infections in the developed world.

Research conducted by civil society activists in Argentina, Cambodia, Moldova, Morocco, Uganda and Zimbabwe shows that efforts to prevent vertical transmission are failing to reach the very group it was designed for – HIV-positive pregnant women. One of the key reasons for this is that the national programs have been narrowly focused on providing antiretroviral prophylaxis and not on the other essentials-prevention, counselling, care and treatment for women and children.The report also warns of a “significant and dangerous inconsistency” in infant feeding guidance given to HIV-positive mothers. “The ITPC report adds to the growing evidence of the vital need to tackle gender inequities in order to provide universal access to health care,” says Lorena Di Giano, an AIDS activist and Missing the Target team leader from Argentina.

In its recommendations, ITPC calls on UN agencies to radically improve coordination at all levels, and for governments, donors and UN agencies to publish a joint action plan to provide comprehensive vertical transmission services to those in need.

“UN agencies were instrumental in helping set the vital goal of universal access to HIV prevention, treatment and care,” said Gregg Gonsalves, co-founder of ITPC. “Along with governments, they too bear responsibility for the daily toll of preventable infections in newborns and the needless deaths of women, men and children.”
Specific report recommendations include:

• At UNGASS in June 2010, UNAIDS, WHO and UNICEF should report progress based on all four prongs of the comprehensive strategy – not just the provision of prophylaxis.

• Governments, with support from donors, should increase mothers’ access to the tripledose ARV regimen, currently provided to only eight percent of those treated to prevent transmission to newborns.

• WHO and UNICEF need to urgently work with governments to revise national infantfeeding policies consistent with global guidelines and latest research, and regularly assess implementation.

The report, published by the Treatment Monitoring and Advocacy Project (TMAP) of ITPC, is based on research conducted in the six countries between November 2008 and January 2009. The full report is available at www.aidstreatmentaccess.org  and www.itpcglobal.org

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