To stop mother-to-child transmission of HIV, focus on safe breastfeeding strategies

"There is great hope that we can finally stop infants from getting infected with HIV by their mothers. But first, countries with high rates of HIV infection must work out how to deliver reliable health programs to protect babies form their mothers' infected breastmilk," Pierre Barker, senior vice president of the Institute for Healthcare Improvement (IHI), writes in the Huffington Post's "Global Motherhood" blog. "Many countries have already developed effective treatment programs to protect unborn infants from their mothers' HIV," he notes, adding, "But once babies are born, protecting them from getting HIV infection in their early years is no easy task. If nothing is done, 15 percent of exposed babies will get HIV through their mothers' milk." He continues, "Right now, most countries don't even have detection systems to know how many babies are getting infected during this time."

"Last week, health care and technical teams from six African countries at the epicenter of the world's HIV epidemic took an honest look at their country plans to eradicate mother-to-child transmission of HIV. At a meeting in Pretoria, South Africa, sponsored by [PEPFAR] and the World Health Organization (WHO) and facilitated by the [IHI], experienced health system technical leaders were challenged to think in new ways about a topic they'd long been grappling with at home," Barker writes. "As global excitement mounts at the prospect of 'elimination' of mother-to-child HIV infections and tantalizing reports unfold for a possible 'cure' for HIV-infected babies, country health system leaders like those who met together in Pretoria last week know that they face a formidable challenge," he notes, and discusses some of these challenges. "We will see whether the ... strategy will bring needed knowledge quickly to nurses in remote clinics fighting a lonely battle to prevent infants and toddlers from getting infected -- and, in turn, allow others around the continent to benefit from their knowledge and experience," he writes (3/21).