Govt steps up paediatric HIV fight



Health Minister Dr ‘Molotsi Monyamane
Health Minister Dr ‘Molotsi Monyamane

Pascalinah Kabi

HEALTH Minister Dr ‘Molotsi Monyamane says the government is implementing a range of strategies to end Lesotho’s paediatric HIV burden by 2030.

Addressing delegates at the 21st International AIDS Conference in Durban, Dr Monyamane said Lesotho was still beset with a high HIV/AIDS infection rate, with two to three children infected with the virus every day.

Held from 18-22 July 2016, the International AIDS Conference is a biennial gathering for people working in the field of HIV, including policy makers, persons living with HIV and other individuals committed to ending the epidemic.

The indaba was held under the theme “Access Equity Rights Now”, with delegates urged to go back home and continue the hard work of ending the threat from the disease by the year 2030.

The minister said an estimated 5 500 children living with HIV in Lesotho were not on treatment, adding the pandemic was the cause of 19 percent of under-five mortalities in the country.

“Therefore, we have taken this as an emergency situation, and we are doing our utmost both to prevent new paediatric infections, and to save the lives of children living with HIV during the window of opportunity in the next five years, ensuring delivery of life-saving treatment to children living with HIV by 2020.  We have to take action now towards the goal of ending paediatric HIV by 2030,” said Dr Monyamane.

The government, he said, had come up with interventions at the policy and programme levels to prevent new paediatric HIV cases.

“Through the Accelerating Children’s Treatment Initiative, we have taken the challenge, starting in 2014, to double the number of children on HIV treatment,” the minister said.

“Lesotho adopted the Option B+ Prevention of Mother-to-Child Transmission (PMTCT) policy in 2013.  We are also innovators in introducing a mother-baby pack in 2011, which provided prenatal and PMTCT medicines to expectant mothers without revealing their HIV status.  To this day, mother-baby packs are given to every woman attending antenatal care (ANC).”

The crucial factors in delivering PMTCT through the Option B+ approach nationally, Dr Monyamane said, were the identification of HIV-positive mothers and ensuring proper care and diagnosis for exposed infants. He said 30 percent of women aged between 15-49 years were HIV-positive.

“The point of entry for services is antenatal care.  Our most recent Demographic Health Survey data from 2014 shows that 95 percent of women attend at least one antenatal care (ANC) visit during pregnancy.  But coverage is lower for women in rural areas and for women in lower wealth categories.”

The data also revealed that only 41 percent of pregnant women attended ANC in the first trimester, while 74 percent attained at least four expected visits.

“Therefore, we need models of antenatal care that reach women where they are,” Dr Monyamane said.

“We are revitalising our implementation of outreach services through the established health posts, to provide services more closely in the community.

“We are formalising and strengthening our Village Health Worker programme, which ensures that women attend health services throughout pregnancy, and that children receive services up to age two.”

He stressed the need to reach women in high risk populations, such as those working in factories.

“They need access to services close to their work and home, available at times of day that they can manage to attend, particularly after work.”

Dr Monyamane said Lesotho was the first Sub-Saharan country to launch the “Test and Treat” strategy in April this year aimed at ensuring that every person who tests positive for HIV is given immediate treatment.

The strategy is part of the 2015 World Health Organisation Consolidated HIV Treatment guidelines recommending that everyone tested HIV positive should receive immediate treatment regardless of their CD4 count.

The minister said new innovations under exploration included very early infant diagnosis in which testing is done at birth or within two weeks of birth. He said they were also exploring the possibility of pre-exposure prophylaxis for adolescent girls and young women at high risk and introducing improved paediatric TB drug formulations for children.

The minister also touched on adolescents, saying girls were particularly at high risk of contracting HIV.

“About 2 000 new HIV infections occur annually among adolescents aged 10-19.  Nearly half of our young people begin having sex before age 18.  This means that we have to make efforts to reach them where they are.  We are doing this in several ways.”

He said some of the strategies they employed included the establishment of adolescent health corners in district hospitals which provided reproductive health services.

The ministry also held adolescent-targeted testing events in conjunction with Kick4Life and Sentebale.

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