Effective aid
June 22, 2009
Some of the core problems facing developing countries in their fight against HIV and AIDS were inadequate health care infrastructure and inefficient health insurance schemes, according to Judith von Gordon, spokeswoman for pharmaceutical company Boehringer Ingelheim.
"This has resulted in high prevalence of HIV and limited access to drugs among other things in recent years," she said, adding that the company had donated the millionth dose of mother-child Viramune (nevirapine) tablets, syrup, HIV test kits and 1ml syringes to prevent mother-to-child transmission (PMTCT) during birth to the Malawi government.
Improved HIV/AIDS situation
The Malawi government has said deaths caused by HIV/AIDS have decreased to 48 per day this year from 240 per day in 2004. An estimated 1 million people, of the country's 13 million, are living with HIV/AIDS and of those just over 80,000 are children, according to Malawi's National AIDS Commission.
About 104,000 HIV-positive women give birth in a year with an infection rate of more than 30 percent of the newborns.
A combination of factors such as HIV testing, access to anti-retroviral therapy and improved nutrition had led to the reduction, said Mary Shaba, the government's principal secretary responsible for nutrition and AIDS.
The Malawi Network of People Living with HIV and AIDS (Manet+) has also said Malawi had been successful in reducing the stigma and discrimination associated with the illness and in increasing the likelihood of those infected with HIV to disclose their status to their partners.
The organization's acting Program Manager George Kampango said Malawi has been able to achieve this by promoting multi-sector approaches, advocacy campaigns, review meetings and the development of national and workplace policies on HIV and AIDS, among other things.
Mother-to-child services
The current coverage and uptake of PMTCT services, which are technically and financially supported by non-government organizations, are still too low to impact the epidemic among children, Doctors Without Borders PMTCT coordinator Leopold Buhendwa said.
"However, all these NGOs operate within government or mission health facilities using existing staff or employing additional ones," he said.
Buhendwa also noted that PMTCT services were not well integrated into maternal and child services and, therefore, were not linked to anti-retroviral therapy services.
"On top of that, up to 50 percent of women do not deliver in health facilities," Buhendwa added.
Traditional midwives still popular
Health experts in Malawi agree that in many remote villages, most childbirths are attended by a traditional birth attendant and their skills and knowledge vary hugely. But to many women they present the best hope of improving the care of the most vulnerable.
The United Nations Family and Population Agency said that maternal death and disability could be dramatically reduced if every woman had access to health services throughout her lifecycle - especially during pregnancy and childbirth.
But there could be a simple and relatively inexpensive way to reduce dramatically the number of women who die in childbirth, said professor Anthony Costello, a pediatrician in London who has worked for several decades in countries such as Malawi.
He said he believes birth attendants and community volunteers need a maternity kit with two critical drugs: antibiotics to treat infection and misoprostol to treat postpartum hemorrhaging - two big killers of women in childbirth.
"If these cheap drugs were distributed widely enough, lives would be saved immediately," he said.
Germany to help with health care reform
African countries are particularly reliant on external donors with 23 countries depending on foreign aid for more than 30 percent of their total health care needs, according to World Bank statistics.
In most cases African governments have used this aid to expand their health services, but they are highly dependent on the uninterrupted flow of aid to keep health services available to people, especially the poor and most vulnerable, the bank said.
Germany's Ministry for Economic Cooperation and Development supports the Malawian government in reforming the health system as part of a cross-sector approach.
"One priority for reform is the decentralization of the health system in order to give the population better access to basic health care," the ministry said in a statement. "To this end, cooperation in the health sector between the state, district parliaments and non-governmental organizations has long been promoted."
Author: Collins Mtika
Editor: Sean Sinico