The Business of Eliminating Mother-to-Child HIV Transmission

By reaching out to private enterprise, we can bring rates of maternal HIV transmission close to zero, realizing the stunning possibility that no infant should start life with HIV.
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Rebecca Awiti and her partner live in Nairobi's Kibera slums. Like many of their neighbors, both are HIV positive. Still, they dreamed of having a healthy child. Before conceiving, Rebecca's doctor referred her to the Prevention of Mother-to-Child Transmission (PMTCT) program at Kenyatta National Hospital. There, clinicians provided her with antiretroviral prophylaxis, which prevents babies contracting HIV from their mothers 99% of the time. Today, they are proud parents of healthy, HIV-negative four-year-old triplets.

Just a few years ago, the idea that one of the three major forms of HIV transmission could be prevented medically seemed fanciful. As antiretrovirals (ARVs) have become more accessible, PMTCT has become a commonplace medical "miracle" in the North. It is affordable and should be a standard component of maternal and child health care. But families like the Awitis are still the exception to the rule in the developing South. In 2010, 430,000 babies will be born with HIV. Because we have the means to stop this tragedy, we must act.

In sub-Saharan Africa, just 45% of pregnant women known to be HIV-positive received antiretroviral drugs to prevent transmission to their infants, including antiretroviral treatment for their own health. An untold number of mothers never receive counseling and testing for HIV, often with devastating consequences for themselves and their newborns. Without any intervention, up to 30% of babies born to HIV-positive mothers will start life infected if the mother does not breastfeed (45% risk of infection if breastfed), and almost half of them will be buried before they are two years old.

Virtually eliminating HIV transmission from mother to child is possible, and can be done by 2015, but only if everyone, including the private sector, is fully committed to take action. We can accomplish this, even in high burden countries, as seen in Botswana, Namibia and Swaziland.

Ending mother-to-child transmission is everyone's business--including business. When we meet with private sector leaders March 15 in New York, we will urge them to leverage their companies' core competencies, resources and advocacy muscle to inaugurate a human generation born free of HIV.

There is a credible business case for supporting PMTCT. Along with the concrete benefits to private sector partners of being part of a groundbreaking global health success story--generating good will and attracting top employees--companies can improve their bottom lines in countries where they do business by fostering a productive workforce.

In addition to producing healthy babies, PMTCT is a gateway for HIV prevention, treatment, care and support services for the whole family. Beyond HIV, it also offers a platform for connecting families with other maternal, child and sexual health services--identifying high risk pregnancies, and detecting other sexually transmitted infections. The most valuable employees are those whose families are healthy and stable.

UNAIDS has established a realistic target of 2015 to virtually eliminate mother-to-child transmission in the 10 most-affected countries. Return on investment can be measured in terms of lives saved--over two million averted infections by 2015.

Around the world, company assets are being turned into assets for supporting PMTCT. The M.A.C. Cosmetics AIDS Fund provides financial aid to community-based clinics offering PMTCT services in South Africa. UNICEF, at the center of global efforts to end mother-to-child HIV transmission, receives PMTCT funding from organizations as diverse as Ikea, Manchester United and FC Barcelona football clubs, Italy's Esselunga supermarket chain and L'Oréal-Maybelline New York.

Financial support from the private sector is welcome of course, but businesses and corporations can also harness the entrepreneurial creativity that sets them apart from non-profits and governments.

Pharmaceutical firm Boehringer Ingelheim donates its ARV, Viramune® (nevirapine), free to developing countries for use in PMTCT. This is exactly what UN Secretary General Ban Ki-moon was asking for when he called on pharmaceutical companies to strengthen their efforts to expand access to HIV prevention, treatment, care and support.

UNAIDS' partnership with the Millennium Villages Project is strengthening PMTCT services in Africa's most resource-poor settings to create "MTCT-free zones"--with help from business. General Electric (GE) supports essential health infrastructure in the villages. Ericsson, the Swedish telecom corporation, is supporting community health workers with mobile phone technology that enables them to collect data and monitor maternal and child health in the Villages--vital to PMTCT efforts. As a result, communities will demonstrate what success looks like and provide valuable lessons for scaling up across Africa.

Over the next 24 months, UNAIDS, GBC and their partners will intensify efforts to save mothers and babies as an achievable and inspirational step toward the goal of Universal Access--for everyone--no matter where or how they live. By reaching out to private enterprise, we can bring rates of maternal HIV transmission close to zero, realizing the stunning possibility that no infant should start life with HIV.

Michel Sidibé, Executive Director, UNAIDS; John Tedstrom, President and CEO, Global Business Coalition on HIV/AIDS, Tuberculosis and Malaria (GBC)

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