by Daniel Ooko

    NAIROBI, May 25 (Xinhua) -- Health experts have called on nine African governments to take urgent actions to expand and strengthen existing prevention of mother-to-child transmission services for pregnant women, and increase the treatment for infected mothers and children.

    Speaking at a media briefing in Nairobi on key issues discussed and consensus reached at the two-day Regional Expert Consultation, convened by the UN Children's Fund (UNICEF), the UN Joint Programme on HIV/AIDS (UNAIDS) and the World Health Organization, the experts said serious challenges remain to increase coverage as well as improve the quality of services being provided.

    "The HIV/AIDS epidemic continues to have a devastating impact on the health of children and their mothers in this region, contributing to increased death rates of both young children and their mothers as well as creating more orphans," David Alnwick, UNICEF's Regional Adviser told journalists on Monday.

    "It is critical at this juncture, when many countries are faced with shrinking budgets and competing demands that we do not lose the momentum of what needs to be done to create an AIDS free generation," the adviser said.

    The experts made the call to the governments from nine countries in East and Southern Africa, including South Africa, Kenya, Mozambique, Tanzania, Zambia, Ethiopia, Malawi, Uganda and Swaziland, who last year accounted for half of the global new HIV infections.

    Experts agreed that these countries must reach 80 percent of all pregnant women, mothers and their children with services, halve the number of mothers and children lost to follow up, and double the number of HIV infected children on ART treatment if it is to succeed in halting the spread of the virus.

    The recommendations were made at the conclusion of regional consultation on accelerating Prevention of Mother-to-Child Transmission (PMTCT) and Pediatric Care and Treatment which ended in Nairobi over the weekend.

    It brought together senior staff from ministries of health of the nine countries along with experts from international and non-governmental agencies that work in Eastern and Southern Africa region to review progress, identify bottlenecks and agree on what needs to be done to address them.

    After a decade of national programs to prevent the transmission of the HIV virus from mother-to-child, great strides have been made. The price of the medicines and diagnostic tests has dramatically fallen. More recently, all of these countries have started to provide treatment to HIV infected children, as well as anti-retroviral drug which potentially can keep mothers healthy and prevent children becoming orphans.

    Yet if global commitments are to be met including reaching the Universal Access goal of ensuring 80 percent coverage of PMTCT by the end of 2010, reduce 50 percent of new pediatric infections as well as to more ambitious goals linked to the Millennium Development Goals, by the end of 2015, much more needs to be done.

    A preliminary analysis by UNICEF of the best available data suggested that two of the nine countries (South Africa and Tanzania) would be likely to meet that goal based on their continued increased coverage in 2007 and 2008.

    With the exception of Ethiopia, seven countries could possibly meet the coverage goal with substantial increases in efforts, for some this would mean increasing coverage by over a third this year, compared with 2007 and by a quarter again in 2009.

    Currently on average, PMTCT coverage for countries in East and Southern Africa remains at around 50 percent.

    There was an agreement amongst experts that serious challenges remain to increase coverage as well as improve the quality of services being provided.

    The experts said most countries are still struggling to expand treatment and shift from single dose Nevirapine to more effective combination ARV regimens.

    Early infant diagnosis is still limited and the initiation of treatment for children is often late, reducing their chances of survival.

    "There is still not sufficient linkages with maternal and child health systems as well as family planning and reproductive health services," the experts recommended.

    They said countries continued to face human resource constraints, with a shortage of health care workers, as well as a lack of knowledge and skills.

    A detailed set of recommendations were made, focusing mainly on relatively low cost and straightforward actions that the governments could take before the end of 2009 which would allow for substantial acceleration in 2010 and beyond.

    Key among these recommendations were increased involvement of communities and community members, especially women and mothers living with HIV/AIDS in supporting local activities, reducing the workload of often overstretched health workers, and helping increase both coverage and compliance with the full course of treatment required.

    They recommended strengthening data management, especially the impacts of measurement mechanisms to better understand trends, identify bottlenecks.

    The health experts also called on the governments to prioritize the geographic areas/districts where prevalence rates are the highest so as to intensity support and services where the need is greatest.