When I was pregnant with Tacy, her 20-week ultrasound showed a marker for chromosomal abnormality. On the advice of the maternal fetal medicine specialists, I had an amniocentesis. Two weeks later the results came back: Two X chromosomes and no abnormalities whatsoever. We went out to dinner at 21 and talked about what to name our little girl.
Contrast my experience with that of mothers and children in sub-Saharan Africa. Maternity and neonatal care is in dire need of improvement. In fact, “Maternal, Infant and Child Health and Development in Africa” was the theme of last month’s African Union Summit in Uganda.
One of the most heart-wrenching public health issues in Africa is mother-to-child-transmission of HIV. According to UNICEF:
“An estimated 420,000 children were newly infected in 2007, over 90 per cent of them in sub-Saharan Africa. Without treatment, an estimated half of these infected children will die before their second birthday.”
Imagine carrying a baby, knowing that you will likely infect them with the virus that will claim your life, knowing that it may claim theirs as well. It certainly puts our worries — though still real and valid — in perspective.
Why are so many African women HIV-positive? It’s a combination of biological and cultural factors. The US Department of Health and Human Services reports:
“Women are more likely to get HIV for several biological reasons.
- There is a more exposed surface area in the female genitals (sex organs) than in the male genitals.
- There are higher levels of HIV in semen than in vaginal fluids.
- More semen is exchanged during sex than vaginal fluids.
- Women often have untreated STDs, which makes them more likely to get HIV.”
Culturally, women are rarely in control of their own sexuality in Africa. From the time they are born and subjected to FGM, to their childhood, adolescence, and adulthood, African women are oppressed sexually. They are raped, enslaved, mutilated, killed, and pressured to “have sex in exchange for gifts and favors.” Along the way, they contract HIV.
The good news is that mother-to-child-transmission of HIV is preventable through antiretroviral drugs and managing the risk of infection via safe feeding practices. Organizations like UNICEF and AVERT are working to offer services to African mothers in need. But the largest effort by far is led by the Global Fund – Born HIV Free.
The Global Fund is devoted to the eradication of AIDS, tuberculosis, and malaria. It’s a “global public/private partnership dedicated to attracting and disbursing additional resources to prevent and treat” these diseases, and “Born HIV Free is a campaign by the Global Fund to mobilize public support for a world where no child is born with HIV by 2015.”
I did some reading about the Global Fund’s performance as evaluated by an independent advisory body. From the Five-Year Evaluation Synthesis Report:
“While the Global Fund has achieved an incredibly rapid startup in its first five years, the board’s focus has drifted from long-term and strategic issues toward ad hoc and incremental decision-making and operational details…The Global Fund has increasingly become a stand-alone entity with a growing and increasingly complex portfolio of grants requiring ever-increasing numbers of staff at the global level to maintain effective financial oversight in countries. The sheer weight of its growing responsibilities as a grant disbursement and oversight entity is increasingly at the expense of its strategic leverage in the global development architecture.
Nevertheless, the overall efforts of the first five years of the Global Fund can only be termed as extraordinary. It has demonstrated tremendous flexibility in adjusting grant disbursement strategies and operational policies, while urgently addressing the global funding gap for HIV/AIDS, TB, and malaria. The Five-Year evaluation found that, at a global level, collective efforts have resulted in increases in service availability, better coverage and reduction of disease burden.”
In short, the Global Fund has taken on a monumental challenge and made exceptional progress, even as that challenge has grown and presented a growing number of obstacles. The Global Fund has focused on action rather than administration, but in order to maintain its success, it needs to direct more attention and resources to planning and oversight. As a former project manager, I understand the reasoning behind these recommendations quite well.
The Global Fund launched the Born HIV Free campaign to publicize its goals for the next five years — namely to eradicate mother-to-child-transmission of HIV — in advance of a “meeting in New York on October 5 this year where donor countries will pledge resources to the Global Fund for the period 2011-13.”
Want to help? It won’t cost you anything but a few minutes, if that.
By signing this petition, you’ll show your support for the Born HIV Free campaign and your country’s donation to the Global Fund. That’s it. Oh, and you might help send me to Africa along with my friend Catherine to see for myself what the Global Fund is doing to help save the lives of mothers and children.
I hope you’ll sign, and I hope you’ll spread the word among your personal circles. For all of us who are healthy and happy and free, there are far too many others who are not. It’s so easy; please help.
