- Thailand has become the first Asian country to eliminate mother to child transmission
- Success attributed to intense political efforts and stringent programs
- 100% condom use by men and frequent check up for pregnant mothers
WHO Elimination Strategy
The country diligently followed the four prongs of the elimination strategy as prescribed by the World Health Organization (WHO).There is transmission of the virus from the mother to child when a woman who carries the virus transmits the virus during pregnancy, delivery, while in labor or during lactation. In the absence of any preventive medicine
- About 15–30% of infants born from mothers who carry the virus may become infected with the virus during pregnancy or during delivery.
- Another 5–15% of infants are infected during breastfeeding.
Primary Prevention of HIV
The primary method of prevention of HIV transmission to infants would be to prevent unintended pregnancies, provide easy access to testing, ensure adequate counseling, and utilize infant feeding practices that are low in risk as well as practice safe delivery methods.Mothers should be counseled about consuming antiretroviral drugs which would prevent transmission to the infants and lower the risk of infant mortality.
The concerted efforts by the WHO has lowered mother to child transmission rates from 20-40% in the mid-1990s to 1.9% in 2015.
Four Prong Strategies of WHO
The focus of the WHO strategy involves- Primary prevention of HIV among women who are in the childbearing age
- Prevention of unintended pregnancies among women with HIV
- Prevention of transmission from an HIV-positive mother to her child
- Provision of necessary therapy and care for mother and child with HIV
Initiatives Carried out in Thailand
The initiatives that were carried out in Thailand include- Encouraging people to use condoms- 100% condom program encouraged all male patrons of commercial sex workers to use condoms. This was a critical step in lowering HIV risk among women in childbearing age
- Disbursing information about risk of transmission
- Introduction of HIV testing during pregnancy and after delivery
- Thailand’s National AIDS policy being transferred to the Office of the Prime Minister from the Ministry of Public Health in 1991 and
- The Government expenditure for the HIV/AIDS programme increasing from US$684,000(1988) to US$82 million(1997)
Antenatal Care
There is a lot of focus on antenatal care in Thailand which has supported the prevention of transmission from the mother to the child.- A voluntary HIV test is routinely conducted with the results provided on the same day.
- The patients can also re-test to ensure that mothers have remained HIV negative.
- Among women who test positive for HIV, anti-retroviral drugs are provided.
- Policies undertaken by the government of permitting production of low-cost generic drugs have resulted in these drugs being more affordable.
- Extensive counseling about the use of contraceptives is given to women of childbearing age who are at a risk of being infected with HIV.
Reference:
- Elimination of mother-to-child transmission of HIV and Syphilis - (http://apps.who.int/iris/bitstream/10665/112858/1/9789241505888_eng.pdf)