BARCELONA – Combining prevention of mother to child transmission (MTCT) programmes with the treatment of the mothers and their family members (MTCT Plus) could provide a critical link between prevention and treatment, according to Dr Wafaa El-Sadr of Columbia University in the United States.

Addressing a session on MTCT solutions, El-Sadr told delegates at the International AIDS Conference that MTCT Plus would include HIV primary care services for families, HIV care and treatment for women identified within the MTCT programme as well as for their children and partners.

El-Sadr is one of the key researchers in the growing move towards introducing MTCT Plus in developing nations. Heavyweights such as UNAIDS, the Bill and Melinda Gates Foundation and the Henry J Kaiser Family Foundation are backing this programme.

It is estimated that South Africa currently has in the region of 400 000 children who have been orphaned after losing their mothers to the epidemic. This figure is expected to rise to close to two million by 2010.

Several studies have shown that MTCT alone would have very little effect on the rising orphan figures, but that treating the mother would have a dramatic effect.

El-Sadr said the MTCT Plus programme was crucial in developing nations in the light of the dire consequences of the loss of the mothers on the health of their children, family and community.

‘€œMTCT Plus would definitely have a positive impact on families,’€ she said.

The essential package at an MTCT Plus facility would include diagnostic testing, prophylaxis and treatment of opportunistic infections, anti-retroviral therapy, psychosocial support and patient education and counseling.

Such a programme would see a decrease in mortality and morbidity, a further decrease in MTCT, a strengthening of the local health care capacity, a decrease in stigma and the promotion of voluntary counselling and testing and other HIV prevention strategies, El-Sadr pointed out.

The challenges included transferring the mothers from an ante-natal care setting to ongoing primary care.

‘€œThe most important part is for the women to have healthy children and watch their children grow up. I firmly believe this programme would strengthen and unite families,’€ El-Sadr said.