This is according to the Dr Tanya Doherty of the Medical Research Council who writes in the latest District Health Barometer that the lack of improvement in child mortality in South Africa since 1990 is specifically due to transmission of HIV from mother to child (MTCT).

The National Strategic Plan (NSP) for HIV, AIDS and STIs recognises PMTCT as a mainstay of the response against the epidemic in children and has a target to reduce mother-to-child HIV transmission to less than 5% by 2011.

Doherty reveals that overall there have been impressive improvements in HIV test uptake among pregnant women across the country with the national average increasing from 69% to 80%. However, there were errors in recording data which would have led to an overestimate of the uptake rate.

Only two metro districts, Cape Town and Johannesburg, achieved higher than the national average with researchers expressing concern over the 52% testing rate in eThekwini, which has one of the highest HIV rates in the country.

‘€œThese low rates result in many missed opportunities for women to access PMTCT services,’€ Doherty wrote.

Health minister Dr Aaron Motsoaledi said in his budget speech last week that the proportion of pregnant women who are tested for HIV would be increased from 80% in 2009/10 to 95% in 2010/11 and 2011/12.

Also, 80% of pregnant women who were eligible would be placed on dual therapy (AZT and nevirapine) in 2009/10 and 95% thereafter.

Motsoaledi added that 30% of eligible pregnant women would be placed on full antiretroviral therapy in 2009/10 while this service will be expanded to cover 50% of pregnant women in 2010/11 and 75% in 2011/12.

‘€œWe will work with provinces in 2009/10 to ensure that 80% of HIV-exposed infants receive ARVs for PMTCT (based on dual therapy). This figure will increase to 95%,’€ said Motsoaledi.

Doherty said that, should these improvements in testing rates continue, the NSP target from antenatal testing will be a realisable goal.

However, statistics indicated that the beleaguered Free State was showing declining nevirapine coverage rates for the second consecutive year, although poor data quality could have played a role. All five districts in the province were below 40% and the Lejweleputswa district recorded a coverage rate of merely 12%.

The nevirapine uptake of babies was generally high with none of the districts being below 80%. More than half of the districts had coverage levels of 100% or more, including all districts in Mpumalanga. However, researchers against cautioned that these could be inflated figures due to under recording of live births.