This follows the announcement yesterday (Thurs) that government has slashed the HIV transmission rate from pregnant mothers to their babies to 3.5 percent, potentially sparing some 67 000 babies from HIV infection.

‘€œIt is winnable to prevent all HIV positive mothers from passing the virus on to their babies, but we now have to concentrate on thecare of babies after birth,’€ said Precious Robinson, deputy director of government’€™s PMTCT programme, at the release of the new figures at the SA AIDS conference yesterday.

The success is due mainly to the health department vastly improving its programme for the prevention of mother-to-child HIV infection (PMTCT) from April last year.

‘€œWe have worked very, very hard to train staff to make the changes and we are so happy with the improvement,’€ said Robinson.

Under the old treatment programme, mothers and their newborns were given one dose of the antiretroviral drug nevirapine.

At best, this reduced the HIV transmission rate to 8.8percent, according to small local surveys. But in some parts of KwaZulu-Natal, one in five HIV positive mothers were still infecting their babies despite getting nevirapine.

The health department estimated that around 70 000 babies a year were still being born with HIV in 2008, and many were dying from AIDS-related illnesses.

In order to save babies, the new health minister, Dr Aaron Motsoaledi, prioritised improving the PMTCT treatment programme when he wasappointed.

From last April, the health department advised that all pregnant women with HIV are given the ARV called AZT from 14 weeks of pregnancy and three ARVs during labour (nevirapine, tenofovir and 3TC), which is whenmost infections take place.

If a pregnant woman has a CD4 count of less than 350, she should be put onto triple therapy (three ARVs) within two weeks of getting her CD4 test results.

Newborn babies are now given nevirapine syrup for as long as their mothers are breastfeeding them, or for six weeks if not they are not breast-fed.

Between June and December last year, the national PMCTC survey tested almost 10 000 six-week-old babies at 580 clinics in all nine provinces.

Almost one-third of these babies had HIV positive mothers, yet only 3.5 percent of the HIV positive mothers had infected their babies.

In KwaZulu-Natal, four out of ten newborns had HIV positive mothers yet only 2.8 percent became infected ‘€“ even lower than the national average.

Gauteng’€™s HIV transmission rate was the lowest in the country at 2.3 percent, while Mpumalanga had the worst rate of 6.2 percent, almost twice the national average. The Free State had the second worst rate (5.7 percent).

Without any ARV intervention, around 30-40 percent of HIV positive mothers can transmit HIV to their babies during pregnancy, labour and after birth through breastfeeding, according to Dr Ameena Goga.

Goga, from the Medical Research Council (MRC) was key in conducting the survey, and warned that more babies were likely to test HIV positive at 18 months.

One of the reasons for this was that some newborn babies were being both breast-fed and given other foods including formula. Mixed feeding makes babies very vulnerable to HIV infection.

Health Deputy Director General Dr Yogan Pillay admitted that government had given ‘€œmixed signals about infant feeding’€ but that it was moving towards exclusive breastfeeding.

‘€œThe Minister is having a high-level consultative meeting in August, and we might stop giving formula feed out at clinics,’€ said Pillay.

Meanwhile, Robinson said 11 percent of pregnant women who tested HIV negative initially became HIV positive during pregnancy.

‘€œWe are worried about these women because these might be the ones that are mostly transmitting HIV to their babies because a newly infected person is highly infectious,’€ said Robinson.

All women who initially tested HIV negative are now being re-tested at 32 weeks of pregnancy.

‘€œIt is possible that we can eradicate mother-to-child transmission by 2015, but we now need to focus on the post-natal process, including infant feeding and improved monitoring of babies,’€ said Robinson

Welcoming the results, Professor Helen Rees, director of the Wits Reproductive Health and HIV Institute, said it proved that the health system could be made to work.

‘€œWe are always told how bad the health system is, but this is an example of how it can be made to work well to save lives,’€ said Rees.