E-drug: infant feeding and HIV
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DRAFT PRESS RELEASE
27 April 1998
UNICEF, WHO, UNAIDS
ANNOUNCE CONSENSUS ON INFANT FEEDING AND HIV
In a concerted effort to stop the spread of HIV/AIDS among young
children and mothers, the UNAIDS program and two of its co-sponsors
have supported the use of alternatives to breastfeeding for infants
born to HIV positive women. The World Health Organization (WHO), the
United Nations Children's Fund (UNICEF) and the Joint UN Programme on
HIV/AIDS (UNAIDS) has endorsed the implementation of new guidelines on
HIV and infant feeding. The guidelines were the product of a meeting
and further discussions which took place in Geneva recently.
The guidelines are intended to help governments devise national
policies to fight the spread of HIV/AIDS and to assist health care
managers in providing appropriate services and support. The
guidelines stress the importance of protecting, promoting and
supporting breastfeeding as the best method of feeding for infants
whose mothers are HIV-negative or who do not know their HIV status.
But at the same time, they recognise the need to support alternatives
to breastfeeding for mothers who test positive for the human
immuno-deficiency virus that causes AIDS.
Participants at the meeting emphasized the need to support
HIV-positive mothers in their right to choose an infant feeding method
appropriate to their needs. They stressed that those mothers who
decide not to breast-feed their children must be ensured access to
sufficient quantities of nutritionally adequate breastmilk
substitutes. They also agreed there is an urgent need for the
resources and information required to enable women to prepare these
replacements as safely as possible.
"These guidelines bring together two important goals: reducing
mother-to-child HIV transmission, and affirming the benefits of
breastfeeding, which is the optimal source of nutrition for most
infants" said Dr Tomris T�rmen, Executive Director, Family and
Reproductive Health, WHO.
The participants included government officials responsible for
maternal and child health, nutrition and HIV/AIDS programmes as well
as representatives of non-governmental organisations, the infant
feeding industry, and scientists with expertise in infant feeding and
HIV/AIDS.
Three Million Children Infected Worldwide
HIV can be transmitted from an infected mother to her child: children
born to HIV positive mothers have a one-in-three chance of contracting
the virus. Of these, one-third become infected by breastmilk, with
the other two-thirds infected in utero or during birth.
To date, 3 million children world-wide have been infected with HIV,
and the rapid and accelerating spread of the disease world-wide has
reinforced predictions that HIV/AIDS is becoming a major killer of
children, especially in the developing world. In 1997 alone, more than
half a million children were infected globally.
Offering a Solution
Recent results from a study conducted in Thailand among non-breast-fed
infants showed a 50 per cent reduction in mother-child transmission
with a short-course regimen of the antiretroviral drug AZT during
pregnancy and childbirth. Participants at a meeting convened by
UNAIDS in March 1998, reviewed issues related to the implementation of
effective interventions in developing countries, particularly those
involving the short course AZT regimen.
In addition to the key recommendation of increasing access to
alternatives to breast feeding for HIV positive women, the HIV infant
feeding guidelines emphasise the need to improve access to voluntary
and confidential HIV counselling and testing, particularly for
pregnant women as well as proper infant feeding counselling.
The participants also endorsed the need to implement measures to
prevent breastfeeding from being undermined among HIV negative women
and among those whose HIV status is unknown. There was a consensus
that methods for procuring, distributing and making available
replacements for breastmilk must comply with the International Code of
Marketing of Breastmilk Substitutes, and subsequent resolutions of the
World Health Assembly.
Health care services, especially in developing countries, were also a
priority on the meeting agenda. There was a focus on the need to
strengthen health services, particularly reproductive and child health
services, to implement interventions that would reduce HIV infection
in women and reduce mother to child transmission of HIV, and to ensure
care and social support for HIV positive mothers and their children.
Working Together to Prevent HIV/AIDS
Professor Fred Sai, the Chair of the meeting, pointed out that "WHO
and UNICEF are committed to working together with UNAIDS and its
partners to take concrete action to prevent mother to child
transmission of HIV infection. They know that HIV positive women and
their families must receive the care and support they need."
As a result of a consensus at both the March and April meetings, a
working group will be established to facilitate and support
accelerated action on the part of the United Nations agencies and
organizations, UNAIDS and others. This working group will move as
quickly as possible to implement interventions to reduce
mother-to-child transmission, including adequate infant feeding
alternatives.
For more information, please contact (UNAIDS info)(WHO info)(UNICEF
info)
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