# E-DRUG: Reduction in Perinatal Transmission of HIV (cont'd) **URL:** \ **Category:** e-drug\ **Created:** [April 2, 1998, 9:39pm UTC](https://talk.edrugplus.org/t/e-drug-reduction-in-perinatal-transmission-of-hiv-contd/2382 "1998-04-02T21:39:34Z")\ **Posts on this page:** 1\ **Page:** 1
**Author:** ![richardl1951](https://avatars.discourse-cdn.com/v4/letter/r/b3f665/32.png) [@richardl1951](https://talk.edrugplus.org/u/richardl1951)\ **Post date:** [April 2, 1998, 9:39pm UTC](https://talk.edrugplus.org/t/e-drug-reduction-in-perinatal-transmission-of-hiv-contd/2382/1 "1998-04-02T21:39:34Z")
E-drug: Reduction in Perinatal Transmission of HIV (cont'd) --------------------------------------------- I think the contribution from Chris Green about the results of the HIV vertical transmission is most useful and I find that I agree with it in general. To summarize, the trial in Thailand has shown us that it is possible to reduce transmission significantly. Albeit that a large number of women need to be treated for a limited benefit. The trial does not address the breast feeding issue either. So what are the implications of the trial. It seems to me that for the individual woman who knows she is HIV positive, has been fully counselled and has the resources to purchase the AZT AND is willing and able to forgo breast feeding this treatment should be offered to her. But I would suggest that this should be done by the private sector or the NGO sector in a country. I think that governments have higher priorities such as adequately treating STD's, tuberculosis, malaria etc. Also, we know from the Mwanza trial that treating is STD's is a more cost effective way to prevent HIV transmission. I agree that mass screening of pregnant women in most countries would be inappropriate without the resources both financial and human to meet the need generated. So I think this dialogue on the issue has been helpful to clarify the issues. But as Chris says progress will come in small steps not giant leaps. For a few rich women who are HIV positive and pregnant this is such an advance. For the vast majority of women they are still likely to die waiting. The one policy implication of these observations is the need to make AZT available at low prices through NGO or private channels in those countries where it will be used. This will be complicated as drug companies prefer to make cut price drugs available through governmental channels so that they can avoid parallel markets. A new challenge! Of interest is that WHO have now added AZT (zidovudine) to their Model Essential Drug list for this indication alone in their latest revision. Richard Laing Boston University e-mail: richardl@bu.edu -- Send mail for the `E-Drug' conference to `e-drug@usa.healthnet.org'. Mail administrative requests to `majordomo@usa.healthnet.org'. For additional assistance, send mail to: `owner-e-drug@usa.healthnet.org'.