The U.S. President's Emergency Plan for AIDS Relief - March 2010 Newsletter

Ambassador Eric Goosby, U.S. Global AIDS Coordinator, visited Nigeria at the end of February to meet with senior government leaders, legislators, implementing partners and members of civil society.

While in Nigeria, Ambassador Goosby reinforced the U.S. Government commitment to Nigeria as a partner in the fight against HIV/AIDS and ensured that the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) would continue to work with Nigerian leadership to develop a sustainable, long-term response to the epidemic.

Ambassador Goosby's trip to Nigeria coincided with the visit of UNAIDS Executive Director, Michel Sidibé. Together, they visited Maitama Public Hospital, which is jointly supported by PEPFAR and UNAIDS. They also attended a roundtable discussion with implementing partners to discuss local ownership of the response to HIV/AIDS and partnerships for sustainability.

During a meeting with Nigerian Minister of Health Professor Babatunde Oshotimehin, Ambassador Goosby reiterated the U.S. Government's support for Nigeria's response to HIV/AIDS.

"It is gratifying to hear that Nigeria has developed a robust, orchestrated response at the primary, secondary, and tertiary levels. What we need to work on is the deficit in prevention of mother-to-child transmission services and shortfalls in counseling and testing. Despite the global economic meltdown, we remain firmly committed to Nigeria's response to HIV/AIDS," he said.

In February, Senator Richard Durbin (D-IL) and Senator Sherrod Brown (DOH) visited St. Peter's Hospital in Addis Ababa, Ethiopia to observe the impact of U.S. Government-supported health programs.

The visit to St. Peter's, Ethiopia's national tuberculosis referral hospital, occurred during their weeklong trip to Africa. During this trip, Senator Durbin and Senator Brown examined U.S. foreign assistance programs, particularly health projects, on the continent.

With support from the U.S. President's Emergency Plan for AIDS relief (PEPFAR); the Global Fund to Fight AIDS, Tuberculosis and Malaria; and the U.S. Agency for International Development (USAID) Tuberculosis Control Assistance Program, St. Peter's Hospital provides care for tuberculosis referral cases and patients with multi-drug resistant tuberculosis.

This hospital also provides a venue for individuals to receive care and treatment for HIV/AIDS as people living with HIV/AIDS are more likely to become infected with tuberculosis, and tuberculosis remains one of the leading causes of death for people living with HIV/AIDS.

Currently, St. Peter's provides antiretroviral treatment to 250 patients. To increase its capacity to treat TB/HIV co-infected patients, the hospital, with U.S. Government support, is undergoing renovations to scale-up its HIV counseling and testing units and to build a TB/HIV chronic care clinic, a drug dispensary and pharmacy store.

"My first visit to Africa was 12 years ago, and it was a sad time. They had discovered AIDS, but there was no cure. People believed it was a death sentence; so much has changed since then. Drugs are now available for many, and there is hope that HIV-

Senator Brown expressed his satisfaction with St. Peter's Hospital and its staff.

"What the personnel is doing is a phenomenal work," said Senator Brown. "In this hospital, they cure people with TB and give them a chance in life they would never have had - especially for those who are taking antiretroviral drugs and treatment for HIV and TB."

In Cambodia, local midwife Suth Sophal is teaching pregnant women about the benefits of being tested for HIV.

Sophal, a dynamic 45 year-old midwife working in a large maternity ward at Battambang Hospital, is responsible for the hospital's prevention of mother-to-child transmission (PMTCT) program.

Sophal and her colleagues noticed that most pregnant women delivering at the hospital did not know their HIV status, which prevented midwives from offering effective HIV-prevention medications to mothers and babies. Realizing the dire consequences of this missed opportunity, Sophal and her team asked the Provincial Health Department to support HIV testing in the maternity ward.

Sophal was able to convince the maternity supervisor and midwifery team to participate in a demonstration project supported by the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) in partnership with the National Maternal and Child Health Center. This project was intended to illustrate that HIV testing around labor and delivery is not only feasible and acceptable to pregnant mothers, but also effective in increasing the number of women and babies given PMTCT interventions.

After just two months, the program began to show results. 73 percent of pregnant women entering the maternity ward did not know their HIV status, making them eligible for testing. Of these mothers-to-be, 98 percent were offered HIV counseling and testing, and 99 percent of them accepted. And, over time, more of the soon-to-be fathers also received HIV counseling and testing.

HIV testing is now commonplace in the maternity ward, allowing the team to identify HIV-positive pregnant women, provide antiretroviral prophylaxis during delivery, and enter the mother and child into the hospital system for appropriate follow-up care.

The results of this demonstration project have also influenced midwives at other maternity wards to start testing pregnant women for HIV.

Sophal keeps in touch with the women who test positive for HIV and connects them with local homebased care organizations. After her patients deliver, she also reminds them to bring their infants to the hospital for HIV testing and follow-up care. Sophal intends to share this experience countrywide.

"Testing during labor is a very important task that can ensure mothers and babies are free of AIDS," she said.