This week I am traveling in the Democratic Republic of the Congo (DRC), a country that, while facing many challenges, is home to families who are seeking to build a better future. Health is an important part of a better future for the DRC, and preventing mother-to-child transmission of HIV (PMTCT) is a key example of a health care service that can strengthen families and communities.
PMTCT provides a triple benefit: in addition to preventing an infant from being infected with HIV, a program can also provide antiretroviral treatment to keep the mother alive, which in turn prevents her other children from being orphaned. So PMTCT is a smart investment — it has an impressive impact, and is strikingly cost-effective as well.
Led by the U.S. through the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), the world has made dramatic progress on PMTCT over the last decade. Tragically, the DRC has not been able to participate in this improvement. According to 2007 demographic and health survey (DHS) data, an estimated 70 percent of pregnant women give birth in facilities. However, only an estimated 2.2 percent of pregnant women have access to PMTCT services, including HIV testing.
Clearly, the challenges are immense. Yet this week in Kinshasa, I visited one of the programs that has made a start, with support from PEPFAR. The Sango Plus program at Bomoi Maternity takes a "one-stop shop" approach, seeking to meet the full continuum of needs of expecting mothers. As an element of the maternal and child health services it offers, the program targets women for HIV testing and PMTCT services if they test positive at two key points: during antenatal care visits and at delivery. Over 94 percent of women who have been counseled to date have opted to be tested for HIV, and of those tested, over 90 percent have received their results. These are encouraging figures, and results we want to duplicate around the country.
Sango Plus has adopted numerous practices to increase the chances that women living with HIV will give birth in a safe environment where they and their babies will receive the PMTCT services they need. For women who test positive for HIV, services are provided not only to mother and baby, but to other family members — adult or child — who also test positive for HIV. Because transportation is often an issue, patients are reimbursed for their costs. Early Infant Diagnosis is provided to eligible infants. And I was particularly impressed to meet a peer education group of mothers living with HIV, who comprise one of the support groups that help women live positively.
In the Kinshasa area I've also visited the remarkable Biyela Champion Community program that has mobilized a community to care for people living with HIV and orphans and vulnerable children in a holistic way, an HIV prevention hotline that is reaching a remarkable number of people, and a pediatric hospital that meets the needs of HIV-positive children and their families.
Of course, programs are only as strong as the people involved in them. At the sites I've visited in the DRC, I have been touched by the deep commitment of the staff — and beneficiaries — to overcome all the obstacles and save lives. The challenge ahead is to make PMTCT and other health services much more widely available. As the DRC increases its own efforts to do so, it will continue to have a committed partner in the United States.