Cambodia is on the brink of a new HIV success story. Linking of services for the prevention of mother-to-child transmission, or PMTCT, of HIV with those focusing on maternal and child health services is putting Cambodia on track to ending the HIV epidemic amongst children.
From June 8-10, world leaders convene in New York City at the United Nations General Assembly High Level Meeting on AIDS. The gathering of heads of state and other leaders from government, the scientific community, civil society and the private sector offers a unique opportunity to review progress, share lessons learned and chart the future course of the global AIDS response.
The High Level Meeting will review six targets set by the Secretary-General for the global community to adopt and achieve by 2015, one of which is to eliminate HIV transmission from mother to child, keep mothers alive and improve the health of women, children and families.
I will join First Ladies from around the world in New York to specifically discuss avenues to advance the agenda of prevention of mother to child transmission, to ensure no infant is born with HIV.
The HIV response in Cambodia has been acknowledged as a global success by the international community, receiving the Millennium Development Goal Award for achievements in halting and reversing the spread of HIV. Prevalence amongst adults aged 15-49 years continues to decline from an estimated 2 percent in 1998 to 0.7 percent in 2010. Coverage of access to treatment and care has dramatically improved with 90 percent of people living with HIV now receiving antiretroviral treatment.
However, challenges must be addressed to build on the gains made and prevent a resurge in infections. There is certainly no room for complacency in Cambodia given the persistently high infection rates amongst key affected populations; injecting drug users, sex workers and men who have sex with men (24.4 percent, 14.7 percent and 5.1 percent respectively). These are worrisome figures.
Moreover, women aged 15-49 years living with HIV now outnumber men. Not enough women are getting access to the services they need, particularly when they are pregnant.
In 2009, only 32.3 percent of HIV-infected pregnant women received antiretroviral prophylaxis to protect their babies, substantially short of the 2010 target. The care and treatment needs of HIV positive babies are not being met. By the end of 2009, only an estimated 68.2 percent of children with advanced HIV infection were receiving antiretroviral treatment, while early infant diagnosis testing covered only 15 percent of HIV exposed infants.
Efforts are being made already to address this. The effective implementation of the “linked response”, a strategy that integrates HIV with maternal and child health, is responsible for an increase in the number of women being tested for HIV.
Recent expansion of antenatal care services provides an important opportunity for the same expansion of PMTCT services for pregnant women, particularly those from affected populations. Priorities must focus on raising community awareness to services, expanding HIV testing for adults and children, integrating PMTCT with maternal and child health services and integrating HIV and sexual and reproductive health services.
I am passionate about this issue and have made my commitment clear on improving the health of women and children, and combating HIV. As National Champion for the UN Secretary-General’s Action Plan for Women and Children’s Health and the National Champion for HIV and AIDS, I will endeavour to advocate for the prevention of mother to child transmission of HIV, elimination of HIV-related stigma and discrimination and increased access to HIV prevention, care and treatment for most-at-risk populations.
By strengthening the “linked response” to address maternal and child health and HIV, I believe Cambodia has a significant chance of eliminating mother to child transmission and thereby improving the health of women, children and families.
Virtual elimination of mother to child transmission is in sight. However, it must be placed high on Cambodia’s agenda and met with political commitment and evidence-based policy and interventions.
As the UN Secretary-General said, the AIDS response is facing “a moment of truth”. Bold decisions are needed to dramatically reshape the response and achieve the UNAIDS vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths.
Cambodia is committed to play its part in a global movement that can and will make AIDS a thing of the past.
Her Excellency Bun Rany Hun Sen, is the President of the Cambodian Red Cross, National Champion for the UN Secretary-General’s Action Plan for Women’s and Children’s Health and the National Champion of the Asian Pacific Leadership Forum on HIV and Development in Cambodia.