By Edward Pentin
ROME, OCT. 15, 2009 (Zenit.org).- A Rome conference which drew together world leaders in the field of HIV/AIDS has highlighted the urgent need to improve prevention of mother-to-child transmission of the disease.
It also managed to unite both the Church and the Obama administration in a potentially highly effective and fruitful partnership in saving the lives of millions of children.
The three-day conference was co-hosted by Caritas Internationalis — a confederation of 162 Church humanitarian organizations — and the U.S. Embassy to the Holy See. The meeting, which ends Friday, was also aimed at improving access to testing and treatment for children living with HIV and HIV/tuberculosis co-infection.
The conference brought together many leading experts in the field, including missionaries, health care workers, and the executive director of UNAIDS. Also participating were representatives of non-governmental organizations, the President’s Emergency Plan for AIDS Relief (PEPFAR), the World Health Organization and pharmaceutical companies.
Every year, approximately 370,000 children under 15 become infected with HIV, mainly through mother-to-child transmission. About 90% of these infections occur in Africa where as many as 800 children die every day from the disease. The children are infected during their mother’s pregnancy, labor and delivery, or through breastfeeding.
“The world has failed these children because there are inexpensive and effective measures to prevent the transmission of HIV to unborn children and to infants, but most HIV-positive women are not aware of them, or do not have access to them,” said Lesley-Anne Knight, secretary-general of Caritas Internationalis, in her opening remarks. “This is a terrible tragedy, but it is also a scandal — because we can do something about it.”
Knight added that not enough effort is being made to diagnose their condition, nor are adequate treatments being produced that are suitable for HIV infected children, 50% of whom die before the age of two.
For this reason, Caritas Internationalis launched the HAART for Children campaign earlier this year. The initiative calls on pharmaceutical and diagnostics manufacturers, governments, and academic and research institutions to develop and provide better medicines and tests for children that can be used in low-income and rural areas.
Extending coverage to make it universal was the focus of many interventions. “HIV infection is certainly not just a scientific problem, but a much more complex, economic, social problem,” said Dr. Giuseppe Profiti, president of the Vatican-affiliated Bambino Gesu Children’s Hospital. “It’s about redistribution of knowledge, means, results, resources and science at large […] to cover everyone if possible.”
Social justice medicine
Michel Sidibe, executive director of UNAIDS, argued that universal access to medicine and resources was principally about social justice. “It’s also about dealing with underlying causes of inequality, building a delivery system that is less costly but which reaches the majority of those people who are unfortunately without a voice,” he said. Quoting Martin Luther King, Sidibe noted that “when the world cares enough, resources can always be found.”
Effective ways to stem mother-to-child transmission include HIV testing and education of parents; counseling HIV positive women to avoid unwanted pregnancies; and preventing the transmission of the virus through the use of anti-retroviral drugs and safer infant practices.
The Church has a major role to play in extending this prevention through its outreach, the speakers agreed. She is already doing so on a large scale with a dedicated army of volunteers working in the field, and is responsible for 30%-70% of health care in various developing countries, said Dr. Carl Stecker, senior technical advisor for HIV/AIDS with Catholic Relief Services. “This is something we can do, that we can shine at, and which is fairly non-controversial,” he said.
It’s partly this non-controversial aspect that promises greater Church-public sector collaboration, even if some governments might favor condom distribution as part of their HIV/AIDS prevention programs. “There’s a lot of common ground here,” said Monsignor Robert Vitillo, head of advocacy efforts related to HIV/AIDS at Caritas’s delegation in Geneva. “But that doesn’t mean we’re in any way stepping back from our insistence of trying to do prevention with responsible behavior within marriage. We do both.”
The U.S. ambassador to the Holy See, Miguel H. Diaz, welcomed what he sees as real potential for collaboration between the Obama administration and the Church on this issue, partly owing to the absence of areas where the two have clashed. “This is a concrete example of coming together, to focus on the care of children, and by doing so we’re focusing on prevention and treatment of children and mothers for the sake of a common cause,” he told ZENIT.
“I’ve argued from the beginning that I’m going to be a bridge builder and I’m going to try as much as possible to engage the positive dimensions and those areas where we can collaborate.” He said this was one such example and, although there are some areas of disagreement, “certainly there is so much we can do together here to save children.”
Partnerships
Since PEPFAR was established by U.S. President George W. Bush in 2003, effective methods of preventing of mother-to-child transmission have grown significantly worldwide, according to Deborah Birx, director of the federal government’s Global AIDS Program. President Obama has set aside a further $65 billion towards combating AIDS, tuberculosis and malaria over six years.
Dr. Antonio Gerbase, of the WHO’s HIV department, revealed that the WHO’s priority for 2010 and 2011 will be the treatment of women and children, and the prevention of mother-to-child HIV/AIDS. “Together with the Catholic Church and other partners, we would like to move on this, because they reach populations which are often difficult to reach,” he said. “For us, this is a very fruitful partnership.”
But there is still a long way to go, and speakers who work in the field gave concrete grassroots examples of how collaboration could be improved. Sister Maria Theresia Hornemann, a nurse in the Congregation of the Missionary Servants of the Holy Spirit, pointed out that antiretroviral treatment is too expensive for patients. “In principle it is the responsibility of the government,” she said. “But more often than not, what we receive from governments is apathy and outright refusal to even recognize the problem.”
Sister Isabelle Smyth of the Medical Missionaries of Mary said resources need to also be allocated to educating mothers and children on how to use antiretroviral drugs, and for nutrition to feed HIV/AIDS sufferers once they have been treated. “This is where PEPFAR, Bill Gates, and others who are giving money need to realize that you need to give it to us in a holistic way,” she said.
Focusing on prevention before infection, another participant called for greater emphasis on education, sowing Christian values, and the need to stress that human trafficking and the number of sexual partners is a “huge cause” in the spread of HIV.
Representatives from the pharmaceutical companies GlaxoSmithKline, Abbott Laboratories and Eli Lilly and Company gave presentations on their progress in producing better AIDS tests and drugs, and how they are doing so freely or without profit to the world’s poor countries. But conference participants stressed that too often the drugs are unsuitable for children and without proper formulations and dosages.
In the midst of dealing with solutions, technical aspects and figures, participants were wary of not losing the human importance of the discussions. “In the final analysis,” said Lesley-Anne Knight, “we are not dealing with global statistics, but with individual,
precious lives.”
Ambassador Diaz said even if one life is saved as a result of this meeting, the collaboration between the U.S. government and the Church on this issue “is already making a difference.”
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Edward Pentin is a freelance writer living in Rome. He can be reached at: epentin@zenit.org.
