Every day Martha extracts her breast milk into a small glass jar. She puts the full jar inside a pot with water and heats it up on her little gas stove until the water reaches a rolling boil. She then takes out the jar with milk and lets it cool down for a few minutes before filling a baby bottle to feed her 3-month-old daughter Ana-Maria.
Sounds complicated to you? Maybe, but Martha is poor and HIV-positive. She knows that feeding Ana-Maria directly from her breast puts the baby at risk of becoming HIV-positive as well. Martha has difficulties getting clean water to feed Ana-Maria with formula… which she couldn’t afford to purchase anyway!
A community health worker visited Martha before she had her baby and talked to her about different feeding options. That´s how Martha found out that by heating her breast milk as described before, the human immunodeficiency virus (HIV)—the virus that causes AIDS –inactivates. However, the properties that make breast milk such a great power food for babies because of the nutritional and infection fighting components stay alive. So, with little effort, Martha can give her daughter what she needs for a good start in life.
This could be a story of any HIV-positive poor mother in Latin America – but it is not. Today, this story would most likely take place in sub-Saharan Africa, more specifically in Zimbabwe. Researchers from the University of California, Davis (UC Davis) conducted a study there to prove that HIV-positive mothers were actually willing to go through the effort of extracting breast-milk and heating it up in order to prevent mother-to-child HIV-transmission.
Can this be an option for Latin American and the Caribbean countries? Although 5% of the population of sub-Saharan Africa was infected with HIV in 2009 and it is certainly the strongest affected region in the world, Latin America and the Caribbean does no fall far behind. It´s the second most affected region worldwide! 0.4% of the population is living with HIV, and if we only look at the Caribbean countries, this number increases to almost 1.7%. In other words, we’re talking about 1.4 million people living with the virus in Latin America and the Caribbean.
Coverage of antiretroviral medicine to prevent mother-to-child transmission in the region was 56% in 2011 according to UNAIDS. This number is lower than in sub-Saharan Africa, where 59% of mothers receive antiretroviral treatment. Although global standards are on a similar level (at around 50%), it is important to remember that this means half of the women who need such treatment –25,600!- , don’t get access to it and are at risk of transmitting HIV to their babies. As a result, 5,100 children tested HIV positive in 2010, according to USAID data .The good news is that this number is much lower than in 2001 (it decreased by 45%). But why settle with this when it is possible to prevent all mother-to-child transmission? If mothers were taught how to feed their babies, would they actually bother to heat up their milk like Martha does?
There are some good ideas being implemented in Africa, we should look at more closely. Giving HIV-positive mothers different choices to care for their newborns is only one of them.
Daniela Philipp is a consultant in the Social Protection and Health Division of the IDB. Daniela’s work focuses on health, nutrition, and early childhood development.