ICASA Presentation on Pediatric HIV Screening Raises Further Questions

By Hloniphile Mabuza
Building Local Capacity for Delivery of HIV Services in Southern Africa Project, MSH South Africa

Earlier this week, I attended a session on monitoring and evaluation, and one of the presentations was on “Analysis of the effect of universal PITC [provider-initiated testing and counseling] of all babies at 18 months of age regardless of history of HIV exposure.” This was a pre/post study conducted in the Ugu district in KwaZulu-Natal, South Africa. The Department of Health in Ugu developed a protocol to test all babies at 18 months when they come for their measles immunization. The study revealed that in the nine months before the protocol was introduced (from October 2011-June 2012), only 18.1% of babies were tested and the HIV prevalence among babies 18 months old was 1.03%. During the nine months after the protocol was introduced (July 2012-March 2013), 42.8% of babies were tested and the HIV prevalence increased to 1.68%. There was no mention if this was statistically significant or not. The study recommended robust implementation of universal HIV testing at 18 months regardless of HIV exposure.

As I listened to the presentation and discussion, more questions came to mind: Is this really the best way to conduct pediatric HIV screening? How much would it cost South Africa to implement this strategy, and is it the most efficient use of funding, considering the HIV prevalence both before and after the study protocol was less than 2%?

Let’s hear other thoughts – reply below to join the discussion.

Now More Than Ever – ICASA Opens in Cape Town

The 17th International Conference on AIDS and STIs in Africa (ICASA) officially opened yesterday on a very sombre note as the world mourns and celebrates the life of global icon and former South African president Nelson Mandela who died Thursday, December 5.  More than 7,000 delegates from all over the world observed a minute of silence in his honor at the start of the opening session.

Photo credit: ICASA

Photo credit: ICASA

While some worried the conference may be cancelled, there could be no better way to celebrate Mandela’s legacy than by continuing to host ICASA and address the global HIV and AIDS epidemic. In a statement released by ICASA, the organizers honored Mandela, saying “We are reminded of the immeasurable contribution Mr Mandela made to the cause. Without his input and guidance many of the successes we have achieved would not have materialised. His legacy will live forever because of his commitment in the many years before his passing.”

All of the opening speakers extolled the role played by Mandela in the fight against HIV, urging all conference delegates to emulate him.

Without taking away anything from all the speeches delivered, I passionately single out those that sought to protect women and girls from acts of sexual violence. This, in South Africa, coincides with the release of several news articles detailing the unpalatable acts of some men raping babies and children as young as six weeks.

Annie Lennox delivers the ICASA opening address. Photo credit: Bright Phiri

Annie Lennox delivers the ICASA opening address. Photo credit: Bright Phiri/MSH

“Madiba walked his talk, we need to do the same today: walk our talk and act now more than ever,” said Annie Lennox, renowned singer, women’s  activist, and UNAIDS international goodwill ambassador. Delivering her speech during the opening ceremony, Lennox argued that while we celebrate the fact that 98% of children today are born HIV negative, the same children are at risk of being sexually assaulted and raped. Sexual violence, she posited, is a cause and consequence of HIV infections.

Lennox emphasized that we need to collectively stop violence against women and children. She challenged everyone to be accountable and help change attitudes of men and boys towards women and girls if we are to reach zero new infections. She closed by stating that we owe it to Mandela that this dream should be fulfilled – that all children are born free of HIV and live a full life.

First Lady of Zambia Christine Kaseba-Sata calling for more SRHR support. Photo credit: Bright Phiri

First Lady of Zambia Christine Kaseba-Sata calling for more SRHR support. Photo credit: Bright Phiri/MSH

Echoing Lennox’s opening and the importance of protecting women and children, Zambia’s first lady, Dr. Christine Kaseba-Sata, urged conference delegates to uphold sexual and reproductive health and rights (SRHR) in order to get to zero deaths. She noted that there is no need for women in Africa to continue to die during child birth and that no child should be allowed to die at birth. Hence, a strengthened focus on SRHR would help address gender inequalities issues that fuel HIV infections.

Indeed, MSH’s goal of saving lives and improving health for all resonates well with each of the opening speakers’ sentiments and our vision of “A world where everyone has the opportunity for a healthy life” epitomizes Mandela’s dreams.

As the conference gets in full swing, one cannot help but to support the statement that “it is fitting that we honour Mr Mandela’s legacy by ensuring our conference makes every effort to ensure meaningful dialogue is matched by tangible outcomes…the inspirations we have received from Mr Mandela are not wasted. We need to guard against complacency at a time when action is most needed .”

Bright Phiri works with MSH’s Systems for Improved Access to Pharmaceuticals and Services Program in South Africa.

MSHers from Around the World Gather at ICASA

Last night, Management Sciences for Health staff from four countries, representing six different projects, met to prepare for a week full of conference sessions, exciting events, and networking with global health and international development peers, donors, and government officials.

MSH ICASA 2013 Staff Picture

MSH staff pose for a group picture at the ICASA 2013 welcome staff meeting.
Photo credit: Michele Alexander/MSH

MSH South Africa Country Representative Bada Pharasi kicked off the meeting, welcoming all MSH attendees while Jackie Sallet from the South Africa Sustainable Response to HIV & TB Services (SA SURE) Project, Global Technical Lead for HIV/AIDS Scott Kellerman, Director of Policy & Advocacy Crystal Lander, and Michele Alexander from Strategic Development and Communications discussed MSH’s goals and messages for the conference.

Jackie Sallet, from the MSH project SA SURE, shares the key messages about MSH's HIV and AIDS work.

Jackie Sallet, from the MSH project SA SURE, shares the key messages about MSH’s HIV and AIDS work.
Photo credit: Bright Phiri/MSH

Overall, the South Africa, Uganda, Zambia, and US-based MSHers shared ways to maximize MSH’s conference presence – most importantly through our exhibit booth, #21, and our panel and reception event on Monday, December 9 from 6-9PM (click here for more details and to RSVP).

Global Technical Lead for HIV and AIDS Scott Kellerman takes a look at the MSH ICASA Orientation Book.

Global Technical Lead for HIV and AIDS Scott Kellerman takes a look at the MSH ICASA Orientation Book.
Photo credit: Crystal Lander/MSH