P.M.T.C.T

Perhaps i got a little ahead of myself on the whole Malawi post earlier .... and perhaps should explain how it is i'm here in Africa again and not in London as i'm supposed to be ....

Some of you know that since I really didn't know what I wanted to do when I got back to London after/despite almost 4 years away .... I typically tried to keep all my options open (yes - my legendary commitment phobia still looms large) .... and so rather predictably I seem to now run around like a headless ninja .... gadding between the NHS, the London School of Tropical Medicine and attempting to do some consultancy work for NGOs on the side (the busy-ness of all this means that I can be smug about not having time to narrow my options down and make a decision) ....

Through the consultancy work - a friend/colleague and I were asked to look at the issue of mothers transmitting HIV to their babies (i.e. mother to child transmission - MTCT) which can occur during pregnancy, at birth and through breastfeeding .... and then tasked with developing a strategy for the NGO to scale up services in a yet-to-be-determined African country to prevent it (hence PMTCT).

The background tragedy is that there are now hugely effective ways to do stop this transmission happening ... and frankly we barely see kids born with hiv here in the west anymore .... but despite the science and treatment being known, tried and tested .... less than 15% of women who need it most actually have access to this treatment .... leading to hundreds of thousands of babies born unnecessarily exposed and infected ..... so that today over 90% of all children infected with HIV were infected by their mothers ....

And so C and I have travelled to Zambia and Malawi for a couple of weeks to look at how these two countries are addressing the problem given their high rates of HIV infection and to see why a prevention issue that seems to be such a no-brainer on the face of it (much easier than abstinence or condoms .... plus its all about babies .... great pics for development pornographers .... etc etc) has seemingly been languishing as the cinderella programme of the HIV world ....