In a sign of hope on a continent ravaged by AIDS, a South African fertility clinic has started a service allowing couples infected with the virus to have a healthy baby.
The Cape Fertility Clinic is the first in Africa to open a laboratory for HIV-positive patients, enabling them to conceive and give birth to HIV-negative babies by using procedures such as in-vitro fertilization.
"HIV is no longer seen as a death sentence but a chronic disease," says Klaus Wiswedel, one of the clinic's directors. "And people with chronic diseases are entitled to have fertility treatment. We can safely deliver an HIV negative child and, with the right treatment, the parent can live a long life."
About five or six couples, with either one or both partners carrying the AIDS virus, visit the clinic every month. It is only for the favored few with enough money to pay for fertility treatment and is a drop in the ocean compared to the huge numbers of infected people.
But it is a small symbol that, after years of despair, Africa is making progress in protecting unborn child from AIDS — and in prolonging the life of the parents.
About 2 million people are receiving lifesaving antiretroviral medicines in Africa, which bears the brunt of the AIDS epidemic, up from 100,000 in 2003.
This has been accompanied by a dramatic increase in the number of pregnant women receiving drugs to stop them from passing the HIV virus to their children. According to a U.N. report on "Children and AIDS" published for World AIDS Day, the number of pregnant women getting therapy in low and middle income countries has tripled in the past three years.
Striking gains
For some countries the gains have been even more striking, thanks to an increase in donor interest and funding.
In dirt-poor Malawi and Lesotho, less than 5 percent of pregnant women infected with the AIDS virus got drugs to protect their unborn babies in 2003. This increased to 32 percent in 2007, according to the report, which was prepared by UNICEF, the World Health Organization, UNAIDS and the U.N. Population Fund.
In Mozambique the proportion of pregnant women on therapy increased from 3 percent to 46 percent; in Uganda from 9 percent to 34 percent; in Swaziland from 5 percent to 67 percent; in Zambia 18 percent to 47 percent and in South Africa from 15 percent to 67 percent, the report says.
Even stricken Zimbabwe, where the health service has collapsed, managed an increase from 8 percent to 29 percent. In Botswana, which has one of the highest AIDS rates in the world but has enough resources and commitment to provide treatment, 95 percent of HIV positive pregnant women were given antiretroviral drugs to protect their children in 2007.
"The prevention of mother-to-child transmission of HIV is not only effective, but also a human right," said UNAIDS Executive Director Dr. Peter Piot, "We are seeing good progress in many countries, especially in parts of Africa, but we need to significantly scale up HIV testing and treatment for pregnant women."
The standard advice given to men and women who are infected with the AIDS virus is to avoid unprotected sexual intercourse. But the Cape fertility clinic's Wiswedel says this should not deny stable couples the right to have a child.
If the woman is HIV-positive but her partner is free of the virus, the procedure is artificial insemination, Wiswedel says. If the man is HIV positive, then the sperm has to be cleansed of the virus, he says. The clinic has a separate HIV laboratory to make sure there is no risk of passing infection to its other clients. Once pregnant, an HIV positive woman has to be followed by an HIV specialist and has to have a Caesarean delivery to reduce the risk of transmission to the infant.
Some clinics in the United States and Europe have offered such treatment for years. But in Africa, the Cape Town laboratory is a first. Wiswedel says couples have come to him from all over the continent and he expects their numbers to increase.
"We jumped into the deep end of the pool because more and more patients want to receive treatment," he says. We saw a huge need for this."
