An African model of care for HIV positive pregnant women: the new challenge is to give birth to healthy children and save the lives of their mothers, reaching also in Africa the goal of zero new infections.
The representatives from 13 African countries have well thought-out these issues. In fact, from 11 to 14 March was held in Maputo the first international seminar titled Towards an AIDS-free generation.
The seminar, organized by the Program DREAM of the Community of Sant’Egidio in cooperation with the Ministry of Health of Mozambique, counted upon the participation of experts from the various ministries of health in Africa, as well as of representatives of the scientific community from Europe and the United States.

Everything stems from the possibility to extend therapy for the mother to child prevention in all HIV positive women in pregnancy for life. In fact, in April 2012, the WHO published an update that adds a third option to the existing guidelines for the prevention of the transmission of the virus in pregnant women who do not meet the criteria to initiate therapy: the option B+, administration of triple therapy for life to all HIV-positive pregnant women.

This option has several advantages: simplify programs of mother-to-child prevention; extend the protection of the therapy also for future pregnancies; prevent the sexual transmission in discordant couples; bring benefits for the health of mothers avoiding the risk associated with constant interruptions and filming of the therapy, particularly in regions with high fertility rates.

Is all this possible in Africa? In 11 years of life, DREAM has proved that yes, it is possible: it has brought excellence also in Africa, the excellence of the diagnostic with its laboratories of molecular biology and the excellence of care with triple therapy. During these days the DREAM model was presented with the results achieved not only in terms of children born healthy from the vertical prevention program (more than 22.000) but also those of adherence and loyalty to a treatment program with a lifelong duration. The holistic approach of the program was emphasized, placing the patient at the center and offering pregnant women, who discover to be ill in such a delicate moment of their lives, not only the therapy but also the social and psychological support.

As mentioned at the opening of the proceedings, “the success of the DREAM program is linked to the ability to demonstrate that also in Africa, even in the poorest and most remote rural, peripheral and more inaccessible areas it is possible to make diagnosis and provide qualitative treatment”. Dulce, a Mozambican HIV positive woman, testified in her own words what it means to give birth to a healthy baby when all those around you say that you just have to wait for death: “When I was told that my baby was seronegative I burst into tears. Vertical prevention has worked and my child was healthy!”. Hence she decided to vote her life to help others, working as an activist of the DREAM program in Maputo.

Today we wish to transmit this excellence to other African countries.
The superiority of the antiretroviral triple therapy compared to the monotherapy is now fully recognized by the world’s scientific community. The B/B+ options are the most effective in reducing the rate of HIV transmission from mother to child during pregnancy and lactation, but also in reducing maternal and child mortality reaching the same levels of the non infected population.

The representatives of the different African countries have brought their contribution to a dialogue which was very constructive, recognizing the need to include in such model specific essential and indispensable points: free care, holistic approach to the patient, integration of the services for the prevention of the transmission from mother to child of the HIV virus within the prenatal care services, peer to peer education to help women to accept their new state of HIV + by promoting adherence to the protocol, early diagnosis of the HIV infection in newborns through laboratory testing, nutritional support to mothers and children, to ensure that medication is always available.

All participants come from these days strengthened and encouraged in their work to combat AIDS, bringing in their own countries the proposal of an achievable dream: together it is possible to give rise to a generation free of HIV, saving the children and their mothers.