Over the past 10 years there have been significant advances in the field of prevention of mother to child transmission of HIV. The international scientific community now recognizes the superiority of triple antiretroviral therapy compared to the mono-or bi-therapy. The options B / B + appear to be able to obtain rates of vertical transmission of less than 5% at 18-24 months of age of the child. Respect to the first one, the second option (B+) offers the advantage of not needing the count of the numerosity of CD4. During pregnancy, HIV-positive women would be put under therapy without the need to make tests about the state of their immune system. This would allow not only to prevent HIV infection in children, but also to deal promptly with the mothers, improving their health and preventing mortality. This is what was declared at the “Maputo Initiative”, an agreement that was reached between the representatives of the ministries of health in sub-Saharan Africa during the workshop organized in March by the DREAM program of the Community of Sant'Egidio.
After Malawi, Mozambique has also begun the implementation of Option B + to HIV-positive pregnant women. The first province to be taken into consideration was that of Gaza.
The intervention in the Province of Gaza is particularly significant if we consider that it is the province of Mozambique with the highest HIV prevalence (25.1% among adults, 33% of pregnant women according to data from UNAIDS, 2012). In addition, due to Cyclone Eline and torrential rains, the area has suffered recently the flooding of the Limpopo River that devastated the province and in particular the town of Chokwe. Over 140,000 people have been displaced. Some of these people poured in the areas of the health centers of Macia and Chicumbane which, being located at a higher altitude, have not been affected by the floods.
The work in this province has relied and still relies in the support of the DREAM program, as established by the agreement made in July 2011 between the Mozambican Ministry of Health (MISAU) and the Community of Sant'Egidio. DREAM health workers in February have in fact held training courses, through a team consisting of doctors, nurses, activists and computer technicians. The medical staff thus formed began the implementation in the area of quality treatment for the prevention of mother to child transmission.
Since February, the centers have begun to make HIV testing to all pregnant women. All those who tested positive have begun treatment for the prevention of vertical transmission, according to the DREAM protocol, following the Option B + WHO. Early diagnosis and quality treatment (triple antiretroviral therapy to all HIV-positive women during pregnancy), looking at women's health and that of children, become a true prevention in the fight against AIDS. The first results can already be seen: in fact, the first children were born from the vertical prevention program. In this context, important is the collaboration with the German AIDS Foundation, which since 2005 supports the DREAM program in Mozambique in the prevention of vertical transmission. These days, a delegation led by the President of the Foundation, visited the Health Centers of Macia and Chicumbane. The National Coordinator of DREAM was able to demonstrate the encouraging results achieved in recent months. The intervention of Gaza represents a step towards achieving the goal of eliminating the infection in children keeping their mothers alive, to be able to reach also in Mozambique a 90% reduction of infection among newborns by 2015.