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INVESTIGATING THE NATURAL WAY
TO PROTECT BABIES FROM HIV IN AFRICA
Wellcome Trust*
The global HIV/AIDS pandemic has reached staggering proportions and, at current rates, threatens to transcend all other health problems in the world. It is estimated that:
- World-wide more than 33 million people are HIV-infected, 95 percent of whom live in developing nations
- Around the world, six million people are newly infected each year, at a rate of 16,000 per day
- Each year, new-borns comprise 600,000 of the newly infected
More than 500,000 children die annually from AIDS
Now, Wellcome Trust researchers in South Africa say that breast could also be best in the fight against the spread of HIV to the next generation of
Africans.
Pioneering pilot studies are testing the theory that breast-feeding exclusively offers babies as much protection from HIV as using formula foods alone.
Professor Jerry Coovadia, who heads a research team at the Wellcome Trust's Africa Centre in KwaZulu Natal, said: "Provisional research suggests that safe breast-feeding may be possible. This challenges established thinking about maternal transmission of the HIV virus and provides real hope for the poor whose only realistic option is to breast-feed."
African mothers are often encouraged to use formula foods, like their Western counterparts, to avoid passing on HIV through breast-feeding. However, cultural factors, economic pressures and the stigma attached to HIV mean that many African women end up mixing breast-feeding with formula foods.
This, say the researchers, is the worst of both worlds because contaminated water used with formula foods may damage the infant's gut and, when breast-feeding takes place, the HIV virus may enter the baby's system. However, they argue, breast-feeding exclusively may carry no greater risk of HIV transmission than using formula foods alone.
Professor Coovadia said: "If more extensive research proves that exclusive breast-feeding is no more risky than formula feeding, this has profound implications for preventing the spread
of HIV in Africa and the developing world. As well as the many advantages of exclusive breast-feeding - its cultural appropriateness, simplicity and well-documented health benefits - another major plus is that breast milk is free."
Preventing mother-to-child transmission of HIV is widely recognized as a crucial part of the overall fight against AIDS. The World Health Organisation estimates that nine in ten of the 570,000 children infected with HIV last year were born to women with HIV. The majority of these cases happened in sub-Saharan Africa.
Progress has been made by providing the drug Nevirapine for mother and baby at birth, which reduces infection at delivery by half. However, because many mothers combine formula foods with breast milk, maternal transmission rates remain high.
Recent small-scale studies have shown that safe breast-feeding may be more realistic than previously thought. The Wellcome Trust is now considering funding a fully-fledged three year investigation involving around 2000 women with HIV, which would cost around £3 million and be the largest study of its kind in the world.
Wellcome Trust Scientific Programme Manager Dr Wendy Ewart said: "There is a pressing need for this type of grassroots research and the Wellcome Trust was pleased to fund the pilot studies. It is vital that bio-medical science comes face-to-face with the reality of life for poor communities in order to find effective solutions which are culturally sensitive and don't cost the earth."
Professor Jerry Coovadia is a prominent leader in
the fight against HIV/AIDS and one of the joint winners of The Nelson Mandela
Award for Health and Human Rights.
*The Wellcome Trust is the world's largest independent medical research charity. It funds biomedical research, supporting more than 5000 researchers at 300 locations in 42 different countries, and seeks to ensure that the potential healthcare benefits of this research are fully realised. Much of the Trust's international research is aimed at tackling infectious and non-communicable diseases prevalent in the developing world. Working in partnership with local government and other organisations, the Trust supports research into basic and clinical biomedicine, veterinary science and into social and demographic change.
*In KwaZulu Natal, where the Trust has established its Africa Centre, up to a third of the sexually active population is infected with HIV. The Wellcome Trust's Africa Centre for Population studies and Reproductive Health is a joint initiative between the Wellcome Trust, the University of Natal, the University of Durban-Westville and the South African Medical Research Council. Its Director, Michael Bennish, was appointed in 1999.
Based in the Hlabisa district of KwaZulu in the Natal province of South Africa, the Centre is tackling some of the most pressing health issues in Sub-Saharan Africa, including sexually transmitted diseases, high fertility, and maternal and child mortality, as well as HIV infection. Its close connection with the surrounding rural community is a key element in its research projects.
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