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Mailman School-Led MTCT-Plus Initiative Commits $50 Million for HIV Treatment in Eight Countries

By Randee Sacks and Laura Efros

Columbia's Mailman School of Public Health and a coalition of private foundations are moving forward with the MTCT-Plus Initiative, the first major multi-country, family-centered AIDS treatment program for developing countries. MTCT-Plus announced its first round of 12 grants for HIV care and treatment -- including antiretroviral therapy -- for infected mothers, children, and other family members at 40 sites in eight African and Asian countries. The program will build on existing programs to prevent mother-to-child transmission (MTCT) of HIV.

MTCT-Plus will commit $50 million to provide life-long care and treatment to more than 10,000 women, children, and other family members. In the first phase, the 12 grantees will receive more than $9 million directly and, in addition, will receive a variety of other support, including antiretroviral drugs, drugs for complications of AIDS, training and other technical assistance, and a commitment to treat enrolled clients for as long as they live.

"MTCT-Plus can and will demonstrate that HIV treatment can be done in the poorest countries," said Allan Rosenfield, dean of Columbia's Mailman School of Public Health. "Our aim is to save thousands of lives now and develop a family-centered care model that can be replicated by others around the world."

MTCT-Plus will provide resources for care, treatment and support services for infected women and families, including:

- A package of services that includes education, counseling, support, prophylaxis and treatment of HIV.
- Psychosocial support, patient education, and counseling.
- Support for community outreach and education, and linkages to local organizations and resources.
- Procurement and delivery of antiretroviral therapy and other treatments for related HIV complications.
- Training, technical assistance, laboratory support, site monitoring, and other support services.

Mothers and children are suffering the heaviest toll with HIV/AIDS, particularly in sub-Saharan Africa. Each year, more than 2.5 million women become infected, more than 500,000 transmit the virus to their infants and more than 1.5 million women die each year from AIDS. Groundbreaking progress has been made in the prevention of mother-to-child transmission. However, these programs offer no HIV care for the mothers themselves. The tragedy is that most of the children saved by MTCT programs are likely to be motherless by the time they can walk.

"MTCT-Plus is an major step towards bridging the gap in access to care, treatment, and support," said Peter Piot, executive director of the Joint UN Program on HIV/AIDS (UNAIDS). "The challenge, now, is to mobilize the necessary resources so that this program can be expanded and tens of thousands of mothers, fathers, and children can face the future with hope."

The MTCT-Plus partners are very pleased and encouraged that on June 26, the United States Senate Committee on Health, Labor, Education and Pensions favorably reported legislation that includes a provision setting aside $75 million over two years for MTCT-Plus efforts. Rapid expansion of this MTCT-Plus effort is critical in order to bring the program to the many more in need around the world.

MTCT-Plus is breaking new ground by linking prevention to treatment on a large scale in resource-poor settings. Women participating in efforts to prevent mother-to-child transmission of HIV will now get treatment for themselves and their families. Based at the Mailman School of Public Health and under the leadership of Rosenfield and Wafaa El-Sadr, MTCT-Plus will extend life-long treatment to infected mothers -- saving thousands of women now and preventing thousands of children from becoming orphans in the future.

MTCT-Plus is the result of an unprecedented collaboration of private foundations. The initiative is supported by a coalition of nine foundations: Bill & Melinda Gates, William and Flora Hewlett, Robert Wood Johnson, Henry J. Kaiser Family, John D. and Catherine T. MacArthur, David and Lucille Packard, Rockefeller, Starr and the United Nations Foundations. MTCT-Plus was launched at a meeting of leaders of private foundations with UN Secretary General Kofi Annan in December 2001 and expects to mobilize $100 million from the community of foundations.

"This initiative brings together many partners in an ambitious and comprehensive approach to provide care to families affected by HIV/AIDS." said Helene Gayle, director of HIV/AIDS & TB for the Bill & Melinda Gates Foundation. "By stopping mother-to-child transmission and offering treatment to parents living with HIV/AIDS, this program will help ensure thousands of children grow up nurtured and cared for by their families."

The first MTCT-Plus grantees, by country, are:

- Cote d'Ivoire: Formation Sanitaire Urbaine de Yopougon-Attie, Abidjan
- Kenya: Moi Teaching and Referral Hospital/Mosoriot Rural Health Center, Eldoret; Nyanza Provincial General Hospital, Kisumu
- Mozambique: Beira and Chimoio Health Centers
- Rwanda: Treatment and Research AIDS Center/Kigali Health Centers
- South Africa: Khayelitsha Clinics, Capetown; University of Natal; University of Witwatersrand
- Thailand: Thai Red Cross AIDS Research Center, Bangkok/selected provincial hospitals
- Uganda: St Francis-Nsambya Hospital, Kampala; Mulago Hospital, Kampala
- Zambia: Chelstone and Mtendere Clinics, Lusaka

Published: Jul 12, 2002
Last modified: Sep 18, 2002

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