By Laura Reaney, Key Correspondent for the Irish Forum for Global Health
We may all be born equal, but those born to mothers with HIV in less highly-developed countries are at a disadvantage before they take their first breath.
I work in a maternity hospital in inner city Dublin, where I come across babies of HIV positive mothers on a fairly regular basis – once a week at least. It’s a routine process. Their mother has almost certainly been carefully managed during her pregnancy with the appropriate antiretrovirals. She will have had her bloods regularly checked for her CD4 count and viral load. When the baby is born, they are bathed and vaccinated against Hepatitis B, have bloods taken and are started on zidovudine. Breastfeeding, another potential means of transmission, is avoided. The baby is linked in with a specialised paediatric infectious disease team who follows their progress until they have been proven to be HIV negative, as is nearly always the case. It’s a safely well-worn path that ensures that the risk of vertical transmission in Ireland is less than 1%.
What a different story it is for the baby born to a HIV positive mum on the same day in a country in East or Southern Africa. There’s a one in four chance that the mother didn’t have access to antiretrovirals during her pregnancy, increasing her baby’s chance of contracting HIV antenatally or during birth to up to 40%. Bottle-feeding may not be an option if access to clean water is a problem. Our Dublin-born baby will have their bloods checked at birth, at two weeks and again at six weeks. Worldwide, if a baby gets tested for HIV before the recommended two months of age they are in the lucky half. Of those who are unfortunate to have contracted HIV from their mother, half again will not have access to essential antiretroviral treatment.
It’s easy for me to forget, in a country where access to specialist care and essential medicines is guaranteed for the handful of children living here with HIV, that globally 290 children die daily from AIDS related diseases. Here’s hope though: these numbers are far less damning than they have been in the not-so-distant past. The annual number of AIDS-related deaths in children under four worldwide has fallen by an astounding 70% since 2000. There’s something to hold onto – and inspiration to keep narrowing the gap.
Inequality grates on us all, but surely never more so than when it begins before life itself.
Laura graduated with a medical degree from University College Cork in 2015 and is currently working as a junior doctor training in paediatrics. She has a keen interest in social justice and global health matters, particularly in relation to children’s rights. Laura’s other passions include breakfast, beaches and writing bad poetry.