A New Scientific Report Says There Is An Increase Of HIV/AIDS Infection Among Young Gambian Women Between The Ages Of 15 And 24!

“The highest site specific HIV prevalence of 2.7% was recorded in Fajikunda Health Centre in the Kanifing Municipality. Based on the prevalence figures the estimated number of PLHIV in the country in 2011 is therefore projected to be 21,224; with the West Coast Health Region having over 11,485, representing 39% of the total number of PLHIVs.  There has not been any HIV prevalence study in the general population or children or young persons in recent times,” reported intimated.

The prevalence of HIV in the Gambia is estimated using results from the National Sentinel Surveillance (NSS) conducted among antenatal women.  According to the 2011 NSS study conducted among 6120 antenatal women in 12 health facilities (3 hospitals and 9 health centres), the prevalence of HIV-1 is estimated at 1.65% and HIV-2 at 0.07%.  Over the years the prevalence within the antenatal women has been fluctuating from 1.4% for HIV-1 in 2002 and peaking at 2.8% in 2006 and showing a sustained decline for the subsequent years 2007, 2008 and 2011^5,6. 

In The Gambia the first case of Human Immuno-deficiency Virus (HIV) was diagnosed in May 1986. Since then there has been on-going efforts to combat the spread of HIV infection. The HIV epidemic includes both HIV-1 and HIV-2, although the former appears to be increasing while the latter is decreasing.

According to the report, which is in the possession of the Freedom Newspaper Editors, the Gambia has a population of 1.78 million people. Out of the country’s population, close to thirty thousand Gambians have been infected with HIV/Aids.Estimated number of people needing ART  6,294^e, while HIV prevalence among pregnant women (1.67%) ^f. HIV positive pregnant women giving birth in 2011, 1317^,the report hinted.

It has been estimated that “HIV positive pregnant women receiving ARVs for PMTCT by 2011 stood at 62.0%, 817,”  while an estimated transmission rate 9.4% has been recorded.

The most scary part of the scientific findings revealed that an estimated number of children (<15 years) living with HIV stood at : 1400^e. , whilst there is an increase among HIV positive pregnant women giving birth in 2011,. The number of infected pregnant women tested positive for HIV is 1317, the report says.  Below is the HIV/Aids statistical infection data:

HIV/AIDS data

·        Number of people living with HIV/AIDS:  21,224e

·        Estimated number of people needing ART  6,294^e

·        HIV prevalence among pregnant women (1.67%) ^f

·        HIV positive pregnant women giving birth in 2011, 1317^b,f

·        HIV positive pregnant women receiving ARVs for PMTCT by 2011 62.0%, 817^g

·        Estimated transmission rate 9.4% ^h

·        Estimated number of children (<15 years) living with HIV: 1400

The report also talked about the financial cost involved in fighting the HIV/Aids epidemic in the Gambia. The majority of funds comes from the Global aids fund and UNAIDS. UNAIDS has closed its offices in the Gambia recently.

Table 1.4: Allocation of Government Spending by category, Dalasis (,000)

Source: Government of The Gambia Estimate of Revenue and Expenditure for 2010 and 2011

Donor funding on the other hand focuses on both recurrent and development, with an emphasis on development. Programs like the eMTCT mostly donor funded, with government providing a subvention (in the form of salaries and general operating expenditure) to the agencies working in the program.      

1.1    Government response and achievements

1.1.1       Political leadership and commitment

Since 2004 the prevention of mother-to-child transmission of HIV has been at the forefront of national HIV prevention activities, according to the PMTCT Strategic Plan. This commitment was further boosted when on July 21st, 2010 the First Lady launched the campaign for the acceleration of PMTCT. The launching was financed by the office of the First Lady. The ceremony also commemorated the attainment of 70,000 antenatal women tested under the PMTCT programme.

In 2011, Gambia participated in the UN High Level meeting in which the new UNAIDS strategy‐Getting to Zero 2011‐2015 (Zero new Infections, Zero AIDS related deaths, Zero Stigma and discrimination) where Global Plan on E-MTCT was launched.  

Recently the senior management of NAS had an audience with the Vice President, and is in contact with the First Lady.  In January 2013 the Organization of African First Ladies Against AIDS (OAFLAA) will be organizing a conference in Addis Ababa, Ethiopia.  The participation of the country’s First Lady will again be an indication of high level political support and commitment to the national HIV/AIDS response.

1.1.2      The strategic context

The MOHSW is focused on revitalizing the Primary Health Care (PHC) Approach to address the health needs of the nation. This is a key area of priority in the Health Policy of Gambia (2012-2020), “Health is Wealth”. This national health policy becomes a reality only when a healthy population can contribute to improved productivity, increased GDP and sustained economic growth and overall ensure social equilibrium, backed by resources effectively applied to community and primary care levels of the health system as “an entry point to wider PHC oriented changes”. In this context the health policy identifies three important objectives of the health system in Gambia – (i) to keep as many people as possible in good health in the community through health protection, health promotion and disease prevention strategies, (ii) to provide appropriate quality services for those needing care in the community and (iii) to provide high quality health centre & hospital services at the appropriate level for those few requiring that form of treatment and care.

The MoHSW has continued to build an impressive framework for improving the health for all, including maternal and neonatal health. This has included a wide range of strategies such as National Reproductive and Child Health Programme Strategic Framework and Plan and PMTCT strategic plan 2010-2015.

A new national strategic framework 2009 – 2014 to guide the HIV/AIDS response in the country has also been developed. The overall approach and strategic direction of the new framework is to establish PMTCT services in all public, private and NGO health facilities conducting RCH clinics and to extend such services at the outreach clinics. The involvement of males and communities will be a new thrust to the programme intervention.

The country’s erratic and controversial President Yahya Jammeh has been accused of being responsible for the nation’s rising HIV/Aids infection rate. Jammeh has claimed that he has been given the mandate to cure HIV. He said he has discovered the cure for the disease. Jammeh uses Bananas, herbs and peanuts to cure aids patients in the Gambia. 
2008.  A trend analysis of the data, however, seems to indicate that the prevalence is declining in the older women’s group and increasing in the younger women, 15-24 years.

The highest site specific HIV prevalence of 2.7% was recorded in Fajikunda Health Centre in the Kanifing Municipality. Based on the prevalence figures the estimated number of PLHIV in the country in 2011 is therefore projected to be 21,224; with the West Coast Health Region having over 11,485, representing 39% of the total number of PLHIVs.  There has not been any HIV prevalence study in the general population or children or young persons in recent times. 

1.1.3      PMTCT Funding

The PMTCT program is mainly funded by the Global fund and UN agencies. The Government of The Gambia also provide basic financial support in the form of subventions to the different departments that work within the PMTCT program (RCH, NPS, NAS, etc). the subventions are mainly in the form of salaries, allowances and some operating expenses. The funding by Government makes up a small proportion of the total expenditure on the PMTCT program. The bulk of the funding is done by the Global Fund, which funds, trainings, drugs and other medical equipment. The funding of training for health personnel and the upgrading and refurbishment of existing health facilities that offer PMTCT falls under the Health systems Strengthening project. 

1.1.1       Conclusion

Despite commendable efforts by The Gambia to scale up PMTCT services, EID is still not offered. This analysis has enumerated a number of bottlenecks that hinders effective implementation of PMTC services. Most of the bottlenecks are related to low capacity of the national system to deliver necessary services to all women of child bearing age including HIV positive pregnant mother. The analysis results also point to weak community systems and engagement in ensuring access to eMTCT services. These bottlenecks can potentially hinder the national and global efforts to eliminate MTCT by year 2015.

To enhance the current system and ensure effective implementation of the national PMTCT programme to achieve the eMTCT goal, national and global best practices needs to be instituted or strengthened. The programmatic goal should be to increase the capacity of the current system to adequately provide appropriate services to all clients who make contacts to the facility including plans for follow up. At the community level, efforts to increase awareness and meaningful engagement of communities, family and men in eMTCT will be critical.

1.2   Strategies to overcome bottlenecks

The bottlenecks are formed by both supply and demand determinants. A root cause analysis done by the task team, FGDs and key informant interviews (Annex I) done to clients including male partners and service providers provided an insight to the causes of the bottlenecks. This facilitated the formulation of the strategies as per Annex II.

2.    Rationale for the eMTCT plan

The major route of HIV transmission in The Gambia is through heterosexual contact. The transmission of HIV from mother to child is the main mode of spread of the infection to children. In view of this, it is therefore, essential to regularly review and update strategies and programmes of prevention of Mother-to-Child Transmission (PMTCT) with the aim of improving the overall effort towards reduction of further spread of HIV in The Gambia.

The experience gained by the PMTCT strategic plan for scaling up PMTCT in The Gambia and the commitment demonstrated by the highest political leadership in the country and the policy frameworks provide a supportive platform for the development of this eMTCT plan. This has led concerted efforts to align national goals with the global initiative and plan to achieve virtual elimination (eMTCT) by 2015.

One of the key challenges faced by countries has been lack of sufficient information to assist countries in proper planning and realistic costing of PMTCT programme plans. It is against this background that this plan was developed through the process of identifying bottlenecks to virtual elimination of MTCT of HIV and estimating the cost for responding to the identified bottlenecks. The process involved review of national strategies, guidelines and reports, consultative meetings with key informants, experts, target audiences and other stakeholders.

The country’s erratic and controversial President Yahya Jammeh has been accused of being responsible for the nation’s rising HIV/Aids infection rate. Jammeh has claimed that he has been given the mandate to cure HIV. He said he has discovered the cure for the disease. Jammeh uses the Koran, Bananas, herbs and peanuts to cure aids patients in the Gambia.

Posted on Monday, September 30, 2013 (Archive on Saturday, November 30, 2013)
Posted by PNMBAI  Contributed by PNMBAI

From: http://www.freedomnewspaper.com/Homepage/tabid/36/newsid367/9110/Breaking-News-A-New-Scientific-Report-Says-There-Is-An-Increase-Of-HIVAIDS-Infection-Among-Young-Gambian-Women-Between-The-Ages-Of-15-And-24/Default.aspx