Alzira Mendes went to the Munhava health center in her neighborhood in Mozambique's port city of Beira, Sofala Province, in February 2003 for her first antenatal checkup. A 29-year-old widow, Alzira was six months pregnant with her third child. During her visit, the nurses gave her information about HIV and about a new program to prevent mother-to-child transmission funded by the President's Emergency Plan.

Alzira had heard about HIV before this visit. In 2002, overall HIV prevalence in Sofala was 26.5 percent, but prevalence among pregnant women in Beira ranged from 27 to 35 percent. Alzira had never been tested, but she decided it was important for her and her baby to know about her HIV status.

While nurse Flora Vaz administered an HIV test, she counseled Alzira about HIV transmission and prevention, as well as the significance of the test. Nurse Vaz had Alzira's results within a short time.

Upon hearing that she was HIV positive, Alzira's first thought was for her baby: Could she prevent the transmission of HIV to her child? Nurse Vaz explained that to reduce the chance of transmitting HIV to a child, an HIV-positive woman should come to the maternity ward upon the onset of labor and take nevirapine, a drug used in HIV treatment. The baby also should receive one dose of nevirapine within 72 hours of birth. Alzira was happy to enter this program to improve the health of her baby. Nurse Vaz also referred Alzira to the Day Hospital at the Beira Central Hospital, which provides care and treatment for HIV-positive persons.

During the final three months of her pregnancy, Alzira participated in a "Positive Mothers" group at the Prevention of Mother-to-Child Transmission program in Munhava. During weekly meetings, Alzira and other HIV-positive pregnant women received information and counseling about breastfeeding, nutrition, preparing food for their babies, social constraints when living with HIV, stigma, and the importance of having their partners tested. Participants also received food supplements.

Alzira's labor began early one morning in May. She immediately went to the health center, received nevirapine, and after a few hours of labor, delivered a baby boy, Apolin�rio, who also received nevirapine. Following the birth, Alzira and Apolin�rio joined a support group for HIV-positive mothers and their babies at the health center, and they continued to go to the Day Hospital for care.

When Apolin�rio was five months old, the Day Hospital tested him to determine his HIV status. Alzira cried with joy and relief when she heard that his test was negative, indicating that her baby was not likely to be infected. Since Alzira is not breastfeeding, there is an excellent chance that her son still will prove HIV-negative at 18 months, when a conclusive antibody test can be done. Because of her participation in the preventive program, Alzira has given her son an opportunity for a life without HIV.

This program to prevent mother-to-child transmission of HIV/AIDS is fully integrated within the Mozambican public health services and operated with U.S. funds by Health Alliance International, a U.S.-based nonprofit private organization. With Emergency Plan funding in 2004, Health Alliance International was able to offer the program's integrated prevention services at 12 new sites, treating about 3,000 pregnant women and their newborns to avert new HIV infections, and providing new hope and services to thousands of Mozambicans like Alzira and Apolinário.

The United States launched its International Mother and Child HIV Prevention Initiative in 2002, to make programs like the one above possible. The initiative, now integrated into the President's Emergency Plan, targets countries in Africa, Asia, and the Caribbean, committing $500 million over five years. The current target countries include Botswana, Cote d'Ivoire, Ethiopia, Guyana, Haiti, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda, Vietnam, and Zambia, as well as participants in a Caribbean regional program. The Emergency Plan is already changing the shape of HIV prevention and treatment in these countries. Since its inception, country capacity has improved significantly; countries that were previously thought to be incapable of providing antiretroviral treatment are scaling up programs that reach pregnant women, their children, and families.

In Mozambique — a country twice the size of the state of California, with a population of 18 million and a national HIV prevalence rate of 13.6 percent — U.S. funding in 2004 has enabled the Ministry of Health to roll out preventive services in 31 new sites, reaching 64,000 additional pregnant women and treating about 4,200 HIV-positive women and their newborns.

Promoting Economic Opportunities for Women »»