Born Free of HIV in West Africa

Living with HIV/AIDS remains a harsh reality for many in Mali. While HIV can be managed through the appropriate medication and frequent monitoring, very few Malians have access to care. UNAIDS has reported the following data for Mali:

• In 2016, Mali had 5,900 (3,800 - 8,600) new HIV infections and 6,100 (4,800 - 7,500) AIDS-related deaths.
• There were 110,000 (89,000 - 130,000) Malians living with HIV in 2016, among whom 35% (25% - 44%) were accessing antiretroviral therapy.
• Among pregnant women living with HIV, 35% (28% - 42%) were accessing treatment or prophylaxis to prevent transmission of HIV to their children. 
• An estimated 1600 (1100 - 2300) children were newly infected with HIV due to mother-to-child transmission.

GAIA Vaccine Foundation works in collaboration with our partner clinic and the regional department of health to bring care to those affected by HIV, AIDS and other infectious diseases in Sikoro, Mali. In 2005, GAIA established the "Chez Rosalie" Mother-to-Child Transmission Prevention program which introduced interventions to prevent HIV+ mothers from passing on HIV to their infants. Additionally, GAIA introduced free HIV testing at Hope Center Clinic and currently runs a "Teen Peer HIV Education" program and a "Nutrition and Peer Support for HIV+ Patients" program weekly. These activities have seen great success and no baby has been born HIV+ at Hope Center Clinic. 

In September, GAIA Vaccine Foundation’s Founder and Executive Director Dr. Annie De Groot traveled to Mali to work on the ground with GAIA’s local team. Part of the importance of this trip was to bring the supplies for GAIA’s pilot Pratt Pouch study to Mali. 

During the visit, Dr. De Groot met with GAIA’s dedicated team of physicians and pharmacists at the Hope Center Clinic and the ASACOBA clinics. She also met with members of the Regional Department of Health and other individuals who will be instrumental in carrying out the project. 

The Pratt Pouch, designed by a team of biomedical engineers from Duke University, is a small aluminum pouch in which the correct dosage of the antiretroviral drugs can be sealed, stored and then administered to babies immediately after birth. When HIV-positive women give birth at the Hope Center Clinic, health workers provide their newborn with the medications needed to prevent HIV transmission. This method is largely responsible for GAIA's 100% HIV-free birth rate at the Hope Center Clinic. 

However, it is more difficult to provide medication to HIV + pregnant women who, for geographical or financial reasons, give birth at home. GAIA intends to provide pre-filled Pratt Pouches and instructions to HIV + pregnant women, in anticipation of home deliveries, so that mothers can administer medication to their own baby immediately after birth. This will be an important first step in understanding the best way to prevent HIV transmission during home births in Mali.

The Pratt Pouch has been successfully tested in Zambia, Tanzania, Uganda and Ecuador. Currently, it has been implemented in the national protocol for the provision of antiretroviral therapy for infants in Uganda. However, GAIA’s pilot study will be the first in a West African or a francophone country. The Pratt Pouch is an economical, easy to use technology which eliminates the need for mothers to measure the dose of medication themselves and does not require cold storage. For home deliveries, mothers receive Pratt Pouches pre-packaged to treat their baby in the first 24 hours after birth. The Pratt Pouch ensures that drug doses are not missed or miscalculated, reducing the risks of potential exposure to HIV. The Pratt Pouch may be an innovative new technology that improves medication delivery for HIV-positive mothers. 

The pilot study aims to launch by the end of 2019. The data GAIA collects during this pilot study will be crucial to informing if the Pratt Pouch technology is feasible in Mali, and perhaps for other francophone and West African countries.

GAIA Vaccine Foundation believes all babies should be born HIV free. Your generous support to GAIA helps ensure that we will be able to continue our life-saving mother-to-child transmission programs and explore innovative new approaches to prevent HIV in Mali. 

Thank you for your support to GAIA and our partners in Mali!