By: Taisiah K. Merfee
Fellow, AAMIN Health and Human Rights Journalism Fellowship
Liberia: In 2000, member states of the United Nations committed to Millennium Development Goals (MDG) 4, 5, and 6 on health for women and children: to reduce child mortality, improve maternal health, halt and begin to reverse the spread of HIV and AIDS by 2015.
At the United Nations General Assembly Special Session on HIV and AIDS (UNGASS) in 2001, member states further committed to reduce the proportion of infants infected by HIV by 20% by 2005 and 50% by 2010, and ensuring 80% of pregnant women accessing antenatal care should receive information, preventive services and treatment to reduce mother-to-child transmission of HIV.
Preventing Mother-To-Child Transmission (PMCT) was officially introduced in Liberia in 2005, at the time the country was recovering from years of civil war. Since that time, Liberia has recorded huge success in the West African region in preventing HIV positive mothers from transmitting the virus to their unborn babies.
In 2018, Liberia reported that 93% of pregnant women living with HIV received antiretroviral medicine to reduce the risk of mother-to-child transmission of HIV.
From that year till now, Liberia remains one of the few countries in the West African region that has successfully scaled up Prevention of Mother to-child Transmission (PMTCT) coverage to over 90%, according to the National AIDS and STIs Program (NACP). NACP said one of the driving forces in the Country’s success is the integration of PMTCT services with routine health services at health facilities.
Amidst this success story, it is reported that Early Infant Diagnosis (EID), supply of cartridges, sample collection, sample transport, viral load testing, low service access for men, children and adolescents, lost to follow up, denial and poor treatment adherence, remain pervasive challenges in eliminating HIV transmission from mother to-child in Liberia.
An NACP update disclosed that that only 15% of children born to HIV positive mothers received virologic testing within 2 months of birth.
In an interview with Anti-AIDS Media Network specialized health and human rights reporters in Sinkor, the Program Manager of the National AIDS and STI Control Program (NACP), Dr. Julia Toomey-Garbo did not hold back her feelings in disclosing that lack of domestic budgetary support is one key factor undermining the national HIV response.
“Financial support is not really coming from the government to fight HIV and AIDS in Liberia. As an institution we always been given commitment, but when time comes for the financial support… there is no support, Dr. Toomey-Garbo said.”
Dr. Julia Toomey-Garbo: “The Government of Liberia needs to do more if we are to end AIDS in Liberia by 2030. There has been lot of achievements made so far, looking at where we came from as a Country since 2005 up to present when it comes to the Prevention of Mother to-child Transmission (PMTCT)”.
She indicated that huge level of stigma and discrimination still exist in Liberia against persons living with HIV ( PLHIV) from family members , friends, community members and the general population, which said is posing serious challenge in the fight against HIV and AIDS the country.
Dr. Toomey- Garbo wants policymakers and state actors to end societal stigma and discrimination if progress must be accelerated and sustained to end AIDS by 2030 as envisioned by the world body.
She said “We should double our effort to educate people who discriminate to change their behaviors toward persons living with HIV and key populations. It is time we tell people that HIV is not a death sentence, drugs are available for treatment…. so let us all put hands on desk to fight HIV and AIDS.”
Dr. Toomey-Garbo disclosed that there are drugs available in the county for children who are born HIV positive from six months since the inception of the program.
“Since 2005, the National AIDS Control Program in collaboration with other partners has over the years ensured the deployment of over 500 PMTCT sites at various hospitals and over 400 facilities providing PMTCT services throughout the Country,” Dr. Toomey-Garbo said.
According to Dr. Toomey-Garbo, NACP which is being provided financial support by Global Fund is present in all of the 15 counties helping 90% of health facilities providing services to people living with HIV and key populations.
Speaking further on the PMTCT program in Liberia, Madam Josephine Godoe and Wokie Cole, President and Executive Director respectively of the Liberia Network of Persons Living with HIV, urged the Liberian Government to be practical in ensuring domestic budget support to maintain and improve on the gains made in the national HIV response.
“Before the coming of the PMTCT program in 2005, things were not good for us as a country, more children were tested positive of the virus due to lack of information on the part of positive mothers. People who were tested positive did not have information specifically about their CD4 count…..whether it was low or not. At that time we had more babies born with HIV, Wokie said”.
Wokie said, “There has been more progress made since the introduction of the PMTCT program. I am a living witness; many positive mothers are today having their babies free of HIV as a result of this program as well as improved education.”
For her part, Josephine Godoe, Executive Director of LibNeP+ thinks that the only guarantee for Liberia to achieve the strategy to end AIDS by 2030 is to encourage collective partnership and involve individuals and institutions who matter in the national HIV response.
“We need to get the men who are our husbands involved to do their test. For the women, HIV test is mandatory once you are pregnant, which makes it easy to protect the unborn baby from getting infected, Josephine said”.