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85 Cents at a Time: Saving Lives and Fighting HIV

After diagnosing the first pediatric case of HIV in Uganda, Dr. Ammann has devoted much of his professional life to combating this deadly virus.

Published November 1, 2002

By Fred Moreno, Dan Van Atta, and Jennifer Tang
Academy Contributors

Image courtesy of salomonus_ via stock.adobe.com.

More than 2000 infants around the world are infected with HIV every day. In sub-Saharan Africa alone up to 46 percent of pregnant women carry the virus, and some 25 to 35 percent of their children will be born infected.

Arthur J. Ammann, MD, is succeeding in improving those statistics. As President of Global Strategies for HIV Prevention, Ammann oversees the Save a Life program, which provides HIV testing and medication to prevent HIV transmission from pregnant women to their infants in Africa, Asia and South America.

At the heart of the program is the antiretroviral drug nevirapine. Giving a single tablet of nevirapine to a woman during labor and delivery together with a single dose of nevirapine syrup to her newborn reduces HIV transmission by 50 percent. Moreover, in many countries the cost of treatment is as little as 85 cents for both mother and child. The program has helped some 50,000 women and infants in more than 72 hospitals in 18 nations. Save a Life also provides antibiotics to prevent opportunistic infections in HIV-infected women.

Obtaining and Administering Nevirapine

Global Strategies makes it easier for start-up programs in developing countries to obtain and administer nevirapine for this use. “They just tell us what they do and how much they need,” explains Ammann. “This is especially helpful for small programs that have the infrastructure to test women and give the drugs, but which may be waiting for additional funding from larger organizations.”

Ammann’s commitment to helping women and children with HIV began some two decades ago. As a professor of Pediatric Immunology at the University of California, San Francisco (where he is still on the faculty), Ammann and his colleagues diagnosed the first child with HIV in this country. The epidemic grew, and in 1987 AZT was introduced as the first anti-HIV drug.

In 1994, a landmark study showed that giving AZT to pregnant women could prevent transmission of the virus to newborns. Thanks to AZT, the number of new pediatric AIDS cases in the United States and Europe plummeted from 2,000 per year to less than 200. “However, that remarkable success story was paralleled by a lack of success in developing countries,” notes Ammann, “where 1,800 children are born with HIV every day.”

HIV Treatment

So, in 1997 Ammann founded Global Strategies. Through a series of international conferences held every two years, and with the assistance of organizations such as the Elizabeth Glaser Pediatric AIDS Foundation, Global Strategies has called on nations to immediately implement countrywide programs to prevent HIV infection of infants, identify HIV-infected women, and provide treatment for children and mothers with HIV. One major step in that direction is the production and distribution of more than 30,000 copies of an educational CDROM.

While Save a Life is clearly rescuing the futures of thousands of infants, Ammann notes that challenges remain. Programs to continue drug treatment of HIV-infected women, as well as their sexual partners, require further development. A new drug that could be used when HIV eventually develops resistance to nevirapine remains to be found. And educational opportunities and support for children orphaned by AIDS need to be expanded.

In the meantime, counseling is becoming more available to women without HIV, so they remain uninfected. “We’re working at the end of the process, the point where HIV infection has already occurred,” says Ammann. “Where we want to go is the beginning, to keep the infection from happening in the first place. Then all those other problems would go away.”

Also read: Improving Women’s Health: HIV, Contraception, Cervical Cancer, and Schistosomiasis


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