Physician and public health researcher Mitchell Besser visited the School of Public Affairs on Oct. 4, delivering a presentation on the prevention of mother-to-child transmission of HIV in Africa. Besser is the founder of Mothers2mothers, an organization that trains mothers with HIV to work in health centers to educate and support pregnant women who are HIV-positive.Besser talked about "task shifting" some of the responsibilities of health care education from nurses and doctors (that are always in short supply and high demand) to the mothers, and utilizing new technologies such as mobile phones to expand the scope of care.As an obstetrician and gynecologist, Dr. Besser professional career has been dedicated to the public health needs of women. In 1999, Dr. Besser joined the University of Cape Town's Department of Obstetrics and Gynecology, assisting with the development of services to meet the needs of pregnant women living with HIV and to prevent the transmission of HIV from mothers to their children (PMTCT). Dr. Besser recognized the need for an education and psychosocial support program that would contribute to PMTCT services achieving the best medical and social outcomes. Hoping to fill this void, he founded mothers2mothers in which mothers with HIV are employed to work in health centers, educating and supporting pregnant women and new mothers with HIV; reducing the workload of doctors and nurses and increasing the effectiveness of interventions that reduce the number of babies born with HIV and keep mothers healthy and alive to raise their children. Since its inception in 2001, the program has grown to provide services in more than 680 health care facilities in nine countries in Africa, with more than 3 million contacts with woman each year, reaching 20% of the HIV-positive pregnant women in the world. Dr. Besser has received Global Health Council’s Best Practice Award, Skoll Award for Social Entrepreneurship, Presidential Citizens Award of the United States Government and is an Ashoka and Schwab Fellow. He has presented at TED, appeared on BBC’s Forum and has given a Friday Evening Discourse at the Royal Institution of Great Britain.
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1. Mitchell J. Besser, MD Founder and Medical Director mothers
2 mothers 4 October 2010 mothers 2 mothers: Preventing
Mother-to-Child HIV Transmission in AfricaUsing New Paradigms in
Health Care Delivery
2. Population HIV Prevalence Zimbabwe South Africa Botswana
Senegal Mali 3. Life Expectancy: 1950-2005 with high HIV prevalence
: Zimbabwe South Africa Botswana with low HIV prevalence:
Madagascar Senegal Mali Source:UN Department of Economic and Social
Affairs (2001)World Population Prospects, the 2000 Revision .
19501955 1955-1960 1960- 1965 1965- 1970 1970- 1975 1975- 1980
1980- 1985 1985- 1990 1990- 1995 1995- 2000 2000- 2005 30 35 40 45
50 55 60 65 Life expectancy (years) 4. Grim Reality UNAIDS: 2007,
2010 FACTS:
2.5 million new HIV infections (2007)
2.1 million adults and children died of HIV/AIDS (2007)
1.2 million people started on treatment in 2009
Each year: Twice as many people become infected withHIV as start
on treatment; Twice as many people die of AIDSas start on
treatment. 5. Global HIV Prevalence 33.4 millionliving with HIV in
2008 Sub-Saharan Africa 22.4 million 6. 90% of HIV-positive
pregnantwomen are inSub-Saharan Africa 1.4 million pregnant women
in low- and middle-income countries are infected with HIV 7.
Towards Universal Access, WHO, 2009 Grim Inequities Prevalence in
Pregnancy Nigeria 2.4 - 4% South Africa 29% US and UK 0.6% Adult
Prevalence Nigeria 3% South Africa 18% US and UK 0.3 - 0.6% PMTCT
Coverage Nigeria 10% South Africa 73% US and UK > 95% ARV
Coverage (children) Nigeria 12% South Africa 61% US and UK > 95%
8. Pediatric HIV infections in U.S. 80% decline CDC PACTG 076 AZT
treatment starts 9. Siripon Kanshana, 2007 Pediatric HIV infections
in Thailand 80% decline HIV testing PMTCT ARVs National PMTCT
program 10. UNAIDS estimates 2008 Pediatric HIV infections in World
11. 1100 children infectedper day in 2008 12. 1in Europe
