Jamra primary scholl for children affected by HIV/AIDS, drugs or poverty, Senegal (c) Nell Freeman/Alliance Participants in the Photovioce project, Ecuador © Marcela Nievas for the Alliance
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HIV crucial to progress on maternal health


A mother with her young daughter at Lean On Me, a project for HIV positive mothers supported by KANCO, Alliance linking organisation in Kenya © Nell Freeman/Alliance

Steven Sinding, Chair of the Alliance and former Director General of the International Planned Parenthood Federation (IPPF), is attending this month’s Women Deliver conference, where the Alliance and ICW are co-organising the HIV track at the conference. He talks about why combating HIV is crucial to accelerate progress on maternal and child health.

As someone who has advocated for many years to improve women’s access to reproductive health services as a step toward reducing maternal mortality rates, I was delighted and encouraged to read recently about the new lower estimates of maternal mortality.

The new evidence, published in the Lancet, shows a fall of over 35%  in maternal mortality rates in the last 30 years. Furthermore, the evidence shows the powerful influence of AIDS on maternal mortality rates and highlights the dramatic contribution HIV services can make to reducing maternal deaths.

Thus, I am delighted to be moderating a session at the Women Deliver 2010 conference in Washington (7-9 June) on the integration of health systems, sexual and reproductive health and HIV/AIDS and its effectiveness. It’s a topic I am particularly keen to see develop and progress.

To accelerate progress the funding commitment needs to step up, but I believe we must also actively tackle the challenges of HIV if we are to have any chance of success.

While I was at IPPF we pushed hard for the integration of SRH services with HIV prevention efforts – a commitment that continues. At the Alliance we are seeing the benefit of community-led approaches that integrate sexual and reproductive health services and HIV/AIDS testing and counselling. The ‘one stop shop’ approach helps reduce stigma and discrimination when it comes to testing for HIV.

Integrated services can also make post-natal family follow-ups easier. Currently too many mothers living with HIV are lost to follow up because mothers, newborns and children are all treated separately for HIV and the prevention of mother-to-child transmission (PMTCT).

Targets around universal access to sexual and reproductive health, and HIV prevention, care, treatment and support are inseparable. According to the new maternal mortality estimates, more than 350,000 women, including adolescents, die each year due to complications during pregnancy and childbirth. HIV directly increases the risk of complications in pregnancy, and it is estimated that for HIV positive pregnant women the risk of maternal mortality can be as much as doubled.

According to the UN Population Fund (UNFPA), despite dramatic improvements in contraceptive use over the years, today one in six women of childbearing age – some 123 million – still have an unmet need for family planning, which, if met, could prevent between a third and a quarter of all maternal deaths. 

This is why the Alliance is calling on experts on maternal and child health, sexual and reproductive health and HIV to join up their approaches to achieve Millennium Development Goals 4, 5 and 6. For too long we have gone our separate ways, thus failing to realise the natural complementarities and mutually reinforcing power that comes with integration. It is time to get on the same path and work together to save women’s lives.

Benefits can include increased condom use by integrating sexual and reproductive health and HIV services, and debunking stigmatising myths such as ‘condoms are only for people with the virus’, making it difficult for all people, regardless of HIV status, to use them to protect themselves.

Sexual and reproductive health needs of HIV positive women must be addressed. Women make up 50% of HIV positive people in Africa - the fastest growing group. Integrated services can enable HIV positive women to prevent or plan pregnancy, and equip them with information and services to prevent mother to child transmission.

When it comes to delivery, communities and community based organisations need to be better supported to provide comprehensive services and to reach the intended service users, which include marginalised women such as drug users and sex workers.

I would echo the conference message that the Millennium Development Goals will not be achieved without investing in women, and that there is just enough time if the world commits now to an additional US$10 billion annually by 2010 and US$20 billion by 2015. And there are plenty of innovative financing cards on the table to help provide the shortfall.

With the potential to save millions of lives, it would be too costly not to.

The Alliance has co-organised the HIV track of the conference with ICW, find details of the program here.

    We know that if we keep the parents alive we keep the children alive