For centuries, breastfeeding has been seen as important to a baby’s development. But what if you’re faced with needing to breastfeed your child, while doing so could pass on a virus? Since Russia invaded in February, this has been the reality for many mothers living with HIV in Ukraine. The health systems in numerous occupied, and previously occupied, areas of the country have collapsed.
A lack of formula milk means mothers who no longer have access to their antiretroviral therapy (ARV) are having to breastfeed babies, heightening the risk of mother-to-child transmission.
No mother should have to choose between her baby starving or being infected with HIV. I found out I was HIV positive and pregnant in 2000. I did not have access to the necessary treatment, but I was fortunate to give birth to a healthy and HIV-free baby.
Sadly, this is not always the case. The World Health Organization (WHO) recommends that HIV-positive mothers can breastfeed if they have access to ARV treatment and a viral load diagnostic each month. For new mothers with HIV in Ukraine at the moment, many do not have any choice. The war has devastated Ukraine’s healthcare system: more than 700 health facilities have been attacked and endless numbers of healthcare workers and patients have been displaced, injured or killed.
Before the start of the war, the Ukrainian Ministry of Health was planning to apply for a certificate from WHO, declaring the end of mother-to-child HIV transmission in the country. This heartbreaking war is likely to stop that achievement in its tracks. In 2001, mother-to-child HIV transmission reached 27.8% in Ukraine, but by 2021 had dropped to 1.3%. When new data is released in 2023, it is likely to have increased tremendously. Despite remarkable achievements in combatting HIV in recent years, Ukraine has the second-largest HIV epidemic in eastern Europe and Central Asia.
Women desperately need help from governments and the humanitarian community to combat HIV being contracted by the next generation of babies in Ukraine. Access to healthcare workers with sufficient experience handling cases of HIV-infected mothers and preventing mother-to-child transmission – without stigma and discrimination – is lacking, especially in western parts of Ukraine, where there are numerous internally displaced people.
ARVs, basic medication, sanitary kits and food are also needed for mothers and their babies. We have been able to provide these services through my organisation, The Positive Women, but it doesn’t cover everything
The Global Fund to Fight AIDS, Tuberculosis and Malaria gave Ukraine $15m (£12.5m) in emergency funding and provided life-saving medicines, equipment and supplies – including generators to power health facilities cut off from electricity. Positive Women also received Global Fund money to provide care and support for women and their children. However, more help is needed from governments and organisations around the world.
We have a duty to help voiceless and vulnerable people. We must not allow this war to undo decades of progress in fighting mother-to-child HIV transmission in Ukraine. We must protect children from contracting the virus, especially when we have the medicines to prevent it.
This World Aids Day, cast your minds to those vulnerable people suffering in Ukraine and other countries around the world and help us make a healthier start to 2023.
• Olena Stryzhak is the chair of the Ukrainian organisation Positive Women
