CD4 500 count cut-off under consideration
Onalenna Kelebeile | Wednesday March 18, 2015 10:25
The current CD4 count cutoff in Botswana is 350. Speaking during the New Directions in Global Health workshop on Monday in Selebi-Phikwe, US Ambassador to Botswana Earl Miller said the World Health Organisation has recommended that countries move to CD4,500 in order to get more people on treatment faster and save more lives.
He said the Anti-retroviral treatment is also a prevention measure hence moving to cell count of 500 would actually cut the number of new infections in Botswana by 22 percent. He added that most countries in the Sub-Saharan Africa had already adopted the recommendation.
“My government through the President’s emergency Plan for AIDS Relief (PEPFAR) is willing to help Botswana make this transaction and adopt this important initiative.
It may cost more initially but will in the long run save Botswana’s health costs through fewer infections and a healthier population. We cannot afford not to do this,” he added.
Miller said the US government had pledged US$7.5 million in funding to support Botswana government’s recent decision to adopt and implement Option B+, which was a programme that provided lifelong treatment to HIV positive pregnant women regardless of their CD4 count.
He said this treatment helped prevent infant infections; saved mothers’ lives, reduced the number of orphans and was cost effective.
“Another key policy change would be to empower mothers by promoting and supporting breastfeeding. Currently the government of Botswana purchases and provides milk formula free of charge to all HIV positive mothers.
If Botswana were to adopt the 2010 WHO recommendations related to infant feeding and promoted breastfeeding over formula feeding for HIV infected mothers on antiretroviral treatment, we would improve health outcomes,” he said.
The Ambassador further noted that the two governments and the Harvard University were working on a four year project called Botswana Combination Prevention Project that would help determine whether coordinated and strengthened prevention methods including HIV testing and counselling, antiretroviral treatment, safe male circumcision and PMTCT when scaled up together at community level can prevent the spread of the virus better than the methods offered individually.
“We have so far learned valuable lessons from the first year of the study.
We were able to pilot Option B+ prior to the national rollout and demonstrate the willingness of HIV positive pregnant mothers to continue antiretroviral therapy for life when recommended.
We also learned that using door to door, home based and community HIV testing campaigns can help to successfully identify community members with HIV who were unaware of their status and to link them to immediate treatment which otherwise they would not have benefited from,” he added.
Miller said there was need to continue with the research that advanced high-impact detection and prevention of HIV and also begin applying the lessons already learned.
He said America and Botswana had an obligation to ensure that every dollar spent on the HIV response in Botswana was maximised and used to accelerate HIV epidemic control.