A Paediatric HIV Care and Treatment Programme in Malawi

Abstract

In Malawi, Acquired Immunodeficiency Syndrome (AIDS) is a major cause of death among 15 – 49 year olds. It is estimated that 900,000 adults and children live with HIV/AIDS in Malawi, a country where the HIV/AIDS prevalence in adults (15–49 years) was 14.1% in 20051,2. In 2005, an estimated 170,000 people were in immediate need of antiretroviral therapy (ART) with children below 15 years accounting for nearly 15% of the those needing ART in Malawi3. In 2001, the Ministry of Health (MoH) introduced subsidized antiretrovirals (ARVs) in three referral hospitals in the three regions of Malawi, rapidly scaling up national access to free ARVs and also introduced a programme for the prevention of mother-to-child transmission of HIV (PMTCT). Until 2005 Malawi's ART programme focused almost entirely on adults2,3. A majority of HIV-infected infants and children were treated symptomatically in the general paediatric clinics with few receiving treatment through the adult ART programme. The Baylor College of Medicine-Abbott Fund Children's Clinical Centre of Excellence-Malawi (COE) is the first stand-alone clinic in Malawi dedicated to the care and treatment of HIV-infected children, and training of different cadres of health professionals in the management of paediatric HIV/AIDS4. The COE is part of a network of clinics established by the Baylor International Paediatric AIDS Initiative (BIPAI) whose headquarters is in Houston, Texas, United States of America. The BIPAI network comprises of centres of excellence in Romania, Botswana, Lesotho, Uganda, Swaziland, and Malawi that provide care and treatment to HIV-infected children and families who qualify to be enrolled in the family clinic. Two additional centres of excellence are in the processes of being established in Kenya and Burkina Faso. BIPAI is also working with partners in Libya and Tanzania. The Malawi COE is located within the grounds of Kamuzu Central Hospital (KCH), a government facility in Lilongwe. The COE was officially opened on 2nd November, 2006. The COE is operated by a locally registered trust known as Baylor College of Medicine Children's Foundation - Malawi.