Tuesday, July 26, 2011

Good Intentions


UNICEF´s Mother Baby Pack is a interesting example of a public health campaign gone wrong.

The pack is a well intended, yet poorly designed intervention meant to prevent the vertical (mother to child) transmission of HIV. The pack contains an astounding 5 month supply of anti-retroviral medications for both mother and infant. It was launched in 2010 in Cameroon, Kenya and Lesotho. While this may have seemed the answer to HIV in rural Africa, where access to medical care is often complicated by long distances from health facilities, 5 months is an awfully long time to go without seeing a doctor when you are both pregnant and HIV+, and 5 months worth of anti-retrovirals is quite a cache of very powerful medication.

While the information in the box may encourage return visits to clinics, by giving this much medication at once, the pack is implicitly discouraging pre and post natal visits. You can see from the picture the labeled boxes for medication taken during and after pregnancy as well as for infants. It seems to imply an HIV+ pregnant woman can do it herself, without a doctor.

Having worked in an HIV clinic and witnessing the vast support system some HIV+ patients truly need, I cannot imagine how this pack became a reality. Many HIV+ patients visit their doctor every three months, to have blood drawn for CD4 counts, to discuss issues with medication, to monitor general well-being. HIV treatment is a beast and patients often need guidance and encouragement to take it properly.

Of course, conditions are different in Africa. The pack is clearly attempting to address the fact that many women simply cannot see a doctor as often as they might if they lived in a developed country. But to expect someone with no medical back round to administer potentially poisonous medication to a new-born infant - it´s strange.

The Mother Baby Pack has now been quietly recalled. You can read UNICEF´s statement here, but you have to look for it under «Ensuring Quality and Effectiveness».To me, it´s a sad story and a little chilling. I am unaware of any reports of death or injury due to the pack, although the potential was there. But I can imagine if there had been, how awful that something so well-intended could have gone so wrong.

It is so easy to make mistakes while trying to do the right thing.

Related Posts:

UNICEF Mother Baby Pack Update
POZ Magazine: HIV and Pregnancy

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