Anit-HIV Strategy Backfires in Botswana

Due to the fact that a third of pregnant women in Botswana were infected with HIV, the Botswana government, going beyond the World Health Organization’s recommendation, advised that all HIV infected women use infant formula. Previous studies had shown that breast-feeding, depending on how it was performed, accounts for 5-20% of the transmission from infected mothers to their children. This public policy along with the use of anti-HIV drugs during labor and delivery were part of the government’s comprehensive strategy in 1998 to decrease these transmission rates.

This policy has lead to approximately 63% of infected mothers in Botswana currently using the formula.

However, from January to March 2006, 532 children under the age of 5 died from diarrhea. A study of this deadly outbreak of disease in children under the age of 5 revealed that infant formula, as compared to breast feeding, increased a child’s risk of death by 50 times. It is believed that this is likely the result of contaminated water used for making the formula. In the article, Tracy Creek, a medical epidemiologist, suspected that the severe flooding in Botswana in 2005 contributed to this outbreak due to increased levels of micro-organisms in the water supply.

This story seems to illustrate the importance of treating a medical case uniquely from others. While this infant formula policy might have helped in a more developed country where the quality of water would not have been an issue, it only served to create an even worse situation in this developing country. In other words, this story demonstrates that the factors in an individual’s life must be considered when administering medical care. The treatment method must be feasible for the patient to perform. I think that is incredible that the governmental medical officials failed to consider how the infant formula would be made by their citizens. Also, this article just shows how even the most basic treatment idea can lead to such horrific outcomes.

http://sciencenow.sciencemag.org/cgi/content/full/2007/226/1