Marseille 2007
| Abstract #680 - HIV, infant feeding and more perils for poor people | ||||
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Session: 7.6: Plenary (Plenary) on Monday @ 08.30-10.30 in HC, Auditorium Chaired by Barbara Hedge, Alice Desclaux, Marty Fishbein Authors: Presenting Author: Prof Hoosen Coovadia - University of KwaZulu Natal - Nelson R Mandela School of Medicine, South Africa |
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| Aim: Abstract The release of the new WHO guidelines on HIV and infant feeding, in a global context of widespread impoverishment, requires countries to re-examine their infant feeding policies in relation to broader socio-economic issues. This widening scope is necessitated by compelling new reports (UNICEF, State of the Worlds Children 2007 and Human Development Report 2006) on the scale of global under-development in the third world. This paper explores these issues by addressing feeding choices made by HIV infected mothers, and programmes supplying free formula milks, within a global environment of persistent poverty. Accumulating evidence on the increase in malnutrition, morbidity and mortality associated with the avoidance or early cessation of breastfeeding by HIV infected mothers, and the unanticipated hazards of formula feeding, demand a deeper assessment of the measures necessary for optimum policies on infant and child nutrition and for the amelioration of poverty. Piecemeal interventions, which increase resources directed only at a fraction of a familys impoverishment, such as basic materials for preparation of hygienic formula feeds, and making flawed decisions on choice of infant feeding, are bound to fail; these are not alternatives to taking fundamental steps to alleviate poverty. The economic opportunity costs of such programmes, the equity costs of providing resources to some and not others, and the leakages due to the temptation to sell capital goods, require careful evaluation. Providing formula to poor populations with high HIV prevalence cannot be justified by the evidence; by humanitarian considerations; by respect for local traditions; nor by economic outcomes. Exclusive breastfeeding, which is threatened by the HIV epidemic, as it has been in the past by unregulated marketing of formula in poor populations, remains an unfailing anchor of child survival. | ||||
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