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Zidovudine to prevent mother-to-infant HIV transmission in developing countries: any questions? [editorial]
Tropical Medicine and International Health. 1998 Sep; 3(9):689-90.The 12th World AIDS Conference in Geneva, Switzerland, held last June 28 to July 3, 1998, pursued the noble aim of bridging the HIV control/AIDS care gap between the developing and developed world. The collaboration of three organizations, namely, the Joint UN Program on AIDS/HIV, the UN Children's Fund, and the WHO, took an initiative to reduce mother-to-child perinatal HIV transmission in developing countries. It will seek support to provide a short zidovudine regimen to 30,000 HIV-infected pregnant women living in 30 project areas in 11 pilot countries. The cost of drugs under the proposed short regimen seems promising, some US$50 per treatment course. However, for the short zidovudine regimen to be effective, at least one antenatal visit is needed before 34-36 weeks of gestation. At that moment pregnant women should have access to voluntary and nonstigmatizing HIV testing. In less developed countries unjust distribution of global health services is prominent. Thus, several ethical problems concerning equity, sustainability, development, and women's and patients' rights remained to be considered in developing countries.