e thank
the many members who have reponded very generously to our appeals
on behalf of our sister organization, IBFAN Africa. The report
which follows was presented by Dr. Joseph Andoh of IBFAN Afrique
in Côte-d'Ivoire at the International Baby Food Action Network's
bi-annual meeting recently held in Swaziland. This is one way
in which the funds we raise are being directed.
The tragedy of large numbers of HIV positive mothers and the enormity of premature maternal death in Africa raises serious infant care and infant feeding dilemmas. Communities, governments, health workers and surviving family members are struggling with increasing numbers of orphaned and abandoned babies, which until recently, were absorbed at the community level. Infants could be cared for by grandmothers or aunts, and their survival was reasonably assured. Since the arrival of AIDS, the numbers have grown dramatically and are expected to rise at an unprecedented pace, outstripping the community's capacity to care for and feed these infants.
Côte-d'Ivoire, a West African country with an infant mortality rate of 97 per 1000 live births, is struggling to find solutions. Currently 12.3 per cent of pregnant women test positive for HIV, and the figure is expected to rise at an alarming rate.
Dr. Andoh and his colleagues at the Centre Hospitalier Universitaire in Treichville, Abidjan, face enormous challenges of public education, screening, testing, treatment, caring and feeding.
Côte-d'Ivoire facts 1993 Expected 1998 Infected Infants................44,836.............120,010 Number of Orphans...............77,972.............282,412 New Cases of Paediatric AIDS.....6,703..............14,207 Infected Adults................640,033.............935,325 New Adult Cases of AIDS.........17,441..............33,504
Daily, they encounter the dilemma of using artificial feeding alternatives which can be life-threatening, yet often the only solution, given the overwhelming numbers of orphaned and abandoned infants. Artificial feeding is only recommended when a mother has AIDS symptoms and the infant is sero negative. When a mother tests sero positive and is sick, and the infant also tests sero positive, breastfeeding is recommended. The third and most common situation is a healthy mother who tests sero positive, and the infant is sero negative. In this instance, only mothers with advantageous social and economic circumstances are recommended to bottle-feed.
Until recently, infant formula manufacturers provided free supplies directly to hospitals, where indiscriminate distribution was a risk. Often infants who do not meet the criteria receive samples, creating new dependencies in circumstances of poverty and desperation. To implement effectively a "needs only" artificial feeding policy, Côte-d'Ivoire -- in consultation with IBFAN Africa -- created a distribution system through the central pharmacy where the supplies were closely monitored, assuring that only infants for whom breastmilk was unavailable would receive infant formula. At first Nestlé tried to discredit the pharmacy and supplies became irregular and eventually dried up. Clearly, Nestlé was not interested in providing for "needs only" infants, but wanted to use the free supplies as a means to develop its market.
In addition to its other activities, IBFAN Africa is very involved in ensuring that breastfeeding is protected, that donations of formula conform strictly to the WHO Code, and that distribution of free supplies is carefully monitored.
Please continue to support the policy and advocacy work of IBFAN Africa.