Prevention of Mother-to-Child Transmission of HIV (PMTCT) is a wonderful programme that has seen expectant HIV positive mothers bringing to the world HIV negative children.
However, it appears the programme has now encouraged more HIV positive people to want to have children and experts are now worried.
The worry comes in view of the fact that the majority of the HIV positive people making this decision, which is a human right, are doing so without due regard to the health of the HIV positive woman.
A recent study has revealed that there is a rise in cases of women living with HIV deciding to fall pregnant in the hope that, with the on-going programme aimed at preventing the transmission of HIV from an infected mother to her child, they would be able to give birth to HIV negative children.
"The best in our situation is where HIV positive women do not fall pregnant. However, we have issues of human rights on the other hand and the PMTCT provision seems to have increased the feeling that after all the offspring shall not be affected by this. It's tricky," said one medical doctor in an interview.
The study on HIV Testing and counselling and Antiretroviral Service Delivery in Malawi carried out by the Kalondolondo Programme finds that the trend is largely premised on friction HIV+ people press for children between the human right to choose to fall pregnant and have a child and the success story of (PMTCT) programme in which HIV positive expectant mothers are known to bear HIV free children.
Kalondolondo Programme Manager Jephter Mwanza said in an interview last Friday that with the 2010 PMTCT guidelines, HIV positive pregnant women are put on ART immediately they are diagnosed as such in the hope of reducing the chances of a baby contracting the virus from the mother.
"In the past, such mothers were advised against breastfeeding their babies beyond six months but with the new arrangement, babies can breastfeed for over a year at a reduced risk of acquiring the virus," Mwanza said.
"In fact, babies are being born without the virus. But the problem we have seen now is that some people are getting pregnant at the expense of their own health.
"These two critical factors are encouraging HIV positive women who are now falling pregnant anyhow. People should be looking beyond just preventing unborn babies from contracting HIV. It is tricky but we are saying that people should have information ready so they can decide knowledgeably."
But Secretary for Health Dr. Charles Mwansambo has put his foot down insisting that according to policy in use in Malawi at the moment, citizens have the right to decide how they want to live their lives.
"It's no to discrimination and zero new infections. Put yourself in the shoes of an HIV positive woman who wants a baby. We don't want to encourage stigma.
We know what social pressures there are out there and we would like to put all these things in context," Dr. Mwansambo said.
He observed that while in the 80s the approach was one that discouraged such women falling pregnant, the existing PMTCT policy provides for them a reduced risk of exposing their unborn to the HIV.
However, in yet another interview, Malawi Health Equity Network (MEHN) Executive Director Martha Kwataine said much of the problem is arising from cultural and rights dictations among Malawians.
She said, while some couples are culturally being forced to have children, they are over-looking the need to look after those children when their health fails them while the children are still dependents.
"People are focusing very much on their rights and very little on their responsibilities.
Everyone has a right to health but we should also always remember that everyone has a responsibility over their health. We have tended to skip a lot on the responsibility side," Kwataine said.