At this point, an expectant mother will be given treatment when their T-cell count drops below 200 per cubic mm. That number will be raised to 350, greatly reducing the child mortality rate in that country.
Prior to this time, the overarching strategy of fighting HIV in the Southern African region has been to allow HIV to spread, so people who are susceptible to the disease will hurry up and die. Eventually, people who remain alive in Southern Africa must be immune to AIDS, since they certainly will have been exposed to it. Although this strategy receives a great deal of criticism, it very well might have worked if it had been allowed to continue unhindered. With this policy flip-flop to a more widely accepted approach, they have the worst of both worlds: they now have to attempt to prevent the spread of HIV despite incredibly high existing rates of infection, and we may never know if their original idea would have eventually been effective.
Personally, I'm a bit disappointed. This is what happens when you listen to namby-pamby scientists after decades of buying into the poo-poo that squirts out of religious and otherwise ill-informed mouths. For years, HIV prevention policy in Southern Africa was about abstinence. Condoms were hard to find and largely not used. Now, with the successful consciousness raising efforts of do-gooder Westerners, armed with their scientific studies and their highfalutin' Germ Theory of Disease, saner prevention policies based on actual, physical barriers to transmission threaten to drastically limit the spread of the virus, and now the mother-to-child transmission route is threatened. By now that's just prolonging the inevitable!
Look at it this way: suppose one in three of the population of your breeding pool has some disease. People are born with it. People get it by various vectors before they even become sexually active. People don't routinely get tested for it. There is a tremendous amount of misinformation about how the disease is spread. You can't contain the disease at that point. The effective window for that strategy has closed. Everybody is gonna get the virus eventually, and that's just tough noogies.
Let me show you an example. In the United States of America, one in four people is infected with the Herpes simplex virus. The overwhelming majority of these people are unknowing asymptomatic carriers. It is, by all accounts, the most widespread sexually transmitted disease in America. There is a class of drugs that, when taken by infected individuals, prevents the spread of the disease pretty well. Nobody in America wants to have Herpes, but you actually have to go get explicitly tested for it if you want to know if you have it. If I go to the doctor and say "Doc, I wanna get tested for sexually transmitted infections." She'll grab a stack of vials and a couple of bristle brushes and test you for Syphilis, Chlamydia, HIV, Hepatitis B and Gonorrhea. She may additionally test you for HPV, PID, and a bunch of other letters. She is not likely to test you for HSV unless you ask her to, because so many people have it that the consensus among the health community is that its not worth the effort to try and track. They don't try to get everybody tested and make sure the medication is available. They're just like "Don't worry about it."
So in Southern Africa, the HIV infection rate is higher than that, plus people don't go to the doctor as often. No credible person believes that they can actually prevent the spread of HIV throughout Africa. But, there are a fairly large number of people around who are immune to the virus. So just wait it out, man! In a few generations, you won't have to worry about any of this crap, because, well, you won't have to worry because you'll be dead. But nobody else will have to worry either, because everybody will be immune.
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