Title : The inherent value of human life: Navigating health economics and ethics in services for prevention of mother to child transmission of HIV
Abstract:
The prevention of mother-to-child transmission (PMTCT) of HIV is one of the most needed public health interventions. Effective implementation of PMTCT services will reduce paediatric HIV infections and improve maternal and child health outcomes. This presentation examines the intersection of health economics and ethics, exploring how financial constraints, policy decisions, and moral responsibilities shape the implementation and sustainability of PMTCT programs.
Health Economics Perspective
Considering that the lifetime cost of treating an HIV-positive child is significantly higher than the cost of prevention, implementation of PMTCT guidelines becomes imperative. Without intervention, the risk of mother to child transmission of HIV ranges from 15–45%. This can be reduced to less than 2% by implementing PMTCT strategies. Countries such as the United Kingdom, Botswana, Iran, Cuba, Belarus, and Thailand have demonstrated success in PMTCT programs.
Economic aspects:
- The lifetime cost of treating a HIV-positive child can range from $200,000 to over $500,000 influenced by cost of treatment depends on the healthcare system, provision, and access to uninterrupted supply of anti-retroviral drug, drug pricing, early infant diagnosis (EID), quality of care, socio-economic conditions, transport cost, social support system, government, and donor funding.
- The cost of PMTCT services per mother-child pair is estimated between $100 and $1,000. Thus, prevention of HIV infection is far more cost-effective than treatment.
Beyond individual healthcare costs, providing PMTCT services reduces long-term healthcare expenditures for the child. A child born who is HIV negative can do his/her schooling and higher studies effectively, can join an occupation of his choice making him/her economic independent thus strengthening national economies. However, despite its cost-effectiveness, funding constraints in low- and middle-income countries (LMICs) may hinder widespread implementation. Many healthcare systems in LMICs may rely on donor funding, raising concerns about financial sustainability. Integrating PMTCT into routine maternal and child health services is a part of strategy to optimize resources and ensure long-term affordability.
Ethical Considerations
While economic factors influence healthcare decisions, PMTCT is fundamentally a human rights issue—ensuring access to life-saving interventions for both mother and child. Key ethical concerns include:
- The Inherent Value of Human Life – Attaching a monetary value to human life raises moral questions. Every child has the right to be born HIV-free, and financial constraints should not come in the way to access essential PMTCT services.
- Equitable Access – In many resource-limited settings, socioeconomic and geographical barriers prevent pregnant women from accessing PMTCT services. Addressing these disparities remains a moral obligation and a global health priority.
Navigating through health economics and ethics in providing PMTCT services requires a comprehensive approach. Policymakers need to ensure sustainable funding, equitable access, and the integration of PMTCT into routine healthcare services. Investing in PMTCT is not just a financially responsible decision—it is a moral imperative that safeguards future generations from the burden of HIV. Every child has the right to be born HIV-free, and financial constraints should never be a barrier to that.
