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There was lots of buzz, at the opening of the 16th International AIDS Conference yesterday, about the new: new drugs; new technologies; new deals on funding and drug access.

Far away from the buzz, in two separate sessions yesterday, clinicians from the developing world talked about keeping pregnant women from passing the AIDS virus on to their babies.

There is nothing new about this: We've known how to do it for nearly a decade. It is, by the standards of AIDS, ridiculously easy. It's cheap, and it's one surefire way of cutting down on new infections. And? More than 90 per cent of pregnant women with HIV around the world do not have access to any of the simple interventions that would keep them from infecting their babies. Seventy children an hour are infected with the virus by their mothers, and 45 die every hour from AIDS.

These numbers suggest that in all the understandable hunger for the new in AIDS, we have lost sight of the fact that we haven't yet figured out how to solve one of the most basic problems. And because this is a problem of women — poor, rural women in Africa, in particular — it has slid quietly to the bottom of the international AIDS agenda.

Women infect their babies with HIV three ways: roughly a third of them in utero; a third in delivery; and a third through breastfeeding.

Fewer than 500 children will be infected in North America this year, because it's very easy to prevent all threeof these things. If a woman doesn't breastfeed, if she delivers by cesarean and if she and her baby are given an anti-retroviral drug before or during labour, the risk of transmission is less than 2 per cent.

Of course, not every rural health clinic in Rwanda can provide a cesarean section. And not every Rwandan woman can feed her baby with formula safely, because many lack clean water. But the drug intervention — that's easy. A single dose of the drug nevirapine can cut transmission by at least 30 per cent. That costs, at most, a couple of dollars, and manufacturer Boehringer Ingelheim Pharmaceuticals donates it free in many parts of the world. Using two or three ARV drugs together can lower transmission by much more. But less than 9 per cent of pregnant women worldwide get any of these interventions.

“It's not paucity of drugs stopping us from preventing mother-to-child transmission,” said Catherine Wilfert, scientific director of the Elizabeth Glaser Pediatric AIDS Foundation.

The simplest regimen of all is difficult to deliver in some settings.

African and Indian doctors talked about how they lack the labs and the staff to test and counsel all the pregnant women; how the women they see at the health clinic may come for an HIV test but never come back to get their return for drugs because they live too far away and can't afford to pay for bus fare or take another day off work to wait for seven hours in line at a busy an understaffed clinic.

Dr. Agnes Binagwaho, who heads the national AIDS agency of Rwanda, talked about her country's program, which is, by African standards, a remarkable success: They're reaching 22 per cent of HIV-positive pregnant women with single-dose nevirapine. But that program is now imperilled. “We had funding from the Global Fund [to Fight AIDS, TB and malaria],” she said, money they used to build labs and train and pay staff. “But that funding ends now.”

Arletty Pinel, chief of the reproductive-health branch of the UN United Nations Population Fund, says the fact that more women don't get this service reflects the overall low priority put on maternal and reproductive health. These programs are almost universally minimally funded and minimally staffed, she said, and so it's no surprise that more women with HIV don't get the basic interventions. “Getting a pregnant women who is HIV positive is remedial, it's damage control — and we don't do damage control well.”

The World Health Organization announced yesterday that it now recommends putting pregnant women with AIDS on full ARV therapy from 28 weeks of pregnancy, as the best way to lower transmission. A fine idea, but if less than 9 per cent of women are receiving a one-off drug dose, how on earth are those little Rwandan clinics that just lost their funding going to do full therapy?

One of the big topics at the conference this week is pediatric AIDS — how to treat more kids, and treat them better. It's high time that pediatrics got more attention; treating kids has lagged woefully behind adults. But in all those sessions yesterday, no one mentioned that there would be no need for pediatric treatment, if we just mastered the one-stop intervention that keeps mothers from inadvertently infecting their kids. snolen@globeandmail.com