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Christmas cheer for Malawi's Mary and Joseph?

By Jonah Fisher
BBC News, Kawale

Mary and Joseph Mlothiwa and baby Idess
Mary Mlothiwa was put on a course of anti-retroviral drugs while pregnant

Their names are Mary and Joseph and they have a newborn child.

But for this Malawian family this is a time of worry and not of cheer.

Both parents have HIV and when we meet them the status of their baby girl, Idess, is still unclear.

"God has been wonderful to us," Joseph says as he sits outside their small hut in Kawale on the outskirts of the capital Lilongwe.

"With all the medicines which we now take to stay alive, God has been good to us."

Life has not been easy for the Mlothiwa family. Joseph is on his second marriage while Mary, at the age of 24, is already on her third. Her last husband died of tuberculosis, a disease often associated with HIV.

The Mlothiwas are fortunate that they live in Malawi.

As they wait Joseph is lectured by one of the nurses - he has stopped taking his anti-retroviral drugs because of the side-effects

It is considered an African success story in the approach the government and international agencies have taken in fighting HIV. Tests are encouraged and anti-retroviral drugs widely available.

During pregnancy Mary was put on a powerful course of anti-retroviral drugs.

Their purpose was to suppress the HIV virus and prevent it passing to baby Idess.

Some 85% of Malawian clinics now offer tests like this and treatment during pregnancy.

At Mary's clinic in Kawale women begin gathering at 6am outside the health centre.

Mary Mlothiwa and baby Idess
Half of all HIV positive babies in Malawi die before their second birthday

At 9am it is Idess's turn and she has the heel of her foot pricked. As she squeals in shock, a spot of blood is squeezed on to a piece of paper.

"For HIV positive mothers who take anti-retrovirals the chances now are 90% that the baby won't contract the virus," says Edison Bowa, the medical officer at the clinic.

"We've seen a big change here."

The statistics are little comfort to Mary.

The couple are told to return later in the week for the results.

We follow Idess's sample to the laboratory in the centre of Lilongwe.

The normal Aids test can only be done when a baby is 18 months old.

For many babies that is too late. Half of all HIV positive babies die before they reach their second birthday.

Malawi is rolling out a new test that spots HIV at just six weeks.

It involves a complex DNA analysis of the sample and means babies can be put on anti-retroviral drugs before they get sick.

Sunday best

"If the test is positive it means that Idess will be put on treatment right away," says Dr Miriam Chipimo, from the UN children's agency in Malawi, as we watch the sample being rehydrated, shaken and passed through a series of machines.

HIV testing at clinic in Kawale
Malawi's rate of child HIV infection is falling

"And then Idess will be able to live a normal life. She shouldn't be sickly. She should go to school and have ambitions and get a job and live a perfectly normal life."

Both Mary and Joseph dress in their Sunday best for results day at the clinic.

As they wait, Joseph is lectured by one of the nurses. He has stopped taking his anti-retroviral drugs because of the side-effects.

Then with a big smile one of the clinical officers strides up.

He shakes Mary and Joseph by the hand. The drugs have done their job and Idess is clear of the HIV virus.

"I'll look after Idess well now," Mary says. "I'll make sure she goes to school and then I hope she'll become a nurse."

We drop Joseph back at his job. He buys fish in bulk on the shores of Lake Malawi before selling them in Lilongwe. Mary and Idess head home.

There is still no cure for HIV but there are thousands of children like Idess who owe their lives to early tests and anti-retroviral medication.

The war is far from over but Malawi's falling rate of child HIV infection shows that battles are being fought and won.

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