PEPFAR Expert Panel Provides Blueprint for Eliminating Pediatric HIV Infections Worldwide
January 19, 2010
Contact: Robert Yule
Report on Prevention of Mother-to-Child Transmission Highlights Successes and Gives Specific Guidance to Overcoming Barriers to Global Scale-Up
A landmark report submitted to the U.S. Congress on Friday provides crucial recommendations for scaling up services to prevent mother-to-child transmission (PMTCT) of HIV, and ultimately eliminating pediatric HIV infections worldwide, according to the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF).
The report presents the findings of world-renowned leaders in the PMTCT field – including experts from the Foundation, UNICEF, CDC, USAID, NIH, and Columbia University, among others. It provides insight on the successes and challenges of PMTCT to date, as well as recommendations for widespread and rapid implementation of this critical prevention method.
Although new pediatric HIV infections are now uncommon in developed countries due to successful scale-up of PMTCT services, nearly 1,200 children are still infected with HIV globally every day, the vast majority through mother-to-child transmission in resource-limited countries. While there has been significant progress in increasing the global reach of PMTCT programs over the past decade, more than half of women living with HIV in low- and middle-income countries still do not receive the antiretroviral drugs they need to prevent HIV transmission to their infants and to protect their own health.
“PMTCT is one of the great success stories in HIV prevention, but it has been slow to reach the women and children around the world who still need it most,” said Charles Lyons, the Foundation’s president and CEO. “This report addresses the barriers to PMTCT scale-up throughout the world and provides a road map to create a global generation free of HIV.”
The report was mandated by the 2008 U.S. legislation that reauthorized the President’s Emergency Plan for AIDS Relief (PEPFAR). The U.S. Office of the Global AIDS Coordinator (OGAC) has recognized the importance of PMTCT as a proven and cost-effective form of HIV prevention, and its role in contributing to several of PEPFAR’s key goals, including HIV prevention, treatment, care and support, and health systems strengthening. As such, the U.S. Congress tasked OGAC with convening an expert panel to draft this report within a years’ time to recommend specific methods of achieving the target of 80 percent global coverage of women and children with PMTCT services in the next five years.
“PMTCT is an essential prevention method that can significantly slow the spread of the HIV pandemic,” said Dr. Laura Guay, the Foundation’s Vice President of Research, who served on the panel. “We hope our recommendations launch further action by the global community to achieve universal access to PMTCT services.”
The report details specific best practices that have made success to date possible, and highlights the progress already made in Africa – particularly in Botswana, Rwanda and Kenya – toward achieving PMTCT scale-up targets. It also chronicles the progress made in six of the ten countries – Kenya, Malawi, Mozambique, South Africa, Tanzania, and Zambia – estimated to have the largest numbers of pregnant women living with HIV. Rates of HIV counseling and testing for pregnant women in these countries have risen to approximately 60 to 80 percent. Progress has also been made in providing antiretroviral medications for PMTCT to those women who test positive.
The report includes a variety of core recommendations to expand upon these successes and overcome specific challenges, including:
- Advancing a women- and family-centered approach to HIV prevention and HIV-free survival;
- The need for high-level political commitment and increased PEPFAR resources for PMTCT;
- Prioritization of pregnant women for HIV care and treatment services;
- Greater emphasis on primary prevention and family planning services;
- Improved integration and coordination of PMTCT and HIV care and treatment programs;
- Integration of PMTCT and care and treatment programs within existing maternal and child health services to achieve broader maternal and child survival goals;
- The need for increased operations research on program models; and
- Inclusion of male partners and other family members in service delivery.
To achieve these goals, the panel recommends greater collaboration and coordination among U.S. government health programs, global organizations, and the ministries of health within individual countries. Specifically, the panel encourages PEPFAR leadership and technical experts to work closely with those responsible for developing the Global Health Initiative (GHI) strategy in order to maximize the potential for joint efforts toward achieving common health and development goals related to PMTCT and maternal, newborn, and infant health. The panel also calls for expanded coordination with international and multilateral organizations, including Global Fund, WHO, UNICEF, and UNAIDS, and prioritizing PMTCT in individual government HIV/AIDS plans.
“By marshalling the necessary resources and working with national governments, NGOs, and other stakeholders, we can make an HIV-free generation a reality,” said Lyons.
The Elizabeth Glaser Pediatric AIDS Foundation is one of the largest providers of PMTCT services under PEPFAR, and has fought the epidemic on behalf of women, children, and families for 20 years. To read PEPFAR’s expert panel report on PMTCT, please visit http://www.pepfar.gov/progress/pmtctpanel/index.htm
About the Elizabeth Glaser Pediatric AIDS Foundation
The Elizabeth Glaser Pediatric AIDS Foundation is a worldwide leader in the fight against pediatric AIDS. Its innovative research programs, collaborative training initiatives, advocacy efforts, and rapidly expanding international prevention and treatment programs are bringing dramatic changes to the lives of children worldwide. For more information, visit www.pedaids.org/jointhemoment