The Fight Against HIV/AIDS and MTCT: A Decade On

When the United Nations General Assembly – Special Session (UNGASS) met in 2001 in New York, a target was set to reduce the number of HIV-infected infants by 50% by the year 2010. To achieve this plan, it was calculated that 80% of HIV pregnant women or mothers would have to be enrolled under a prevention of mother-to-child transmission (PMTCT) program.

To see what an uphill task it was to undertake, we need to have a look at some figures:

  • Of the global HIV positive population, a little over 50% of them are women. At the end of 2010, there were an estimated 34 million people living with HIV, and that same year saw 2.7 million people newly infected with the disease.

  • While the HIV epidemic had peaked somewhere in between the years 1996 and 1997, in Eastern Europe and Central Asia the number of people living with HIV rose by a staggering 250% from 2001 to 2010. The hardest hit countries were the Russian Federation and Ukraine which accounted for almost 90% of the region’s epidemic.
  • Each day, an estimated 1000 children under the age of 15 are infected by the disease. And of these, more than 90% of them are infected due to mother-to-child transmission (MTCT) of HIV.

These figures show that the goal that was set in 2001 was a very ambitious one. No one could have anticipated that it would get much worse before it could get any better. And then, no one could have anticipated the huge amount of work and effort that would be needed to meet the goals and milestones.

Let us not forget, the number of children that were born HIV positive has been brought down greatly. The number of infected children in 2001 was estimated to be around 560,000. In 2010 the number had shrunk to around 390,000 – a reduction of around 31%. While this was a major achievement, it was a number that was still 19% shorter than what was aimed for.

But, realizing that the game plan needed to be changed, UNGASS had to come up with a newer roadmap spanning the years 2010 to 2015 regarding the PMTCT of HIV and achieving the millennium development goals (MDGs).

The plan has been divided into 7 strategic directions:

1 – Commitment and leadership to achieve 100% PMTCT services.

2 – Technical Guidance to optimize HIV prevention, care and treatment for women and children.

3 – Integration of PMTCT, care and treatment of HIV with maternal, newborn and child health reproductive health programs.

4 – Equitable Access, ensuring for all women.

5 – Health Systems promotion to improve delivery of HIV prevention, care and treatment service for women and children.

6 – Measurement of performance and impact on MTCT rates and on maternal and child health outcomes.

7 – Collaboration of global effort for providing HIV prevention care and treatment for women, infants and young children and advocate for increased resources.

We are still seeing improvements on a global scale especially in Sub-Saharan Africa, but there are still new hotspots that are flaring up in other parts of the world. Let us hope that this is the final battle plan that will win us the war.

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