Elimination of mother to child transmission of hiv

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Elimination of Mother-to-Child Transmission of HIV Moving Beyond the Talk Arlington, March 23, 2011 Justin Mandala Presented by Barbara Sow, 6 Feb, 2012

Overview ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Basic facts: Magnitude & Risk of MTCT ,[object Object],[object Object],[object Object],Critical Time Rate During pregnancy 5 to 10% During labor and delivery 10 to 20% During breastfeeding 10 to 20%

Basic facts: Risk of MTCT with interventions ,[object Object],[object Object],Type of intervention MTCT rate Short course ARV with breastfeeding 15 to 25% Short course ARV, no breastfeeding 5 to 15% Highly effective ARVs, with breastfeeding < 5% Highly effective ARVs, no breastfeeding < 2%

[object Object],[object Object],[object Object],[object Object],2 . Prevention of unwanted Pregnancies in HIV+ women 1 . Primary prevention 4 . Long term follow-up of mother-infant pair Basics facts: Global Strategic Response to MTCT

“ Elimination of MTCT”: Definition ,[object Object],[object Object],[object Object],Elimination of MTCT should translate into this: from the 2009 baseline , by 2015

“ Elimination of MTCT”: clarifications ,[object Object],[object Object],[object Object],[object Object]

3. What tools do we have to “Eliminate MTCT”?

Tools to eliminate MTCT: The momentum ,[object Object],[object Object],[object Object]

Tools to eliminate MTCT: the cash ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Tools to eliminate MTCT: all prongs need to contribute… ,[object Object],[object Object],[object Object],[object Object],[object Object],Courtesy of UNAIDS

[object Object],[object Object],[object Object],Tools to eliminate MTCT: “Prong-3 new guidelines” (1) Three major changes with the new guidelines:

[object Object],[object Object],[object Object],Tools to eliminate MTCT: “Prong-3 new guidelines” (2) Breastfeeding by HIV+ mothers is now safer…

How much would it cost?: US$ 94 to 360 millions/ year Courtesy of PEPFAR ,[object Object],[object Object],[object Object],[object Object]

How much would it cost?: Cost of inaction Courtesy of PEPFAR ,[object Object],[object Object]

Where to focus efforts: 25 countries with highest burden of MTCT ,[object Object],[object Object]

What role for Peace Corps ?: ,[object Object],[object Object],[object Object],[object Object]

What role for PCV? , “ make things happen ” ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

In Summary ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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