PEPFAR – Prevention of Mother-to-Child Transmission

March 08, 2011


Ambassador Eric Goosby


This week, we celebrate International Women’s Day. According to the World Health Organization, HIV/AIDS is the leading cause of death among women between the ages of 15-44, and nearly 60 percent of the people living with HIV in sub-Saharan Africa are women. Throughout the week, PEPFAR will be highlighting its work in addressing gender and the needs of women in this epidemic.

Pregnant women in developing countries face a range of obstacles in getting health services they need, including support to protect their babies from HIV. Mother-to-child transmission is a significant cause of new HIV infections among children worldwide. Yet interventions to prevent mother-to-child transmission of HIV (PMTCT) are extraordinarily effective. Without PMTCT, 25-40 percent of babies of HIV-positive mothers will be born infected; with PMTCT that number can be reduced to below 5 percent. PMTCT has a triple life-saving benefit: saving the life of the woman, protecting her newborn from HIV infection, and protecting the family from orphanhood. Because it works so well and touches so many lives, PMTCT is a smart investment for PEPFAR — high-impact and cost-effective.

In 2010 alone:
• PEPFAR directly supported HIV counseling and testing for nearly 8.4 million pregnant women;
• More than 600,000 HIV-positive pregnant women received antiretroviral prophylaxis to prevent mother-to-child transmission; and
• Through these PMTCT efforts, more than 114,000 children are estimated to have been born HIV-free.

These are the highest PMTCT results of any year in PEPFAR’s seven-year history. The 114,000 infants born HIV-free add to the nearly 340,000 from earlier years of PEPFAR. We are working hard to ensure that every partner country affected by the HIV epidemic has at least 80 percent coverage of testing for pregnant women at the national level, and 85 percent coverage of antiretroviral drug prophylaxis and treatment, as indicated, of women found to be HIV-infected.

Since its creation, PEPFAR has dramatically increased its focus on saving lives through the elimination of mother-to-child transmission. In 2010, PEPFAR established “PMTCT Acceleration Plans” for six countries with high rates and burden of maternal-to-child transmission. PMTCT Acceleration Plans provided $100 million in additional FY 2010 PEPFAR funding — above the more than $956 million being spent on PMTCT from FY 2004-2009 — to fund plans targeting bottlenecks to expanding services. Based on the encouraging early results of this effort, PEPFAR has continued this funding in FY 2011.

These efforts to address PMTCT have benefits for overall health care for women. Linking HIV testing with antenatal care helps to identify women who are in need of care. In addition, counseling and testing can help women who are HIV-negative remain negative. The availability of these additional services also provide an incentive for women to seek antenatal care. In Kenya, for example, strong linkages between PMTCT, maternal and child health and other programs dramatically increased program coverage, allowing programs to focus on the needs of each woman and family in a more holistic way.

PEPFAR reflects America’s deep commitment to improve the health of women around the world. When women are healthy, they are better able to keep their families and communities together, leading to benefits for all of us. Our PMTCT programs are truly smart investments that save lives.


By Ambassador Eric Goosby, U.S. Global AIDS Coordinator (Cross-posted from the State Department Blog)



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