Getting to 2015: Making Prevention of Mother-to-Child Transmission of HIV a Universal Routine Service

700 children still become infected with HIV every day. In 2011, 230,000 children died from AIDS-related illnesses. To get to zero, we need to strengthen our efforts toward the prevention of mother-to-child transmission (PMTCT) of HIV.
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Evadius, father of three, sits with his nine-month-old son, Lauben. The whole family has traveled to this health center to attend a Family Support Group, a key intervention in the prevention of mother-to-child transmission (PMTCT) of HIV.

Lauben is getting tested for HIV today, and as a precaution, all three family members will also get tested. Like Lauben, hundreds of babies at this health center receive quality HIV care and treatment services thanks to "Strengthening TB and HIV/AIDS Response in Southwestern Uganda," a project funded by the U.S. Agency for International Development (USAID).

Similar projects are bringing these life-saving services to children around the world, and as a result, great progress has been made toward achieving the 2015 goal of "Getting to Zero" -- zero new HIV infections, zero AIDS-related deaths and zero discrimination. Momentum is building as we get closer to that goal. Between 2009 and 2012, the annual number of newly infected children fell by 35 percent. While it is looking unlikely that the world will reach zero new infections by 2015, setting that goal has helped prioritize this life-or-death issue.

As Global Health Corps fellows at the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), we are inspired by and want to build on the incredible efforts to make HIV/AIDS a menace of the past. We serve in Uganda, where we see both the magnitude of the pandemic and the outcomes of efforts to bring HIV transmissions to zero.

While we must laud the remarkable accomplishments of recent years, we fear complacency when conversations focus solely on the incredible progress that has been made. Much work remains. At a time when an AIDS-free generation could soon be a reality, it would be devastating to see progress reversed.

According to the 2013 UNAIDS Global Report, 700 children still become infected with HIV every day. Ninety percent of those infections occur through mother-to-child transmission of the virus. In 2011, 230,000 children died from AIDS-related illnesses. To get to zero, we need to strengthen our efforts toward the prevention of mother-to-child transmission (PMTCT) of HIV, which is our main focus at EGPAF.

Currently available antiretroviral therapy can reduce the risk of mother-to-child transmission to fewer than two percent. Yet most PMTCT services are still provided by time-bound projects funded by external donors -- rather than being integrated into the routine package of services at all health facilities. When a program ends or funding dries up, health facilities are unable to continue providing these life-saving services. With such uncertainty and instability, getting to zero will be immensely difficult.

Are health facilities ready to deliver PMTCT services routinely, rather than just through short-lived programs or interventions? We think so. But it will require that people working to eliminate HIV/AIDS rethink the distribution model for HIV prevention services and redouble technical assistance.

You can find a Coca-Cola in nearly every spot in the world -- but you may not be able to find an HIV test kit.

Lauben and his family were able to be tested for HIV because the Family Support Group program at their clinic is supported by USAID funds. Family members will begin antiretroviral therapy if they test positive -- dramatically improving the quality and length of their lives. If Lauben's mother tests positive and adheres to treatment, the likelihood of her transmitting HIV to future babies is near zero. But if Lauben's family were to go to a different clinic, it is quite possible that they would not have access to those services.

We know what works from years of experience providing these PMTCT services on a project level. On this World AIDS Day, it is time to make the entire world part of the project by making prevention of mother-to-child transmission of HIV a routine service and ensure that every single health center is on track to get new HIV infections to zero.

Global Health Corps selects fellows with diverse skill sets ranging from art to architecture to engineering. Applications are now open for the sixth class of Global Health Corps fellows. If you are passionate about making an impact in global health, we encourage you to apply for a fellowship in Burundi, Malawi, Rwanda, Uganda, Zambia, or the United States.

To apply for a 2014-2015 Fellowship, please visit http://ghcorps.org/fellows/apply/. All applicants must be 30 years or younger, have earned an undergraduate university degree by July 2014, and be proficient in English. Applications close on January 26.

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