By Margaret Reeves
Prevention of mother-to-child transmission of HIV (PMTCT) is an essential tool in the fight against HIV. A comprehensive PMTCT approach includes four components: primary prevention of HIV among women of childbearing age; preventing unintended pregnancies among women living with HIV; preventing HIV transmission from women living with HIV to their infants; and providing appropriate treatment, care, and support to women living with HIV and their children and families. It is estimated that PMTCT, when done exceptionally well, can reduce the rate of transmission of HIV in pregnancy, at birth, and while breastfeeding, from 25–45 percent to less than 2 percent. Mother-to-child transmission accounted for over 90 percent of the estimated 370,000 new HIV infections among children in 2009. Better PMTCT programs have the promise of significantly reducing this number.
The United States has an opportunity to make rapid progress on PMTCT in the 14 countries where PEPFAR is already partnering with governments to implement PMTCT Acceleration Plans. To facilitate progress more broadly, the United States should use its leadership role and influence in global health to encourage other donors, partner organizations, and institutions such as the Global Fund to do more to lower the incidence of mother-to-child transmission. Through its own programming and diplomatic partnerships, the United States can do better by addressing more aggressively stigma and gender inequity, integrating programs, and strategically targeting investments to address persistent obstacles.
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