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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]
1. Basic facts about PMTCT
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
2. Defining “Elimination of 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…
4. How much would it cost?
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]
5. Where do we focus efforts?
Where to focus efforts:  25 countries with highest burden of MTCT ,[object Object],[object Object]
6. What role for Peace Corps?
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]
What role for PCV:  measuring progress
7. In Summary
In Summary ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
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Elimination of mother to child transmission of hiv