WE HAVE ONLY JUST BEGUN….<br />Goal: Elimination of pediatric HIV <br />Universal access and uptake of services<br />Cost effective, efficient, integrated services<br />Call To Action was a major springboard for the rapid expansion of PMTCT programs throughout Africa <br />and C&T programs!<br />and HIV research! <br />Great progress, but still a long way to go; many challenges remain<br />2<br />
Long and bumpy roads lead to great places<br />8<br />
Where do we go from here?<br />The CTA laid the first stones in the path to elimination of pediatric HIV<br />Completing the path requires GLOBAL action<br />Mobilization of resources to expand PMTCT programs:<br />Effective HIV prevention! <br />PMTCT = MNCH<br />Contributes to multiple MDGs<br />Embodies a woman- and family-centered approach<br />Supports health system strengthening<br />9<br />
WHO’s 4-Component Strategy for MTCT Prevention<br />Prevention of unintended pregnancies in HIV-infected women<br />Prevention of transmission from an HIV infected woman to her infant<br />Prevention of HIV in women, especially young women<br />Support for HIV infected women, their infant, and family<br />Component<br />1<br />Component<br />2<br />Component<br />3<br />Component<br />4<br />10<br />
Requirements for Achieving Scale-up<br />Global advocacy<br />Strong government leadership and prioritization of PMTCT in the country’s HIV/AIDS plan <br />Public health approach to PMTCT<br />Ensure universal access to high-quality PMTCT services<br />Provision of PMTCT in all health services that offer HIV/AIDS care and treatment<br />Universal access to treatment for all eligible HIV-infected pregnant women<br />11<br />
Requirements for Achieving Scale-up<br />Decentralize PMTCT to district and sub-district levels<br />Build capacities for leadership, management, planning and budgeting, M&E<br />Strengthen MCH capacity (staff, infrastructure)<br />Supportive national policies on level of health facilities/workers allowed to provide PMTCT services<br />Greater coordination and collaboration among implementing agencies, international organizations & government entities<br />12<br />
Program-Level Activities<br />Country-level integration of PMTCT, HIV care & treatment, MNCH, FP programs <br />Increase reach of PMTCT programs:<br />Focus resources on women outside the “cascade”<br />Prioritize the inclusion of male partners, family members & community in PMTCT service delivery <br />Address stigma within health workforce<br />Facility program ownership with feedback of program results to support QA/QI activities<br />13<br />
Implementation Research<br />Optimal strategies for cost-effective implementation of PMTCT programs and maximal retention along the PMTCT cascade<br />Models of integration of MNCH, PMTCT, and comprehensive care and treatment services to optimize maternal, infant and child health and survival<br />14<br />
Conclusion<br />2009 WHO Guidelines for PMTCT: Framework for Elimination<br /><ul><li>Blurs the lines between MCH, PMTCT, and HIV CST
Complexity requires renewed intensity, integration, and innovation</li></ul>15<br />
Tunaweza<br />Together, We Can … Eliminate Pediatric HIV<br />Photo Credit: Nigel Barker LLC<br />16<br />DISCLAIMER: This program was made possible through support provided by the Office of HIV/AIDS, Global Bureau Center for Population, Health and Nutrition, of the United States Agency for International Development (USAID), through the President’s Emergency Plan for AIDS Relief, as part of the Elizabeth Glaser Pediatric AIDS Foundation's International Family AIDS Initiatives (“Call To Action Project”/ Cooperative Agreement No. GPH-A-00-02-00011-00). Private donors also supported costs of activities in many countries. The opinions expressed herein are those of the authors and do not necessarily reflect the views of USAID. <br />
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