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Published: 2012

Total Pages: 30

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"Impressive advances in scaling up programmes for the prevention of mother-to-child transmission (PMTCT) of HIV have been made in many low-income and middle-income countries. However, these successes have not been seen yet in the Eastern Mediterranean/Middle East and North Africa (EM/MENA) Region, and special efforts are needed in this Region to prevent mother-to-child transmission of HIV. A situation analysis shows that while most countries in the Region are characterized as having a low level or concentrated epidemic, the EM/MENA Region is among the top two regions in the world with the fastest growing HIV epidemics. Three countries--Djibouti, Somalia and South Sudan--are already experiencing generalized epidemics. The health sector response to HIV has been variable; some countries have made great strides to better understand their epidemic and to scale up testing and treatment. However, regional antiretroviral therapy coverage remains low at 13% (2011). The scaling-up of PMTCT interventions in the Region has been generally slow. Primary prevention efforts may have missed the women who are usually infected by spouses, but who have little, if any, awareness of their risk. Data on unmet need for family planning among all women, including HIV-infected women, are not widely available. HIV testing for pregnant women is not universally offered and coverage for the Region remains one of the lowest in the world. Consequently, coverage of pregnant women receiving the most effective antiretroviral regimen for PMTCT in 2010 was less than 5%. The Region has embraced the global vision for elimination of new HIV infections among children and keeping their mothers alive. It has adopted the overall global goals of reducing the number of new HIV infections among children by 90% by 2015, and reducing the number of AIDS-related maternal deaths by 50%, also by 2015. Further, experts in the Region have determined that the globally-endorsed, comprehensive approach to prevention of mother-to-child transmission is essential for the elimination of HIV infections among children. This approach includes primary prevention; preventing unintended pregnancies among women living with HIV; preventing transmission of HIV from HIV-infected pregnant women to their children; and providing treatment, care and support to mothers, children and families living with HIV. The regional initiative "Towards the elimination of mother-to-child transmission of HIV in the Middle East and North Africa" demonstrates the Region's commitment to the elimination of new HIV infections among children, and will guide countries to move productively and expeditiously toward this goal. The initiative is not separate from the goal of universal access to prevention, treatment and care but rather forms part of the comprehensive HIV response, and will also contribute to the progress being made to reach the targets of the United Nations Millennium Development Goals 4, 5 and 6. This document is designed to provide the Region with a common systematic approach to the elimination of mother-to-child transmission of HIV. The framework serves as a tool to advocate for government endorsement of the elimination initiative. The intended audience for this document includes implementing partners, programme managers, clinicians and networks of people living with HIV."--Executive summary, p. 5.