THE FIRST DECADE: PROGRESS AND CHALLENGES
Plan.16 This means reaching an estimated 1.5 million (1.4 million–1.7 million) pregnant women living with HIV annually, based on 2012 estimates (see Figure 1.1).17 Without any interventions, between 15 per cent and 45 per cent of infants born to these women will acquire HIV: 5–10 per cent during pregnancy, 10–20 per cent during labour and delivery, and 5–20 per cent through breastfeeding.18
TOWARDS AN AIDS-FREE GENERATION – Children and AIDS: Sixth Stocktaking Report, 2013
Since the first effective ARV regimen for the prevention of mother-to-child transmission (PMTCT) of HIV was reported in 1994, the outlook for children born to mothers living with HIV has improved dramatically. In high-income countries, mother-to-child transmission of HIV has been virtually eliminated.14 Today, steadily expanding coverage of the most effective ARVs, together with new approaches to providing them, offer hope that mother-to-child HIV transmission can also be virtually eliminated in low- and middle-income countries.
Significant progress is being made in expanding access to ARVs for PMTCT Encouraging progress has been made in scaling up and improving the quality of programmes. In 2012, approximately 900,000 pregnant women living with HIV in low- and middle-income countries received ARVs to prevent mother-to-child transmission – either ART primarily for their own health or the most efficacious antiretroviral prophylaxis.19 This represents one third more than the number who received it in 2009. While the world is currently reducing new HIV infections among children faster than at any other time in history, the pace will have to be accelerated even more to achieve the 2015 target of 90 per cent reduction (see Figure 1.2).
The Global Plan Towards the Elimination of New HIV Infections Among Children by 2015 and Keeping Their Mothers Alive (‘the Global Plan’) identifies 22 priority countries where almost 90 per cent of all new HIV infections among children occur. Of these countries, 21 are in sub-Saharan Africa; the other country is India.15 Reducing mother-to-child transmission to less than 5 per cent of breastfeeding infants and to less than 2 per cent of non-breastfeeding infants is an important target of the Global
FIGURE 1.1 Estimated number of pregnant women living with HIV in low- and middle-income countries, 1990–2012 1.5 million pregnant women living with HIV (2012)
2,000,000
1,500,000
1,000,000
500,000
0 1990
1995
2000
Note: The area in blue indicates the uncertainty ranges around the estimates. Source: UNAIDS 2012 HIV and AIDS estimates.
6
2005
2010
2012