07a pregnant women in hiv and aids (national)

8/10/2019 07a Pregnant Women in HIV and AIDS (National)

1/16

Elimination of Mother-to-Child

Transmission (EMTCT) of HIV

The 13th

Philippine National Convention on AIDS,

24-25 October 2014, Manila, Philippines


2/16

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

0

100,000

200,000

300,000

400,000

500,000

600,000

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

PMTCTcoverage

New

HIVinfection

s(#)

Maternal ARVs for PMTCT

New HIV infections in children (0-4)

Source: UNAIDS 2013 HIV and AIDS estimates, 2014, and UNAIDS/WHO/UNICEF Global AIDS Response Progress Reporting (GARPR)/Universal Access data, 2006 -2014

EMTCT Global Progress

Number of new infections in children has fallen

Decreased from 575,000 (2001) to 240,000 in (2013)

Source: UNAIDS 2013 HIV and AIDS estimates, 2014, and UNAIDS/WHO/UNICEF Global AIDS Response Progress Reporting (GARPR)/Universal Access data, 2006-2014


3/16

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

20

01

20

02

20

03

20

04

20

05

20

06

20

07

20

08

20

09

20

10

20

11

20

12

20

13

20

14

20

15

New

HIVinfectionamo

ngchildren(#)

22,000 (2013)26,072 (2009)

16% decline

2,607

Decline in new HIV infections among children (0-14 year)

Asia -Pacific, 2001-2013

2015 Target

17% decline, 2001 - 2009

Elimination calls for 90% reduction in new infections

Decline of HIV incidence among children by 16%between 2009 and 2013


4/16

Global Elimination of New HIV Infections Among Children and KeepingTheir Mothers Alive (EMTCT) Goals and Targets

Child Targets

6 prong targets

TARGETS AND INDICATORS

2


5/16

2013All countries in the Region have made the switch to Option of B or B+(The 9th PPTCT task force meeting, August 2013, Kathmandu, Nepal)

2010

Endorsement of the Regional goal of EMTCT of HIV and syphilis(The 8th PPTCT task force meeting, November 2010, Vientiane, Lao PDR)

Conceptual framework for EMTCT of HIV and syphilis

in the Asia Pacific by 2015 (2011)

- 8 countries (Cambodia, China, Fiji, Indonesia, Malaysia,Papua New Guinea, Sri Lanka and Thailand)

committed to the Dual goal of eliminating new paediatric

HIV and congenital syphilis

- China and Fiji committed to Triple goal of eliminating

HIV/syphilis and Hepatitis B

Commitment: Asia-Pacific


6/16

7

17%

4%

0%

22%

4%

49%

68%

14% 13%

59%

20%

4%

34%

4%

60%

98%

48% 49%

68%

28%

8%

38%

0%

73%

98%

56% 57%

75%

30%

10%

43%

1%

88%

98%

62% 62%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Eastern and

Southern Africa

West and Central

Africa

Middle East and

North Africa

East Asia and

Pacific

South Asia Latin America and

Caribbean

CEE/CIS All low- and

middle-income

countries

22 Global Plan

priority countries

2005* 2010 2011 2012

Source: United Nations Childrens Fund, TowardsanAIDS-FreeGenerationChildrenandAIDS:SixthStocktakingReport,2013, UNICEF, New York, 2013. Note: data for

South Asia excludes India

PPTCT Coverage- the most effective ARV for PMTCT


7/16

Testing Infants - % infants born to HIV positive pregnant women receivedvirological HIV test within 2 months of birth, 2012

Source: Prepared by www.aidsdatahub.org based on 1)UNAIDS. (2013). Global Report: UNAIDS Report on the Global AIDS Epidemic 2013.; 2)

2

4

6

8

E

y

n

a

n

d

a

n

s

(

)

Low coverage despite ready linkages to EPI programme
http://www.aidsdatahub.org/http://www.aidsinfoonline.org/http://www.aidsdatahub.org/


8/16

Pediatric ART Coverage

9

13%

6% 6%

44%

18%

42%

29%

13%11%

26%

10%

4%

51%

30%

44%

88%

23% 22%

34%

13%

10%

49%

28%

48%

88%

29% 29%

40%

15%

7%

53%

39%

67%

85%

34% 34%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Eastern and

Southern Africa

West and Central

Africa

Middle East and

North Africa

East Asia and

Pacific

South Asia Latin America and

Caribbean

CEE/CIS All low- and

middle-income

countries

22 Global Plan

priority countries

2007 2010 2011 2012

Source: United Nations Childrens Fund, Towards an AIDS-Free Generation Children and AIDS: Sixth Stocktaking Report, 2013, UNICEF, New York, 2013


9/16

PMTCT Option B/B+

Simplification of regimen and service delivery and

harmonization with ART programmes Once daily, single-pill, TDF + 3TC (or FTC) + EFV (B/B+)

ART delivery in MCH settings (task-shifting, coordination with ART programmes)

Not dependent on CD4 testing for initial decision: prophylaxis vs. treatment

Protection against MTCT in future pregnancies

Prevention against sexual transmission to

serodiscordant partners Avoiding stopping and starting ARV drugs

Benefit to the mother's health of early ART

Source: WHO PMTCT Guidelines 2010 and 2012 updates, Dr Razia Narayan Pendse, WHO SEARO


10/16

Option B Option B+China Cambodia

Lao PDR Fiji

Myanmar Indonesia

Malaysia

Mongolia

Papua New Guinea

Thailand(through test and treat policy)

Timor Leste

Vietnam (6 provinces)

Option B or B+ has now been adopted

in 12 East Asia Pacific countries

Source: WHO SEARO and EAPRO compilation of regimens adopted in South East Asia and East Asia Pacific July 2014


11/16

1046

429

307

825

0

200

400

600

800

1000

1200

No. est.Pregnant

women with HIV

No. pregnant

women diagnosed

with HIV

No. HIV+ve

pregnant women

receiving ARV

No. infants

receiving ARV for

PMTCT

No. Infants

receiving EID

Number

?No Data

PNG: Cascade of PPTCT Services (2013)

Source: 2014 UNAIDS GARPR data for Papua New Guinea (2013)


12/16

4287

3066

1323

0

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

No est. Pregnant

women with HIV

No. pregnant

women

diagnosed with

HIV

No. HIV+ve

pregnant women

receiving ARV

No. infants

receiving ARV for

PMTCT

No. infants

receiving EID

Number

Myanmar: Cascade of PPTCT Services (2013)

Source: 2014 UNAIDS GARPR data for Myanmar (2013)

? ?No Data No Data


13/16

3081

3374

1433

0

500

1000

1500

2000

2500

3000

3500

4000

No. est pregnant

women with HIV

No. pregnant

women

diagnosed with

HIV

No. HIV+ve

pregnant

receiving ARV

No. infants

receiving ARV for

PMTCT

No. infant

receiving EID

Numbe

r

? ?No Data No Data

China: Cascade of PPTCT Services (2013)

Source: 2014 UNAIDS GARPR data for China (2013)


14/16

Validation of EMTCT

Target

HIV: 50 new paediatric new

infections per 100 000 live births

and a transmission rate of either


15/16

2012 Pilot validation of EMTCT in countries

Cambodia, Malaysia, Sri Lanka, and Thailand

2014 Regional Core Group Meeting for theValidation of EMTCT in Asia and the Pacific

(10th November 2014, Bangkok, Thailand)

- To discuss regional mechanisms for validation

- To review operational tools developed by HQ and other regions

- To prepare for the establishment of the Regional Validation

Committee

Validation of EMTCT in Asia-Pacific


16/16

THANK YOUAcknowledgements

UNICEF EAPROUNICEF Philippines

WHO Regional Office for Western Pacific

07a pregnant women in hiv and aids (national)

Documents