1. Mitchell J. Besser, MD Founder and Medical Director mothers 2 mothers 4 October 2010 mothers 2 mothers: Preventing Mother-to-Child HIV Transmission in AfricaUsing New Paradigms in Health Care Delivery

2. Population HIV Prevalence Zimbabwe South Africa Botswana Senegal Mali 3. Life Expectancy: 1950-2005 with high HIV prevalence : Zimbabwe South Africa Botswana with low HIV prevalence: Madagascar Senegal Mali Source:UN Department of Economic and Social Affairs (2001)World Population Prospects, the 2000 Revision . 19501955 1955-1960 1960- 1965 1965- 1970 1970- 1975 1975- 1980 1980- 1985 1985- 1990 1990- 1995 1995- 2000 2000- 2005 30 35 40 45 50 55 60 65 Life expectancy (years) 4. Grim Reality UNAIDS: 2007, 2010 FACTS:

2.5 million new HIV infections (2007)

2.1 million adults and children died of HIV/AIDS (2007)

1.2 million people started on treatment in 2009

Each year: Twice as many people become infected withHIV as start on treatment; Twice as many people die of AIDSas start on treatment. 5. Global HIV Prevalence 33.4 millionliving with HIV in 2008 Sub-Saharan Africa 22.4 million 6. 90% of HIV-positive pregnantwomen are inSub-Saharan Africa 1.4 million pregnant women in low- and middle-income countries are infected with HIV 7. Towards Universal Access, WHO, 2009 Grim Inequities Prevalence in Pregnancy Nigeria 2.4 - 4% South Africa 29% US and UK 0.6% Adult Prevalence Nigeria 3% South Africa 18% US and UK 0.3 - 0.6% PMTCT Coverage Nigeria 10% South Africa 73% US and UK > 95% ARV Coverage (children) Nigeria 12% South Africa 61% US and UK > 95% 8. Pediatric HIV infections in U.S. 80% decline CDC PACTG 076 AZT treatment starts 9. Siripon Kanshana, 2007 Pediatric HIV infections in Thailand 80% decline HIV testing PMTCT ARVs National PMTCT program 10. UNAIDS estimates 2008 Pediatric HIV infections in World 11. 1100 children infectedper day in 2008 12. 1in Europe