1. XVII International AIDS Conference
PMTCT and Paediatric AIDS Care and Treatment: measuring progress in low and middle income countries
XVII International AIDS Conference
Mexico City, Mexico
7th August, 2008
Unite for Children,
Unite against AIDS.
Patricia Doughty
Programme Officer, HIV/AIDS and Health
Health Section, Programme Division
UNICEF New York

2. Background
Women and girls account for half of all people living with HIV worldwide, and for 60% in sub-Saharan Africa.
2 million children (<15) were estimated to be living with HIV in 2007.
370,000 were newly infected, 90% through mother-to-child transmission.
270,000 children died of HIV related causes

3. Tracking progress: Methodology
PMTCT and paediatric HIV care and treatment Report Card questionnaire developed in 2004.
PMTCT data available for 2004, 2005, 2006 & 2007; paediatric HIV care and treatment for 2005, 2006 & 2007.
Data collection is administered by UNICEF & WHO on behalf of the PMTCT Interagency Task Team (IATT).
Collect coverage data on the PMTCT cascade, paediatric HIV CST, and programme implementation information. 36 indicators
In 2007, data was available from 109 countries accounting for 99% (1,493,320) of the estimated 1.5 million women living with HIV giving birth in 2007.

4. Core indicators
New developments on normative guidance on implementation of PMTCT and paediatric HIV interventions have led to revisions of existing M&E to align with latest recommendations and address gaps.
Examples:
Existence of policies & programme components– scale-up plans, PITC, DBS, bottlenecks
Scale-up of service provision sites – MNC health facilities providing HIV testing and counselling, ARVs, CD4 testing, virological testing, ART
Follow up & care of HIV positive pregnant women & postpartum mothers – use of more efficacious prophylactic regimens, treatment of eligible HIV-infected pregnant women; access to ART & care, family planning
Follow up & care of infants born to HIV positive mothers – cotrimoxazole prophylaxis, early infant diagnosis for HIV, access to ART & care, nutritional support

5. Results

6. Percentage of pregnant women with HIV receiving antiretrovirals for PMTCT of HIV in low-and middle-income countries,
NOTE: Values for East and Southern Africa and West and Central Africa are included in sub-Saharan Africa

7. Percentage of pregnant women with HIV receiving antiretrovirals for PMTCT of HIV in low-and middle-income countries,
NOTE: Values for East and Southern Africa and West and Central Africa are included in sub-Saharan Africa

8. Percentage of pregnant women with HIV receiving antiretrovirals for PMTCT of HIV in low-and middle-income countries,
NOTE: Values for East and Southern Africa and West and Central Africa are included in sub-Saharan Africa

9. Coverage of ARVs for PMTCT varies among the 10 countries with the largest number of pregnant women with HIV, 2007
UNGASS target for 2010

10. Distribution of antiretroviral regimens received by pregnant women living with HIV, 2007
NOTE: Data was analysed with 60 countries accounting for about 60% (911, 500) of the 1.5 million pregnant women living with HIV.

11. Number of children receiving antiretroviral therapy in low- and middle-income countries, 2005-2007
>150% increase from
% Increase
E. and S. Africa - 200%
W. and C. Africa - 550%
Latin America and the Caribbean - 50%
Europe and Central Asia - 150%
East, South and SE Asia - 190%
75 000

12. Countries using Dried Blood Spots (DBS) for virological HIV testing and countries with paediatric HIV care, support and treatment scale-up places,

13. Limitations and ways forward
M&E systems in many countries continue to need strengthening.
Availability of data is increasing and the quality of data is improving.
Greater coordination and harmonization of data at national and global levels.

14. Acknowledgements
UNICEF colleagues at HQ, regional, and country offices
National governments
UNICEF/WHO/UNAIDS PMTCT and paediatric HIV care and treatment data collection and harmonization team
Priscilla Akwara, UNICEF
Michel Beusenberg, WHO
Saba Moussavi, UNAIDS
Yves Souteyrand, WHO
John Kirkwood, WHO
Chika Hyashi, WHO
Members of the Inter Agency Task Team (IATT) on the prevention of HIV among pregnant women, mother and children

15. Thank you.