Pmtct

ACCELERATING CHILD SURVIVAL AND DEVELOPMENT 2009 Uganda’s Battle Against the Top Childhood Threats .© UNICEF Uganda/Chulho Hyun

PREVENTING MOTHER TO CHILD TRANSMISSION OF HIV SITUATION SUMMARY According to the recent 2007 Uganda Child Verbal Autopsy Study carried out by the Uganda Bureau of Statistics, HIV/AIDS accounts for close to 6% of deaths for children under-five. Approximately 110,000 children are living with HIV, of which 50,000 are in immediate need of life-saving treatment. Tragically, however, only 10,000 (<20%) of these children are receiving treatment, which is less than 10% of all the people on AntiRetroviral Therapy (ART). Paediatric AIDS is a result of failure of the Preventing Mother-to-Child Transmission (PMTCT) programme as 95% of children with HIV acquire the virus from their mothers. However, having a healthy baby is possible. Developed countries have reduced HIV transmission from mothers to children to less than 2% - yet in Uganda, transmission rates remain between 25-30%. To arrest transmission, pregnant mothers should be tested during their ante-natal care (ANC) visits, and be given ARVs, if positive for the virus. According to according to the UDHS 2006, approximately 94% of women made at least one ANC visit, showing the enormous potential of this intervention to reach women with life-saving information and care. However, at the end of 2008, the PMTCT intervention was available in only 66% of all health facilities providing ANC in UNICEF-supported districts (up from 43% in 2007). Positively, 70% of women were tested for HIV in ANC in 2008, up from 48% in 2007. However, only 55% of HIV+ pregnant women received ARVs to reduce MTCT in 2008 (up from 29% in 2007). In the absence of the PMTCT intervention close to 30,000 children are infected with HIV per year.

REGIONAL PERSPECTIVE There are regional variations in coverage levels but all have increased over the last year. For example, only 3% of HIV+ pregnant women in Karamoja received ARVs for PMTCT in 2007 but in 2008 this rose to 41%. Performance by Region on PMTCT - 2008

80

90

83

60 40

57

61

81 64

59 49

51 42

56

50

20 0

Acholi

Lango

Karamoja

UNICEF’S CATALYTIC RESPONSE UNICEF works at both the national level, and in 23 districts to remove bottlenecks in systems and structures, enhancing the Government of Uganda’s capacity to deliver essential services in pursuit of MDG6 (to arrest and reverse the spread of HIV) Our “catalytic” support aims to ensure that: • Children represent at least 15% of all patients benefiting HIV care and treatment programmes (through advocacy and leveraging of resources from HIV partners/donors in Uganda); • Children and mothers access early diagnosis and referral by scaling up availability of PMTCT services to 80% of all ANC clinics (through technical assistance and support to Districts/Ministry of Health); • 80% of expectant mother are tested for HIV and 70% access ARVs (by ensuring districts have adequate stocks of drugs and supplies for the ANC/ PMTCT intervention through supply, cash and technical assistance); • Medical Workers and focal-points have adequate qualifications, training and authority to implement the full ANC and PMTCT package; • Community members are aware of HIV-related risks and the services available for treatment, leading to an increase in utilisation of services (through social mobilization activities).

UNICEF CHILDREN AND AIDS PROGRAMME INDICATIVE BUDGET FOR 2009 Budgetary Requirements: 6 million USD • 5 million USD for interventions in 23 focus districts; • 1 million USD to expand advocacy, leveraging and partnerships at the national level.

A NC sites with P M TCT Expected pregnant wo men tested HIV at A NC HIV+ wo men given A RVs fo r P M TCT

100

A UNICEF-supported Voluntary Counseling and Testing Site in northern Uganda.

West

FOR MORE INFORMATION Dr. Dirk Stefan Buyse Chief, Children and AIDS [email protected]

Karen Allen Deputy Representative [email protected]