XVII International AIDS Conference PMTCT and Paediatric AIDS Care and Treatment: measuring progress in low and middle income countries 2004-2007 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

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

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.

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

Results

Percentage of pregnant women with HIV receiving antiretrovirals for PMTCT of HIV in low-and middle-income countries, 2004-2007 NOTE: Values for East and Southern Africa and West and Central Africa are included in sub-Saharan Africa

Percentage of pregnant women with HIV receiving antiretrovirals for PMTCT of HIV in low-and middle-income countries, 2004-2007 NOTE: Values for East and Southern Africa and West and Central Africa are included in sub-Saharan Africa

Percentage of pregnant women with HIV receiving antiretrovirals for PMTCT of HIV in low-and middle-income countries, 2004-2007 NOTE: Values for East and Southern Africa and West and Central Africa are included in sub-Saharan Africa

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

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.

Number of children receiving antiretroviral therapy in low- and middle-income countries, 2005-2007 >150% increase from 2005-2007 198 000 127 000 % Increase 2005-2007 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

Countries using Dried Blood Spots (DBS) for virological HIV testing and countries with paediatric HIV care, support and treatment scale-up places, 2005 - 2007

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.

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

Thank you.