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PMTCT Update N. Shaffer PMTCT/Peds TWG PEPFAR Track 1.0 Annual Meeting Aug 12, 2008 Washington DC. Key Messages. PMTCT programs have made important progress but lagging behind ART scale-up High PMTCT coverage and impact is achievable soon , but only with renewed focus
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PMTCT UpdateN. ShafferPMTCT/Peds TWGPEPFARTrack 1.0 Annual MeetingAug 12, 2008Washington DC
Key Messages • PMTCT programs have made important progress but lagging behind ART scale-up • High PMTCT coverage and impact is achievable soon, but only with renewed focus • HAART for treatment-eligible womenand combination prophylaxis regimens essential for high-impact PMTCT • PEPFAR programs should intensify focus onpregnant women, infants and families as key entry-point for care and treatment • PMTCT and ART programs need to be unified and coordinated – comprehensive approach
% of Pregnant Women Attending at least one ANC Visit in the 15 Focus Countries who Received HIV Counseling and Testing in FY06 and FY07, with USG Support, by Country Denominator source estimates used for 2007 are the same as 2006
% of HIV+ Pregnant Women Attending at least one ANC Visit who Received PMTCT ARV in FY06 and FY07 with USG Support, by Country Denominator source estimates used for 2007 are the same as 2006 * S. Afica data incomplete
PMTCT/Peds TWG: Priorities • Routine, opt-out testing (PITC) – key success • Linking PMTCT with ART (more effective ART) • M&E (critical need for harmonization and systems) • PMTCT and Peds targets and national scale-up • Early Infant Diagnosis and early treatment • Safe infant feeding • Training and capacity-building • Operations Research/Public Health Evaluations • Program quality, effectiveness and impact • Integration (EPI, malaria, MCH) • Funding
Comprehensive Approach with PEPFAR ART Partners • PMTCT as part of comprehensive approach • Support regional / provincial health system • Mapping and coordination of clinical sites in region • PMTCT sites? ART sites? • Levels of care and network referrals • PMTCT as HIV care site (pre-ART) • Support PMTCT and care and tx linkages • Active support for ART screening (CD4), HAART and combination prophylaxis • Active links for mother and child follow up • Supply chain • Monitoring and reporting
PEPFAR II: PMTCT Priority • Reauthorization bill emphasizes PMTCT as priority • Targets: at least 80% of pregnant women with prevention and treatment for MTCT • Targets: pediatric care and tx proportional to numbers • Integrate care and treatment with PMTCT … follow up and continuity of care of mother and child • Integrate PMTCT and MCH – access and referral • Expand OVC (key opportunities to link with PMTCT) • More effective regimens: expand access; goal of achieving universal use as soon as possible • PMTCT expert panel – strategic review and guidance to the Global AIDS Coordinator