Preventing mother-to-child transmission of HIV within HIV proposals funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria
This article aims to to analyse interventions for the prevention of mother-to-child-transmission of HIV (PMTCT) included in HIV proposals approved for funding by the Global Fund to fight AIDS, Tuberculosis and Malaria (Global Fund).
PMTCT interventions are guided by a comprehensive strategic approach, which includes four components:
- primary prevention of HIV infection among women of childbearing age
- preventing unintended pregnancies among HIV infected women
- preventing HIV transmission from a woman living with HIV to her infant
- provision of appropriate treatment, care and support to mothers living with HIV and their children and families.
The first comprehensive analysis of sexual and reproductive health components in HIV proposals funded through the Global Fund has shown that an average of 25 per cent of all HIV proposals include interventions related to PMTCT. In light of the priority by many partners including UNAIDS to scale up PMTCT services and for the elimination of paediatric HIV in newborn, the authors conducted an in-depth analysis of the four components of the global PMTCT strategy in funded HIV proposals. A particular focus was to assess whether the interventions included comprehensive PMTCT services where a balance between the different components was apparent. Individual approved HIV proposals submitted to the Global Fund were analysed for these components.
In total, 345 original HIV proposals approved for funding from Rounds 1 to 9 were reviewed. The four components of the global PMTCT strategy do not feature equally. In particular, prevention of unintended pregnancies in HIV infected women (component 2) was the least represented, appearing in 34 per cent of the proposals. On the other hand, preventing HIV transmission from a woman living with HIV to her infant (component 3) was present in approximately 90 per cent. However, component 2 represents the only component that consistently increased throughout the Rounds, with signs of the greatest increase between Rounds 3 and 7.
The authors conclude that it is important for countries to support comprehensive PMTCT interventions that are balanced across the four components. The Global Fund is one of the largest donors and this study shows interventions that countries could capitalise on to scale-up PMTCT efforts as well as synergise efforts in linking with other global and national initiatives in maternal, reproductive, and child health.