Fewer children newly infected with HIV and better health for mothers living with HIV are among the standout achievements of the global AIDS response in recent years, driven by a global movement to eliminate the mother-to-child transmission of HIV.
The Start Free Stay Free AIDS Free initiative is promoting a range of policy and programmatic interventions aimed at reaching the elimination target, as well as other targets set by the United Nations General Assembly for women, young people and children. The initiative is focused on 23 countries that are home to the vast majority of women, young people and children living with HIV.
Progress towards the elimination of mother-to-child transmission has been primarily achieved by dramatically increasing the proportion of pregnant women living with HIV who receive antiretroviral medicines to prevent vertical transmission: from 44% [33–54%] globally in 2010 to 80% [62–>95%] in 2018. Leading the charge are high-performing programmes in much of eastern and southern Africa, where 92% [69–>95%] of all pregnant women living with HIV received antiretroviral therapy in 2018, up from 49% [37–59%] in 2010.
However, alongside such impressive gains are some concerning details. In the 23 focus countries, the number of women receiving antiretroviral medicines for preventing mother-to-child transmission of HIV has changed little since 2015, even though women are receiving more effective regimens than before. In western and central Africa, antiretroviral coverage among pregnant women living with HIV declined from 61% [43–80%] in 2014 to 59% [42–78%] in 2018. Weak health systems are holding back progress, as are competing national priorities and shifts in donor funding. The 2020 target of a 95% reduction in new HIV infections among children is in danger of being missed.
This report details the key progress made in this area, while also highlighting the necessity for continued efforts to hit global targets, starting on page 103.