Like many other countries in Africa, Malawi is preparing to revise its policies for prevention of mother-to-child transmission (PMTCT) of HIV and for antiretroviral therapy (ART) in response to WHO’s 2010 guidelines. This guidance is timely in view of the limited efficacy of single-dose nevirapine used in many PMTCT programmes and the challenges facing the effective expansion of health service delivery. The drive from the Global Fund to Fight AIDS, Tuberculosis and Malaria to increase coverage of PMTCT services is increasing, particularly in countries with high burdens of HIV infection; high coverage is essential to reduce transmission to infants, to provide treatment for HIV-infected women, and to meet the relevant 2015 Millennium Development Goals of reducing child mortality, improving maternal health, and combating HIV infection and AIDS, malaria, and other diseases.