UNAIDS has set the ambitious target of eliminating mother to child transmission of HIV through implementation of antiretroviral therapy based prevention of mother to child transmission (PMTCT) programmes. Although substantial progress has been made over the years, in 2018 160,000 children were estimated newly infected in the 23 countries that are part of the Start Free Stay Free AIDS Free Initiative (https://free.unaids.org/).
The World Health Organization (WHO) has regularly updated their PMTCT guidelines for developing countries, in response to new evidence about the efficacy of PMTCT regimens. In 2010, WHO recommended ‘Option A’. In 2013, WHO updated their guidelines, recommending that all pregnant women, regardless of clinical stage, receive ART at a minimum during pregnancy and breastfeeding (Option B) or ideally lifelong (Option B+).
Option A was implemented in Zimbabwe starting 2011. And Option B+ was implemented starting in 2014. CeSHHAR, in partnership with Ministry of Health and Child Care, University California Berkeley and others has been evaluating the population level impact of these programmes and working Ministry to bring about elimination of paediatric HIV in Zimbabwe