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close this bookPrevention of HIV Transmission from Mother-to-Child: Planning for programme implementation - Conclusions of the meeting (UNAIDS, 1998, 16 p.)
View the document(introduction...)
View the documentBackground
View the documentTaking interventions to scale
View the documentOptimum context
View the documentKey principles
View the documentUnresolved issues
View the documentThe need for action and support
View the documentCoordination mechanisms

Taking interventions to scale

Any national strategy to prevent mother to child transmission of HIV should be part of broader strategies to prevent the transmission of HIV and STDs, to care for HIV-positive women and their families, and to promote maternal and child health. The ability to make widely available, and as soon as possible, the interventions to reduce HIV transmission from mother to child depends on political will, affordability of the interventions, and the strength of existing human resources and infrastructures. Powerful means of effecting change lie in demonstrating the success of interventions to reduce mother to child transmission of HIV, as well as the costs of not acting to prevent this kind of transmission.

Three factors that affect the affordability of interventions to prevent mother to child transmission are: (i) the cost of drugs; (ii) the cost of safe alternatives to breastfeeding; and (iii) the cost of HIV tests. WHO has added zidovudine for mother to child transmission to the Essential Drug List. Glaxo-Wellcome has recently offered zidovudine at substantially reduced prices. Further negotiations are planned to minimise the cost of each of these components.

Service delivery, including voluntary HIV counselling and testing, represents a further set of costs. In countries with well-functioning health systems, the additional service delivery costs of interventions to prevent mother to child transmission may be affordable. Other countries may require more substantial investments in order to strengthen their health infrastructure to allow for the incorporation of large scale interventions. Where applicable, traditional health and community support systems should also be fully utilised. Such investments will have a broad beneficial effect on the health sector more generally and should be encouraged.