INTRODUCTION

The HIV/AIDS epidemic is resulting in more than 600,000 infants becoming infected each year, and in many countries HIV/AIDS has become a major cause of infant and young child mortality. From a human rights perspective, governments and UN agencies have an obligation to support action to prevent infants from becoming infected.

Since the initiative for the prevention of mother-to-child transmission of HIV (PMTCT) was launched in 1998, it has become clear from the increasing scientific evidence and recent results from countries such as Botswana, Cote d’Ivoire, Uganda, Rwanda and Zimbabwe, that it is possible to make a difference.

At country level, more national leaders and governments are recognising the seriousness of the situation and are creating a supportive political environment by setting up national HIV/AIDS councils and secretariats and committing government resources to the response to HIV/AIDS. Within the framework of the International Partnership against HIV/AIDS in Africa (IPAA), a number of international agencies (UNICEF, WHO, UNFPA) under the coordination of UNAIDS, have already demonstrated their commitment to supporting interventions aimed at preventing mother-to-child transmission (MTCT) in Africa. Some countries are moving from pilot projects to scaling-up.

The current actions, however, are clearly not enough. There is an urgent need for more countries to start implementing PMTCT interventions on a national scale in order to have a meaningful impact. In addition, the planning and implementation of PMTCT interventions should be broadened to increase participation and support for HIV-infected women, and encourage greater involvement of males and people living with HIV/AIDS. Primary prevention of HIV infection in women of reproductive age should remain the focus of interventions to reduce MTCT of HIV. Early identification of HIV-infected women of reproductive age through improving accessibility and acceptability of voluntary counselling and testing (VCT) services and appropriate counselling on reproductive options should also be given due consideration in the context of PMTCT strategies.

In short, a much more substantial response to PMTCT of HIV is urgently needed from all actors - governments, non-governmental organisations (NGOs), local communities, the private sector and international development organisations.

In light of the above, participants from 14 countries in Africa, Latin America and the Caribbean representing government and NGOs met in Gaborone, Botswana, from 27-31 March 2000 with the specific objectives of taking stock of the present status of implementation of interventions for the prevention of MTCT of HIV and proposing appropriate corresponding actions. The list of participants is attached in Annex 1.