1.3 The cost of inaction

The cost of doing nothing to reduce MTCT will depend a great deal on the prevalence of HIV infection among parents-to-be. In areas where 20% or more of pregnant women are HIV-positive, the financial cost of caring for sick and dying HIV-infected children will be enormous, and there will be significant loss of the benefits from the huge commitment of time, energy and resources spent on reducing child morbidity and mortality over recent decades. Where HIV prevalence is low, health care costs will be relatively low too, and the waste of resources already spent on child survival not quite so dramatic. However, the costs for families and communities cannot be measured in financial terms alone, and many couples will bear responsibility for looking after their infected babies, often while struggling to cope with their own ill-health.