Prevention of MTCT: Strategies

Implementation of interventions to prevent MTCT, UNICEF:

Supports regional and national efforts to reduce mother to child transmission of HIV; develops tools for analysis and provides technical assistance to governments to develop and implement country strategies to prevent MTCT. Supports communication and social mobilisation efforts to promote informed and safe behaviour. Works with the UNAIDS co-sponsoring agencies, including the World Health Organisation and the United Nations Population Fund, to identify the most effective ways to reduce the risk of HIV infection in the children of HIV-positive mothers and to improve the survival rate of children with HIV.

As a member of the UNAIDS Inter-Agency Task Group on Prevention of MTCT, UNICEF participates in a range of global actions to support the prevention of mother to child transmission of HIV. One of the Group's first actions was to initiate a series of pilot projects to implement interventions to prevent MTCT. The Group has been instrumental in securing financial resources as well as material supplies for these pilots and is providing practical support for their implementation. The pilot projects include a comprehensive package of interventions:

Ensuring early access to adequate antenatal care. Providing voluntary and confidential counselling and HIV testing for women and their partners to enable women to find out their HIV status. Administering AZT to HIV-positive women during pregnancy and delivery. Improving care during labour and delivery. Counselling for HIV-positive women to explore infant feeding options. Supporting HIV-positive women who choose not to breastfeed.

UNICEF has been building partnerships with the private sector to help combat HIV/AIDS. One example is working with the pharmaceutical industry to make antiretroviral drugs available for prevention of MTCT. As a result, donations of AZT have been secured from a pharmaceutical for the pilot countries. The manufacturer has announced substantially lower pricing for AZT.

UNICEF is also assisting Ministries of Health, National AIDS Control Programmes and other partners to carry out the pilots by working with governments and suppliers of breastmilk substitutes to identify practical ways to provide infant feeding alternatives such as home-prepared or commercial infant formula with generic labels to participating mothers. Making alternative feeding options available to HIV-positive mothers who have decided not to breastfeed creates the danger of spillover of artificial feeding. UNICEF, therefore, continues to promote and support breastfeeding as the best feeding method for infants of mothers who are HIV-negative or who do not know their HIV status. It also works to ensure that methods used for procuring and distributing alternatives to breastmilk comply with the International Code of Marketing of Breastmilk Substitutes and resolutions of the World Health Assembly. Additionally, UNICEF is working with governments in the pilot project countries to strengthen the implementation and monitoring of the Code.

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