Elimination mother-to-child transmission of HIV and syphilis

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This guidance document provides standardized processes and consensus-developed criteria to validate EMTCT of HIV and syphilis, and to recognize high-HIV burden countries that have made significant progress on the path to elimination. The guidance places strong emphasis on country-led accountability, rigorous analysis, intensive programme assessment and multilevel collaboration, including the involvement of communities of women living with HIV. It provides guidance to evaluate the country’s EMTCT programme, the quality and accuracy of its laboratory and data collection mechanisms, as well as its efforts to uphold human rights and equality of women living with HIV, and their involvement in decision-making processes.

The second edition of the global guidance presents a new approach to recognizing high-burden countries that may not have reached elimination targets but are on the “Path to Elimination”. The approach and defining criteria for the Path to Elimination were developed during a series of consultations with countries in the Africa Region in 2016 and early 2017. They are designed for countries with a high prevalence of HIV and/or syphilis which have made tremendous progress in preventing MTCT but cannot as yet reach elimination targets due to the high prevalence of HIV and syphilis in antenatal care (ANC) attendees. The Path to Elimination comprises three tiers of accomplishment, each with its own set of process and outcome indicators. Moving to a higher tier brings a country progressively closer to elimination.