Mclean, J Women’s Health Care 2012, 1:1 DOI: 10.4172/2167-0420.1000101 Volume 1 • Issue 1 • 1000101 J Women’s Health Care ISSN: 2167-0420 JWHC, an open access journal Open Access Research Article Preventing Mother-To-Child Transmission of HIV within HIV Proposals Funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria Manjula Lusti-Narasimhan*, Rhea Bright, Francis Ndowa and Susana Salgado Pires Department of Reproductive Health and Research, WHO, Switzerland Abstract Objectives: To analyse interventions for the prevention of mother-to-child-transmission of HIV (PMTCT) included in HIV proposals approved for funding by the Global Fund to fght AIDS, Tuberculosis and Malaria (Global Fund). Methods: The global strategy for PMTCT outlines four main components. Individual approved HIV proposals submitted to the Global Fund were analysed for these components. Results: In total, 345 original HIV proposals approved for funding from Rounds 1 to 9 were reviewed. The four components of the global PMTCT strategy do not feature equally. In particular, prevention of unintended pregnancies in HIV infected women (component 2) was the least represented, appearing in 34% of the proposals. On the other hand, preventing HIV transmission from a woman living with HIV to her infant (component 3) was present in approximately 90%. However, component 2 represents the only component that consistently increased throughout the Rounds, with signs of the greatest increase between Rounds 3 and 7. Conclusions: The global community has committed itself to accelerate progress towards the prevention of mother- to-child HIV transmission (MTCT) by 2015 through the initiative to eliminate new paediatric HIV infections. Given this commitment, it is important for countries to support comprehensive PMTCT interventions that are balanced across the four components. The Global Fund is one of the largest donors and this study shows interventions that countries could capitalize on to scale-up PMTCT efforts as well as synergize efforts in linking with other global and national initiatives in maternal, reproductive, and child health. *Corresponding author: Manjula Lusti-Narasimhan, Department of Reproduc- tive Health and Research, World Health Organization 20, Avenue Appia CH- 1211, Geneva 27, Switzerland, Tel: + 41 22 791 1414; Fax: + 41 22 791 41 71; E-mail: lustinarasimhanm@who.int Received November 09, 2011; Accepted December 07, 2011; Published December 17, 2011 Citation: Lusti-Narasimhan M, Bright R, Ndowa F, Pires SS (2012) Preventing Mother-To-Child Transmission of HIV within HIV Proposals Funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria. J Women’s Health Care 1:101. doi:10.4172/2167-0420.1000101 Copyright: © 2012 Lusti-Narasimhan M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Keywords: HIV; PMTCT; Reproductive health; Health fnancing Introduction Te prevalence of HIV infection in women has steadily increased since the early 1990s, primarily through heterosexual transmission and is now the leading cause of mortality among women of reproductive age worldwide [1]. In southern Africa, HIV is also estimated to be directly responsible for 12-15% of all child mortality. Furthermore, the risk of death for children of mothers living with HIV is not only due to becoming HIV-infected themselves, but also indirectly increased by the efect of HIV on mothers who become unable to care for their infants and families. When a mother’s CD4 count drops below 200cells/ml, then all of her children are 3.5 times more likely to die, and when a mother dies her children are 4.2 times more likely to die [2]. A comprehensive approach to preventing mother-to-child transmission (PMTCT) of HIV is designed not only to save infants becoming infected with HIV, but preventing HIV among women and young girls, and preventing unintended pregnancies among women living with HIV. Comprehensive PMTCT interventions therefore provide an important opportunity for improving maternal, newborn and child health and survival. PMTCT interventions are guided by a comprehensive strategic approach [3] which includes four components: Primary prevention of HIV infection among women of childbearing age Preventing unintended pregnancies among HIV infected women Preventing HIV transmission from a woman living with HIV to her infant Provision of appropriate treatment, care and support to mothers living with HIV and their children and families Tere has been uneven progress to date in implementing these four programming areas. Ofering family planning services, for instance, is critical for component 2 and is an underutilized component in PMTCT services, where provision of antiretrovirals (ARVs) has remained the main PMTCT intervention since 2000 [4]. In sub-Saharan Africa, where HIV prevalence is highest, one in four women who wish to delay or stop childbearing do not use or have access to family planning methods. Strengthening linkages between sexual and reproductive health and HIV prevention and care services, in this instance through strengthened family planning, ofers opportunities to scale-up PMTCT services. Te Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) is one of the largest donors for HIV/AIDS programmes worldwide and as of March 2010 the Global Fund had committed US$ 10.8 billion (Approved Grant Amount) in 140 countries out of US$ 17.4 billion (Total Lifetime Budget) [5]. Te adoption and implementation of the Global Fund Gender Equality Strategy [6] supports integration of HIV with maternal, newborn an child health that includes scaling up J o u r n a l o f W o m e n s H e a l t h C a r e ISSN: 2167-0420 Journal of Women's Health Care