Intended for healthcare professionals

Letters Vertical transmission of HIV in high prevalence settings

WHO’s path to elimination of mother-to-child transmission of HIV and syphilis

BMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m562 (Published 17 February 2020) Cite this as: BMJ 2020;368:m562
  1. Nathan Shaffer, WHO consultant in HIV and elimination of mother-to-child transmission1,
  2. Melanie Taylor, medical officer2,
  3. Morkor Newman, medical officer2,
  4. Innocent Nuwagira, medical officer in reproductive, women’s health, and ageing3,
  5. Francoise Bigirimana, medical officer4,
  6. Merceline Dahl Regis, consultant5,
  7. Angela Mushavi, national prevention of mother-to-child transmission and pediatric HIV care and treatment coordinator6,
  8. Meg Doherty, coordinator HIV treatment and care2,
  9. Marc Bulterys, manager of the WHO global hepatitis programme2,
  10. Ian Askew, director of the department of reproductive health and research and human reproduction programme2,
  11. Gottfried Hirnschall, director of the department of HIV and hepatitis2
  1. 1Atlanta, Georgia, USA
  2. 2World Health Organization, 20 Avenue Appia, 1211 Geneva, Switzerland
  3. 3World Health Organization Regional Office for Africa, 86 Enterprise Road, Harare, Zimbabwe
  4. 4World Health Organization, Regional Office for Africa, cite du Djoue, PO Box 06/Office 279, Brazzaville, Congo
  5. 5Commonwealth of the Bahamas, Bahamas Medical Council, # 37 Collins Avenue, Nassau, Bahamas
  6. 6Ministry of Health and Child Care, Mukwati Building, 5th Street and Livingstone, Harare, Zimbabwe
  1. mtaylor{at}who.int

In their recent article in The BMJ (“Is elimination of vertical transmission of HIV in high prevalence settings achievable?”)1 Goga and colleagues make several important points, including that more realistic targets are needed to maintain momentum to reduce vertical transmission of HIV in countries with high prevalence. They also make a constructive proposal to encourage countries to use “dashboards” to track key coverage and process indicators, particularly during the “pre-elimination period,” and to encourage continuous programme assessment and use of data for improvement.

We are concerned, however, that they misrepresent the World Health Organization (WHO) and global partners’ elimination of mother-to-child transmission of HIV and syphilis (EMTCT) initiative.2 The authors include a box showing the criteria for elimination of vertical transmission of HIV from the …

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