Uganda Adopts New PMTCT Strategy, Option B+

Uganda Adopts New PMTCT Strategy, Option B+

Uganda. {Photo credit: Paydos/MSH.}Photo credit: Paydos/MSH.

The Ugandan government launched a new prevention of mother-to-child HIV transmission (PMTCT) strategy on September 12.

Uganda will transition from an approach based on the World Health Organization's (WHO) Option A --- which is contingent on an HIV-positive pregnant woman’s CD4 count --- to WHO's newest PMTCT strategy, Option B+.

Option B+ — whereby HIV-positive pregnant women receive lifelong treatment, regardless of their CD4 levels — originated in 2010 when the Malawian government decided to combine antiretroviral therapy (ART) with PMTCT in response to the challenges of providing reliable CD4 testing in remote settings.

The WHO updated its PMTCT guidelines with Option B+ in April of this year.

MSH, through USAID's Strengthening TB and AIDS Response – Eastern Region (STAR-E) project, is providing technical assistance to Ugandan health officials and sharing lessons learned from implementing Option B+ in Malawi.

"Option B+ is not just a different approach to PMTCT, but since all pregnant HIV infected women are receiving ART for life, it is a way to decentralize ART to many more health facilities, bringing services closer to more people," said Dr. Erik Schouten of MSH in a recent interview regarding the origins and implementation of Option B+ in Malawi.

"There are also health benefits for the mother — reduced maternal mortality — and reduced HIV transmission to her discordant sexual partner(s)."

Implementing Option B+ could help Uganda reduce its yearly estimated 20,000 to 25,000 pediatric HIV infections and improve its health system, in addition to helping pregnant women and their partners.

Uganda will be phasing the roll-out of Option B+ in stages, starting in the areas with the highest HIV prevalence, according to Godfrey Esiru, the national PMTCT coordinator at the Ugandan Ministry of Health.

"We are at a crossroads as a country," said David Kihumuro Apuuli of the Uganda AIDS Commission to IRIN/PlusNews. "HIV has been a burden to this country's people and development. We are going to sit down in the next two or three weeks to plan on how to mobilize funding, resources, human resource and infrastructure to achieve the target of up to 90 percent coverage of Option B+."

For more on Uganda’s decision to adopt Option B+, see the IRIN/PlusNews report.

Learn more about Option B+ and read MSH's statement.

Post updated: September 18, 2012, 12:03 pm