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Prevention of mother to child transmission of HIV (PMTCT) has continued to gain immense significance in the fields of HIV prevention and care, mostly in the last 10 years. This significance has come about due to the growing recognition that HIV is not only in blood and sexual fluids but also in breast milk. The fact that over 58% of all infections in sub-Saharan Africa are found among women in reproductive ages (19–49 years) makes PMTCT a life and death subject.  In Africa, women face the ravages of HIV/AIDS in uneven proportions; they often bear the heaviest brunt of the epidemic, as caregivers, as persons living with HIV/AIDS and as the pivotal points of every society. When they are infected, their roles in society do not change much, as often, the society still expects them to play their parts as ever before.  It is estimated that about 30% of all babies born to HIV positive mothers will acquire the virus. Our experiences show that this percentage only talks of the ones that will get the virus either in the womb or during delivery. We suspect that a bigger fraction get the virus through breastmilk.  In developed countries, almost all HIV infected women will receive good PMTCT care. With the best treatment and formula feeding, the chance of HIV being transmitted to the baby is less than two percent. In developing countries it is very different. While a few developing countries have launched effective responses, on average less than ten percent of women receive even the most basic PMTCT services. (Source: The Stop AIDS in Children Campaign).  As a result, around half a million children are infected with HIV every year. Why are so many pregnant women not receiving the help they need? Most often it is because PMTCT services are unavailable or inefficient, or because women are unable to access them. Stigma and fear may also play a role by making a woman unwilling to take an HIV test, or unwilling to take PMTCT drugs. These problems, though challenging, can be overcome. Some developing countries, such as Botswana and Brazil, are already providing PMTCT services to most of their pregnant women.

Great challenges to PMTCT in the South: the role of the developed nations in supporting strategies that work