Asia Pacific roadmap points to triple mother-to-child transmission elimination goal

In 2010, at age 23, Ayu Oktariani learned she was HIV positive. Not only did she lose her husband to AIDS, but during her pregnancy her daughter was infected.

“I had no chance at all to protect my family,” she said. “I had no information about the HIV situation and even less knowledge about HIV and pregnancy.”

Ten thousand children were infected with HIV in Asia and the Pacific in 2023, roughly 30 each day. Although prevention of mother-to-child transmission (PMTCT) services helped avoid nearly 72,000 new HIV infections among children since 2015, over one-third of pregnant women in Asia Pacific who require antiretroviral treatment still do not receive it.

Today not only are Ms Oktariani and her daughter thriving, but she heads Ikatan Perempuan Positif Indonesia (IPPI), Indonesia’s national network of women living with HIV. Through its Emak (mother) Club, IPPI helps women living with HIV to get the information and care that did not reach her and so many others.

Ayu Oktariani, IPPI National Coordinator (Photo via UN Women)

“We support them to get on treatment, make sure they access maternal and child health services based on their needs and ensure all the babies get prophylaxis (preventative medicines) and Early Infant Diagnosis. We do it with the hope that mothers can give birth to healthy babies, free from HIV,” she explained.

Ms. Oktariani spoke at the launch of the Regional Roadmap for the Triple Elimination of Mother-to-Child Transmission (EMTCT) of HIV, Syphilis and Hepatitis B in the Asia and Pacific Region. This resource offers guidance to strengthen national strategies and operational plans to end these three diseases among children by 2030.

The roadmap tracks the progress of 21 countries since 2018. It outlines strategic priorities to pick up the pace, including policy leadership, universal service access, integration with reproductive and child health systems, community engagement and strengthened monitoring.

In the region, Thailand, Malaysia, Sri Lanka and the Maldives have already achieved the dual elimination of HIV and syphilis mother-to-child transmission. These four countries are all on the way to achieving EMTCT validation for hepatitis B. Bhutan, Cambodia, China and Mongolia, are making solid progress toward either single, double or triple elimination. However, other countries still face significant challenges.

The roadmap specifically calls for increased syphilis and hepatitis B monitoring and for hepatitis B strategies to be integrated into programmes and policies to prevent vertical transmission. It is designed to support countries at varying stages of evolution. At the launch there were Health Ministry updates from a mix of countries.

Sri Lanka eliminated HIV and syphilis in children in 2019 and maintained validation in 2023. It is now on-track to add hepatitis B to the list thanks to continuous work to strengthen maternal and child healthcare.

China launched its PMTCT programme 24 years ago and has fully integrated these services with maternal and child healthcare. The national rate of mother-to-child HIV transmission is now 1.3%.

In Nepal which has the region’s best overall HIV prevention results, the 2021 – 2026 National HIV Strategy aims to eliminate these three diseases along with congenital hepatitis C and other sexually transmitted infections.  

In the midst of an HIV outbreak, Fiji is developing a Triple Elimination Strategy aligned with global and regional frameworks. It hopes to capitalize on the fact that virtually all its deliveries take place in hospitals.

Papua New Guinea, which also faces rising new infections, is mobilizing resources for its own Triple Elimination Framework. It is currently focused on increasing testing and ensuring women in the provinces access treatment and community support.

At the launch, Regional Directors from WHO, UNICEF and UNAIDS all emphasized the need for integrated services.

“The triple elimination agenda helps us to get the most out of every interaction and investment,” said Eamonn Murphy, Regional Director of UNAIDS Asia Pacific and Eastern Europe Central Asia. “No child should begin life with a disease we can prevent.”

Select news media coverage

UNAIDS Asia Pacific press release – April 10, 2025 New five-year roadmap guides Asia Pacific countries toward elimination of mother-to-child HIV, syphilis and hepatitis B transmission

Fiji Times (editorial), Fiji – April 15, 2025 Asking the tough questions!

Post Courier, Papua New Guinea – April 14, 2025 Elimination of mother-to-child HIV, syphilis and hepatitis B transmission–a roadmap

The Friday Times, Pakistan – April 16, 2025 New Roadmap Aims To Eliminate Mother-To-Child HIV, Syphilis, Hepatitis B In Asia Pacific By 2030

Kuensel Online, Bhutan – April 17, 2025 Bhutan among four nations in Asia-Pacific near to ending mother-to-child infections

Kiripost, Cambodia – April 21, 2025 More Effective Policies Needed to Eliminate Mother-to-Child HIV Transmission

The Himalayan Times, Nepal – April 29, 2025 New roadmap aims to eliminate mother-to-child transmission of HIV, Syphilis and Hepatitis B in Asia Pacific