In 2016 the General Assembly, in its Political Declaration on HIV and AIDS, committed to the goal of ending AIDS as a public health threat by 2030. [1] This included an undertaking to “eliminate new HIV infections among children by reducing new infections by 95 per cent in every region by 2020”. The same year, the World Health Assembly endorsed the World Health Organization (WHO) 2016-2021 global health sector strategies on HIV, [2] viral hepatitis, [3] and sexually transmitted infections. [4]
These strategies mandate Member States to collaborate towards the goals of zero new HIV infections in infants by 2020, combating viral hepatitis as a public health threat by 2030, and the elimination of congenital syphilis. Mother-to-child transmission of HIV remains a significant contributor to the HIV pandemic, accounting for 9 per cent of new infections globally. [5] The targets of the 2016 “Start Free, Stay Free, AIDS Free framework” were that by 2018, fewer than 40,000 children would become newly infected, and 95 per cent of pregnant women living with HIV would be receiving lifelong antiretroviral therapy. [6] However, in 2019 an estimated 150,000 children became newly infected with HIV (although this represented a decrease from 280,000 in 2010), and only 85 per cent of pregnant women living with HIV were on antiretroviral therapy. [7] In 2019 people who inject drugs accounted for an estimated 10 per cent of new HIV infections globally. [8]
International declarations and documents encourage and support countries to provide women and girls who use or inject drugs with access to comprehensive services for the prevention of mother-to-child transmission (PMTCT) of infectious diseases. [9] The sixty-first session of the Commission on Narcotic Drugs, held in Vienna in March 2018, adopted resolution 61/4 “Promoting measures for the prevention of mother-to-child transmission of HIV, hepatitis B and C and syphilis among women who use drugs”. [10] Targeted interventions and programmes are essential in order to reach women who use drugs who are otherwise unable to access services due to stigma and discrimination. Harm reduction services,1 the entry point to health and social services for most people who use drugs, play a key role in PMTCT of HIV, viral hepatitis B and C and syphilis among women who use drugs.
Without access to harm reduction services, and without strong linkages and integration with other relevant health services, women who use drugs and their children will continue to be disproportionally affected by these diseases. If women who use drugs are left behind, the efforts of countries towards the triple elimination of mother-to-child transmission (EMTCT) of HIV, hepatitis B and syphilis, as well as of hepatitis C, are likely to experience significant delays.
