Government has stepped up its efforts to eliminate the vertical transmission of HIV/Aids, syphilis, and hepatitis B — three infections that continue to threaten the lives of mothers and their babies, despite the availability of effective prevention tools.
The Joint United Nations Programme on HIV/Aids (UNAIDS) recently lauded Uganda for reducing mother‐to‐child transmission if HIV/Aids by 76% between 2010 and 2024. The three highlighted diseases, which are primarily passed from mother to child during pregnancy, delivery, or breastfeeding, are a major cause of preventable infant illness and death, especially in low‐ and middle‐income countries.
The World Health Organization (WHO) has prioritized the elimination of their vertical transmission, and Uganda has joined the global momentum with integrated interventions aligned with maternal and child health services.
New HIV/Aids infections among children aged 0–14 years have dropped globally by 62% between 2010 and 2024. Uganda has made commendable strides, reducing its vertical transmission rate to 6%, edging closer to the WHO elimination benchmark of below 5%.
South Africa is currently the only Global Alliance country that has achieved this target, with a 2% transmission rate. In 2024, Uganda recorded 4,700 new HIV/Aids infections from mother-to-child transmission.
However, according to Uganda Aids Commission (UAC), this a tremendous drop compared to 20,000 infections in 2010. UAC also revealed that out of the 4,700 infections, 61% occurred during the breastfeeding period. Dr Robert Mutumba, the head of the Aids Control Programme at ministry of Health, attributes the majority of these cases to mothers who either dropped off treatment or acquired HIV/Aids during pregnancy or breastfeeding.
According to an article by Centres for Disease Control and Prevention (CDC), for a woman living with HIV/Aids, achieving viral loaf suppression through effective HIV/Aids treatment virtually eliminates the possibility of transmitting HIV/Aids to her child.
From 2017 to 2019, PEPFAR provided $3.25 million through CDC to evaluate the impact of programs geared toward Prevention of Mother‐ To‐Child Transmission (PMTCT) in Uganda.
The impact evaluation (IE) study, conducted by the ministry of Health in collaboration with CDC’s partner Rakai Health Sciences Program (RHSP), in 2024, assessed several key indicators. These indicators included HIV/Aids transmission rates, rates of new HIV/ Aids infections among mothers during pregnancy and the breastfeeding period, and infant mortality rates.
The findings of the study showed a significant reduction in rates of mother‐to‐child transmission in Uganda over the 20 years of support from CDC and PEPFAR implementing partners. Progress on syphilis and Hepatitis B prevalence
When it comes to syphilis, Uganda still grapples with high prevalence. Active syphilis infections stand at 2.1% among adults, according to ministry of Health, with a higher prevalence among HIV‐ positive individuals (6.2%) compared to those who are HIV‐negative (1.8%).
Progress on hepatitis B, on the other hand, has been slower. Among adults, the HBV infection rate is 4.1%, while among children, it stands at 0.6%. Regional disparities persist, with prevalence as high as 4.6% in the mid‐North.
Dr Harriet Nankunda, a senior reproductive health officer at the ministry of Health, notes that syphilis is often overlooked.
“Syphilis doesn’t get as much attention as HIV/Aids, yet it’s just as dangerous for unborn babies. Stillbirths, deformities, and neonatal deaths linked to untreated syphilis are preventable — if we strengthen early diagnosis and timely treatment,” she said.
While no country has been validated for the elimination of mother‐to‐child transmission of hepatitis B, Uganda began hepatitis B vaccination at birth in December, 2022 — a crucial step within its broader PMTCT.
“Unlike HIV/Aids or syphilis, hepatitis B requires a very specific timing — that birth dose must be given within 24 hours,” explained Dr Michael Baganizi, an immunization expert with the Uganda National Expanded Programme on Immunization.
“If we miss that window, the risk of chronic infection increases drastically.” The ministry of Health, in partnership with development agencies, has rolled out a national elimination plan that integrates HIV/Aids, syphilis, and hepatitis B services into maternal and child health care.
The country has increased access to testing kits, scaled up point‐of‐care testing for HIV‐exposed infants, and implemented viral load monitoring for mothers at over 350 health facilities.
LOOKING FORWARD
As of November, 2024, 19 countries globally had been certified for halting vertical transmission of HIV/Aids and/or syphilis, with Botswana and Namibia also nearing this milestone. Uganda is not far behind but must sustain its efforts to meet the targets.
The elimination of vertical transmission is no longer a distant goal — but achieving it will require continuous investment, a resilient health system, and unwavering political and community commitment.