Eliminating Mother-to-Child Transmission of HIV and Syphilis in Thailand through South-South Cooperation

New cooperation modalities prove successful during, and possibly after, the COVID-19 pandemic

Towards a Solution

The elimination of mother-to-child transmission (EMTCT) of HIV and syphilis in Thailand is attributed to the meeting of science, medicine and political commitment. Through the government’s South-South and Triangular Cooperation agenda managed by the Thailand International Cooperation Agency (TICA) under the Ministry of Foreign Affairs, the government has been sharing its experience, knowledge and technical expertise with other countries globally. Since 2017, TICA has partnered with UNICEF on EMTCT. Other stakeholders brought into the partnership include the Department of Health, Department of Disease Control, UNAIDS, WHO, TUC (a Thailand Ministry of Public Health-U.S. Center for Disease Control collaboration), independent experts and civic organizations, resulting in the attainment of a comprehensive set of technical expertise, experience, inputs, insights and resources. Through Thailand's South-South Cooperation initiatives, several countries globally have had a chance to learn from Thailand’s experience and receive support to adapt solutions to their context. These include China, India, Kazakhstan, Myanmar, Tajikistan, Ukraine and Uzbekistan.

The current collaboration agreement on EMTCT between UNICEF, TICA and the Department of Health, covering June 2020-December 2021, includes cost sharing, technical expertise and manpower for increased coordination. The cooperation is framed within SDG 3: good health and well-being, especially ending the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combatting hepatitis, waterborne diseases and other communicable diseases (target 3.3), and aims at the following:

1. promoting health systems strengthening and universal health care using successful EMTCT as an entry point;
2. facilitating systematic and sustained partner country access to Thailand’s experience, knowledge and expertise in EMTCT through different South-South Cooperation modalities and follow-up support;
3. strengthening Thailand’s role as a knowledge hub and the capacities of the Ministry of Public Health and related local and national institutions in providing technical assistance and capacity building support to countries dealing with the challenge of vertical transmission of HIV and syphilis; and
4. facilitating experience sharing across countries as agreed between agencies and/or TICA as appropriate. 

Since the outbreak of the COVID-19 pandemic in 2020, Thailand adapted its country support to new modalities. An online workshop was organized in October 2020 with 21 participants from Lao PDR to disseminate and share knowledge, experience and lessons learned. The workshop covered several topics, including PMTCT programme and service delivery (HIV and syphilis), active case management networks for early anti-retroviral therapy initiation among HIV positive infants, EMTCT validation processes, data and information management systems, laboratory systems and information management and human rights, gender equality and community engagement. Prior in-person hospital visits were transformed into two five-minute videos displayed during the presentation (on entry of pregnant women into formal health systems at antenatal care and laboratory systems and information management for antenatal care).

Prior direct observational learning, knowledge sharing and mentorship methods had proved successful, with most of the 47 participants in the 2019 workshop expressing through an evaluation their satisfaction with the content of the sessions. A main output from the workshops was a practical application of the learning, in which participants prepared roadmaps to EMTCT validation, and revisions were incorporated into existing EMTCT plans of the respective countries.

It has been found that the more recent online methodology, used in the context of COVID-19, may be even more replicable and sustainable. During an online workshop, interaction with participants was stimulated during Q&A at the end of each session and through the Zoom chat box function. Translation was provided to participants who do not speak Thai. Evaluations were conducted twice during the workshop, at the end of the morning and afternoon sessions, which reflected the participants’ satisfaction with the online modality. This new modality of remote collaboration through SSTC can be extended as systematic programme support to achieving the global commitment to end AIDS by 2030, focusing on EMTCT.