Since 2011, progress has been made globally in reducing mother-to-child transmission of HIV, but not fast enough to reach the 2020 targets, especially the ‘Super-Fast-Track Framework to end AIDS’. In 2019, there were approximately 150,000 new HIV infections among children under five, highlighting the need to accelerate the prevention and treatment for all pregnant and breastfeeding women living with HIV in order to eliminate new infections among children and reduce HIV-related deaths among pregnant women and new mothers. In line with the targets of Sustainable Development Goal (SDG) 3 (Good health and well-being), the global community has committed to eliminating mother-to-child transmission (EMTCT) of HIV and syphilis as a public health priority, but this requires an increased focus on integrating HIV interventions and prevention of mother-to-child transmission (PMTCT) services within broader sexual, reproductive, maternal, newborn, child and adolescent health programmes, as well as ensuring equitable access for all women, including the most vulnerable.
Towards a Solution
The Government of Thailand stepped up to leverage South-South and triangular cooperation (SSTC) to support other countries to achieve what it has achieved in 2016 – the elimination of mother-to-child transmission (EMTCT) of HIV and syphilis. To address the challenge, Thailand acts as a global knowledge resource, showcasing good practices and sharing lessons learned from successfully eliminating the transmission of HIV and syphilis from mothers to children. This has been achieved by strengthening universal health coverage (UHC) and health systems to increase access to quality maternal and child health (MCH) services. One of the key features of Thailand’s success is its decision to extend health coverage to migrants living in Thailand. Through the Government’s South-South cooperation (SSC) agenda managed by the Thailand International Cooperation Agency (TICA) under the Ministry of Foreign Affairs, the Government is sharing its experience, knowledge and technical expertise with other countries.
In 2019, TICA, the Ministry of Public Health of Thailand and United Nations Children’s Fund (UNICEF) co-signed a joint plan of action to systematically accelerate progress in EMTCT through different South-South and triangular cooperation (SSTC) modalities. Under this initiative, a capacity-building training session was delivered in 2019 for Ministry of Health representatives from Kazakhstan, Tajikistan, Ukraine and Uzbekistan. TICA covered the costs of the training and of hosting – a model for the future of cost-sharing in middle-income countries and emerging economies. While UNICEF was instrumental in overall coordination together with TICA and the Ministry of Public Health (MOPH), and in mobilizing and funding participating countries, World Health Organization (WHO) and the Joint United Nations Programme on HIV and AIDS (UNAIDS) were engaged during the capacity-building training. Together with UNICEF, WHO provided guidance on validation processes, and UNAIDS built capacity on strengthening data and human rights components towards achieving the EMTCT.
Successful SSC within the Asia Pacific Region has opened the door for many more countries in the region and around the world to have the opportunity to learn from Thailand and access solutions that could be adapted to support their own efforts in working towards achievement of SDG 3, on good health and well-being. In 2017 and 2018, UNICEF East Asia and Pacific Regional Office and Thailand Country Office, in collaboration with the International Training Centre on AIDS, TB and STIs, the Department of Health, MOPH, Thailand’s MOPH-U.S. CDC Collaboration (TUC), and with support from WHO and UNAIDS organized the South-to-South Learning and Exchange Experiences Workshop on Thailand’s Validation of the EMTCT for Ministry of Health representatives from China, India and Myanmar. In 2019, TICA, MOPH and the UNICEF Thailand Country Office further formalised this collaboration and co-signed a plan of action SSTC for EMTCT and expanded the training to other countries beyond the Asia-Pacific Region.
To date, in order to facilitate the systematic cross-regional/-country transfer of good practices and knowledge, SSTC between Thailand and recipient countries has enhanced capacities through direct observational learning, knowledge sharing, mentorship and experience sharing through workshops. Based on the evaluation of the 2019 workshop most of the 47 participants expressed their satisfaction with the content of the sessions, citing especially the usefulness of learning about Thailand’s experience with EMTCT validation, strong laboratory and data systems, case management for women living with HIV, and the efficient national testing and treatment programmes. One of the main outputs from the workshops was the practical application of the learning, where participants prepared roadmaps to EMTCT validation, and revisions were incorporated into existing EMTCT plans of the respective countries.
To ensure sustainability and formalize planning for future SSTC on EMTCT and other public health issues, UNICEF Thailand, with support from UNICEF East Asia and Pacific Regional Office (EAPRO), developed a rapid needs assessment survey to identify potentially interested countries for further capacity building and technical support through the SSTC mechanism. Several requests have been received from countries in Asia, Central Asia and Latin America A Joint Work Plan for 2020–2021 on EMTCT of HIV and Syphilis through SSTC between UNICEF, Thailand International Cooperation Agency and the Ministry of Public Health will guide collective efforts in contributing to the global commitment on HIV and AIDS and achievement of the SDGs.