Peer-reviewed article

Progress towards the elimination of vertical transmission of HIV, syphilis and hepatitis B in 21 high-burden countries.

Melanie M Taylor, Rania A Tohme, Robert McDonald, Michele Montandon · 1 Apr 2026

Abstract

INTRODUCTION: Elimination of mother-to-child transmission (EMTCT) of HIV, syphilis and hepatitis B by 2030 is a global goal endorsed by countries. To achieve EMTCT, countries need to meet targets for programme and impact indicators. METHODS: We examined progress and gaps in service delivery across the three infections among 21 countries with a high burden of HIV, syphilis and/or hepatitis B. We summarized national coverage of interventions to prevent vertical transmission of HIV, hepatitis B and syphilis. Service coverage indicators were extracted from public data sources for the most recent available years (2014-2024). RESULTS: Antenatal care (ANC) coverage (at least one visit) ranged from 62% to 99%; 14 countries (67%) had coverage ≥90%. Twelve countries (57%) had ANC HIV testing coverage above 90%; 13 countries (62%) reported antiretroviral treatment coverage ≥90%. Eight countries (38%) reported ANC syphilis testing coverage ≥90%; ten countries (48%) reported ≥90% treatment coverage among pregnant women diagnosed with syphilis. All 21 countries have introduced three infant doses of hepatitis B vaccine (HepB3), and six countries have introduced the hepatitis B birth dose vaccine (HepB-BD) in their national immunization schedule. Among the six countries that provide HepB-BD, only four reported coverage with timely HepB-BD given within 24 hours of birth (range 52-70%). Seven (33%) countries have achieved HepB3 coverage ≥ 90%. DISCUSSION: Antenatal service delivery for prevention of mother-to-child transmission of syphilis and hepatitis B lags behind that of HIV. Despite the availability of ANC platforms for the delivery of HIV, syphilis and hepatitis B services, many countries face new and ongoing implementation and funding challenges in reaching global targets for EMTCT of these infections. CONCLUSIONS: Integrating HIV, syphilis and hepatitis B prevention of vertical transmission services into ANC and maintaining support for EMTCT efforts is critical to close these gaps.