With HIV funding cuts affecting country goals and shifting priorities, health leaders from the six countries in the HIVE network met in Johannesburg, South Africa, for the 2025 HIVE Strategic Planning Meeting to share approaches for eliminating vertical transmission of HIV.
On Friday, June 13, 2025, ICAP at Columbia University in partnership with Pediatric-Adolescent Treatment Africa (PATA), convened approximately 60 representatives from ministries of health, national networks of people living with HIV, the Gates Foundation, WHO, UNICEF, implementing partners, and other key vertical transmission prevention (VTP) stakeholders to share challenges, adaptations, and strengthen solutions for protecting pregnant and breastfeeding women and their infants.
“We are looking toward a meeting where we’ll be able to highlight innovations and country-led solutions that stabilize prevention, identification, linkage, and retention, and improve health outcomes across the VTP cascade,” said Dr. Maureen Syowai, interim project director for HIVE and CQUIN, during the meeting. “Our goal is to define priority activities to mitigate service disruptions and strengthen member country emergency responses through coordinated, sustainable action planning.”
Country Spotlights
Country presentations from Mozambique, Zambia, South Africa, Nigeria, Kenya, and Tanzania highlighted the hard-won progress made despite recent service disruptions due to the U.S. government stop work order and closure of USAID supported programs. Mozambique reported a 43% pre-exposure prophylaxis (PrEP) uptake rate among pregnant and breastfeeding women. Zambia shared its community-driven efforts to support early antenatal care and PrEP adherence, alongside the development of a sustainable minimum care package. South Africa emphasized integration with maternal and child health services. Nigeria described its efforts to reach women who often bypass traditional health facilities by expanding HIV counseling and testing in unconventional community settings.
“Community testing is not just a stopgap. It is an essential strategy for reaching the women we missed at the facilities,” said Dr. Hafsat Iyanda, Nigeria’s national PMTCT lead.
Kenya reported service disruptions tied to changes in national health insurance and the global funding landscape. First ANC visit coverage dropped from 90.4% to 81.7%, and early infant diagnosis was impacted by supply chain breakdowns. However, Kenya leveraged its robust EMR system, which is active in more than 2,300 high-volume facilities, to sustain mother-infant tracking and program performance. The country is also integrating community health promoters into its VTP response and scaling partnerships with networks or women living with HIV.
“We’re focused on maintaining continuity of care and strengthening the systems that support it,” said Dr. Nelly Pato, VTP lead at the Kenya Ministry of Health.
Tanzania highlighted the value of embedding VTP services into 98% of reproductive and maternal health clinics; a move that preserved service delivery in the country as donor-supported staff were withdrawn. Postnatal testing was streamlined and prioritized, and the country piloted electronic sample tracking while shifting sample transport to public postal services and government vehicles.
“We’ve learned that integration and decentralization are our best tools for resilience,” said Dr. Michael Msangi, national PMTCT coordinator for Tanzania. “We are using those lessons to build a stronger foundation moving forward.”
During a VTP action plan development session, country teams engaged in scenario planning in response to shrinking funds. Country teams worked through two scenarios – zero funding and 50% funding – to identify essential VTP services that address technical assistance needs for maintaining services.
Community Voices Call for Inclusion
Recipient-of-care representatives also challenged stakeholders to move beyond rhetoric and meaningfully include recipients of care living with HIV in every stage of program design and implementation.
“We’re not just imagining community-led responses, we’ve already been doing the work,” said Robinah Babirye, program officer with African Young Positives Network, AY+ Uganda. “But now it’s time for practical engagement and resourcing. We are ready.”
Participants emphasized that mentor mothers, community health workers, and peer networks are essential to reaching underserved women and sustaining early infant diagnosis and treatment adherence.
Looking Ahead
The final plenary featured regional and global perspectives from leaders across UNAIDS, the Gates Foundation, and the Global Alliance to End AIDS in Children. “Although children account for only 3% of infections, they represent 12% of all HIV-related deaths,” said Dr. Paula Munderi, team lead, Science, HIV Treatment & Pediatrics, UNAIDS. “We cannot end AIDS without addressing vertical transmission, and we cannot do that without community leadership.”
The meeting concluded with an urgent call to align VTP services with primary health care, social protection, and resilient, community-led systems that can weather future disruptions.
In the meantime, HIVE will continue to offer technical support as countries refine their national strategic plans. The network will encourage ongoing sharing of knowledge and best practices through meetings, webinars, learning exchanges, and technical assistance visits.
“Even if we can’t move forward, the least we must do is maintain the gains we’ve made,” said Yasteel Maharaj, senior regional program manager at PATA. “Together, I believe we can push toward real elimination.”
The meeting concept, agenda, and presentations are available to browse here.
