Uganda: Cash crunch delays shift to WHO-recommended PMTCT regimen

A shortage of money means Uganda is unlikely to shift its prevention of mother-to-child transmission (PMTCT) programmes to a more efficient UN World Health Organisation (WHO) regimen soon, say government officials. In 2010, WHO recommended two equally effective options for PMTCT. The first, Option A, is fairly similar to the system Uganda currently uses. It involves single-dose antiretroviral (ARV) drugs for the mother - if her CD4 count is over 350 - from the 14th week, as well as ARVs during labour, delivery and one week post-partum. Pregnant women with CD4 counts below 350 are advised to start taking ARVs for their own health. Option B involves triple therapy ARVs from the 14th week of pregnancy until one week after breastfeeding has ended, which can be up to one year. The Ugandan government has expressed its intention to shift to Option B, which is simpler for health providers and mothers to implement than Option A. However, an already stressed HIV budget may make this impossible.