About 1 HIV+ pregnant women in 3 will deliver an HIV infected child. This ratio drops to less than 1 in 100 with appropriate precautions and timely medicines. However the tests to diagnose HIV in these women and medicines to treat HIV+ women are expensive. Furthermore, in a country such as Pakistan where less than 1 in 2000 women are expected to have HIV, choosing whom to test or give these medicines is a challenge. The alternative of treating every pregnant woman with these medicines is unreachably expensive and is therefore inadvisable. To meet this challenge, a strategy has been developed, based on Worldwide experience and is being pilot tested in select sites around the nation. This national PPTCT strategy is consistent with international evidence and support requested in this PC-1 is consistent with that strategy. The UNICEF provided initial support to the project, with trainings and the inception of the first centres for 13 PPTCT in select locations. The government of Pakistan will continue and expand this initiative.

The Prevention of Parent-to-Child Transmission (PPTCT) of HIV: Strategic Framework for Pakistan (NACP 2006) emphasizes the comprehensive four-pronged strategy for prevention of PTCT in Pakistan (Table 1). Being a generally low-prevalence country, the major focus is on efforts targeted towards preventing HIV infection in the general population as well as high-risk groups such as intravenous drug users, migrant workers, and commercial sex workers.

The NACP, Pakistan has developed separate guidelines for PMTCT (Prevention of Mother to Child Transmission of HIV - Clinical Guidelines for Pakistan, 2006).