New PEPFAR Initiative: Safe Births, Healthy Babies – United States Department of State

In 2024, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) intends to, subject to availability of appropriated funds and completion of congressional notification procedures, launch the Safe Births, Healthy Babies Initiative – a two-year $40 million PEPFAR effort to accelerate progress to eliminate mother-to-child transmission (MTCT) in PEPFAR supported high HIV burden countries.

Through PEPFAR, 25 million lives have been saved and 5.5 million babies have been born HIV-free. Since 2010, PEPFAR-supported efforts cut in half the number of new HIV infections for children by scaling up prevention of mother-to-child transmission (PMTCT) interventions.

However, many high HIV burden countries continue to see high rates of MTCT, with an estimated 130,000 children newly infected with HIV in 2022. In response to this persistent challenge, PEPFAR is announcing the launch of a new $40 million initiative – Safe Births, Healthy Babies, which will begin in 2024.

The goal of Safe Births, Healthy Babies will be to accelerate progress to eliminate MTCT in high HIV burden countries over two years. By the end of those two years, the goal will be to reduce the number of babies born infected with HIV by at least 33 percent and for beneficiary countries to reach a minimum of the Bronze Certification level of MTCT as defined by WHO.¹

Safe Births, Healthy Babies will build upon the lessons learned from the U.S. led public-private partnership Saving Mothers Giving Life Initiative, which PEPFAR supported from 2012, achieving major success in target countries in reducing maternal mortality and addressing the core challenges of MTCT. The new initiative will primarily focus on scaling up community-level and facility level interventions, aiming to attract and retain pregnant women in HIV care. PEPFAR will select the countries of focus for the initiative based on the PMTCT coverage gaps and the maternal mortality rates.

High HIV burden countries like Botswana have reached the previously unthinkable milestone of less than 500 new HIV cases per 100,000 live births on the path to eliminating MTCT.  This success story demonstrates that with focused effort, an AIDS-free generation is achievable. The Safe Births, Healthy Babies initiative promises to do just that and will advance the global effort to end HIV/AIDS as a public health threat by 2030.