Uganda Intensifies Efforts to Eliminate Mothers-to-Child Disease Transmission

Updated by Faith Barbara N Ruhinda at 1000 EAT on Wednesday 30 July 2025

The government has intensified efforts to eliminate the vertical transmission of HIV/AIDS, syphilis, and hepatitis B — three preventable infections that continue to pose serious risks to the health of mothers and their babies, despite the availability of effective prevention tools.

The Joint United Nations Programme on HIV/AIDS (UNAIDS) has commended Uganda for its significant progress in reducing mother-to-child transmission of HIV, noting a 76% decline between 2010 and 2024.

This achievement highlights the country’s ongoing efforts to combat vertical transmission of HIV, syphilis, and hepatitis B — infections primarily passed from mother to child during pregnancy, childbirth, or breastfeeding. Despite the availability of effective prevention tools, these diseases remain among the leading causes of preventable infant illness and death, particularly in low- and middle-income countries.

Uganda’s progress signals a promising step toward the global goal of eliminating vertical transmission.

The World Health Organization (WHO) has identified the elimination of vertical transmission of HIV, syphilis, and hepatitis B as a global health priority. Uganda has joined this global momentum by implementing integrated interventions that align with maternal and child health services.

Globally, new HIV/AIDS infections among children aged 0–14 dropped by 62% between 2010 and 2024. Uganda has made significant progress, reducing its mother-to-child transmission rate to 6% — a major milestone that brings the country within reach of the WHO elimination benchmark of below 5%.

South Africa remains the only country within the Global Alliance that has achieved this target, currently reporting a 2% transmission rate. In 2024, Uganda recorded 4,700 new HIV infections among children due to vertical transmission.

However, the Uganda AIDS Commission (UAC) reports that the current figure represents a remarkable reduction from 20,000 new infections recorded in 2010. The UAC further revealed that 61% of the 4,700 new infections in 2024 occurred during the breastfeeding period. According to Dr. Robert Mutumba, Head of the AIDS Control Programme at the Ministry of Health, the majority of these cases are linked to mothers who either discontinued treatment or acquired HIV during pregnancy or breastfeeding.

Research from the U.S. Centers for Disease Control and Prevention (CDC) affirms that for women living with HIV, achieving viral load suppression through consistent and effective treatment virtually eliminates the risk of transmitting the virus to their child.

From 2017 to 2019, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), through the CDC, invested $3.25 million to evaluate the impact of Uganda’s Prevention of Mother-to-Child Transmission (PMTCT) programs. This funding supported efforts to enhance service delivery, identify gaps, and strengthen the integration of HIV services within maternal and child health systems.

The impact evaluation (IE) study, conducted in 2024 by the Ministry of Health in collaboration with CDC’s partner, the Rakai Health Sciences Program (RHSP), assessed several key indicators related to mother-to-child transmission.

These included HIV/AIDS transmission rates, the incidence of new HIV infections among mothers during pregnancy and breastfeeding, and infant mortality rates.

The study findings revealed a significant reduction in mother-to-child transmission rates in Uganda over the past two decades, underscoring the sustained impact of support from CDC and PEPFAR implementing partners.

The evaluation also highlighted continued progress in addressing the prevalence of syphilis and hepatitis B among pregnant women and infants, though challenges remain in reaching elimination targets.

Despite Uganda’s progress in reducing mother-to-child transmission of HIV, challenges persist in addressing syphilis and hepatitis B.

According to the Ministry of Health, active syphilis infections remain high, with a national prevalence of 2.1% among adults. The burden is disproportionately higher among HIV-positive individuals (6.2%) compared to HIV-negative individuals (1.8%). Dr. Harriet Nankunda, a senior reproductive health officer at the Ministry of Health, emphasized the urgency of tackling syphilis more aggressively.

“Syphilis doesn’t get as much attention as HIV/AIDS, yet it’s just as dangerous for unborn babies. Stillbirths, deformities, and neonatal deaths linked to untreated syphilis are preventable — if we strengthen early diagnosis and timely treatment,” she noted.

Progress in the fight against hepatitis B has been slower. Among adults, the national prevalence of HBV stands at 4.1%, while among children, it is 0.6%. However, regional disparities remain stark, with prevalence reaching as high as 4.6% in the mid-North.

Although no country has yet been validated for the elimination of mother-to-child transmission of hepatitis B, Uganda took a critical step in December 2022 by introducing the hepatitis B birth-dose vaccine — a cornerstone of prevention efforts.

“Unlike HIV/AIDS or syphilis, hepatitis B requires a very specific timing — that birth dose must be given within 24 hours,” explained Dr. Michael Baganizi, an immunization expert with the Uganda National Expanded Programme on Immunization.

Uganda Strengthens Push to Eliminate Mother-to-Child Transmission of HIV, Syphilis, and Hepatitis B

Significant progress made in reducing new HIV infections, but challenges remain with syphilis and hepatitis B

The Government of Uganda, with support from global health partners, has intensified efforts to eliminate the vertical transmission of HIV, syphilis, and hepatitis B — infections that continue to threaten the health of mothers and infants despite the availability of proven prevention methods.

The Joint United Nations Programme on HIV/AIDS (UNAIDS) recently commended Uganda for reducing mother-to-child transmission of HIV by 76% between 2010 and 2024. This progress reflects growing momentum to end vertical transmission, a critical global health goal set by the World Health Organization (WHO).

Globally, new HIV infections among children aged 0–14 have declined by 62% over the same period. Uganda has brought its mother-to-child transmission rate down to 6%, edging closer to the WHO elimination benchmark of below 5%. South Africa remains the only Global Alliance country to have achieved this target, with a 2% rate.

In 2024, Uganda recorded 4,700 new pediatric HIV infections through vertical transmission — a significant drop from 20,000 in 2010. However, 61% of these cases occurred during the breastfeeding period. According to Dr. Robert Mutumba, Head of the AIDS Control Programme at the Ministry of Health, these infections were primarily among mothers who dropped off treatment or acquired HIV during pregnancy or breastfeeding.

Research by the U.S. Centers for Disease Control and Prevention (CDC) confirms that women living with HIV who achieve viral load suppression through consistent treatment can virtually eliminate the risk of transmission to their child.

From 2017 to 2019, PEPFAR, through the CDC, invested $3.25 million in evaluating Uganda’s Prevention of Mother-to-Child Transmission (PMTCT) programs.

The impact evaluation study, conducted in partnership with the Rakai Health Sciences Program (RHSP), assessed transmission rates, maternal infections during pregnancy and breastfeeding, and infant mortality. The findings confirmed a dramatic decline in mother-to-child transmission over two decades of support.

Addressing Syphilis and Hepatitis B

Despite these gains, Uganda continues to face challenges with syphilis and hepatitis B. The Ministry of Health reports a 2.1% prevalence of active syphilis among adults, with significantly higher rates among HIV-positive individuals (6.2%) than those who are HIV-negative (1.8%).

“Syphilis doesn’t get as much attention as HIV/AIDS, yet it’s just as dangerous for unborn babies,” said Dr. Harriet Nankunda, Senior Reproductive Health Officer at the Ministry of Health.
“Stillbirths, deformities, and neonatal deaths linked to untreated syphilis are preventable — if we strengthen early diagnosis and timely treatment.”

For hepatitis B, progress has been slower. Among adults, the national HBV infection rate is 4.1%, while among children it is 0.6%. Regional disparities persist, with the mid-North reporting rates as high as 4.6%. In December 2022, Uganda introduced the hepatitis B birth dose — a critical component in breaking the cycle of vertical transmission.

“Unlike HIV/AIDS or syphilis, hepatitis B requires very specific timing — that birth dose must be given within 24 hours,” explained Dr. Michael Baganizi, an immunization expert with the Uganda National Expanded Programme on Immunization.
“If we miss that window, the risk of chronic infection increases drastically.”

Integrated Approach and Health System Strengthening

To address these challenges, the Ministry of Health, in collaboration with development partners, has launched a national elimination plan that integrates HIV, syphilis, and hepatitis B services into maternal and child health care. Efforts include the expansion of testing services, scaling up point-of-care diagnostics for HIV-exposed infants, and viral load monitoring at over 350 health facilities.

Looking Forward

As of November 2024, 19 countries had been certified by the WHO for halting vertical transmission of HIV and/or syphilis. Botswana and Namibia are nearing this milestone. Uganda is not far behind — but achieving full elimination will require sustained commitment.

The elimination of vertical transmission is no longer a distant goal. With continuous investment, a resilient health system, and unwavering political and community support, Uganda is on the path to protecting every child from preventable infections at birth.

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