Prevention of mother-to-child transmission of HIV in Africa: successes and challenges in scaling-up a nevirapine-based program in Lusaka, Zambia

AIDS. 2003 Jun 13;17(9):1377-82. doi: 10.1097/00002030-200306130-00012.


Background: Nearly half of perinatal HIV infection is preventable with nevirapine (NVP), which has transformed the ability to confront this transmission route in resource-limited settings.

Methods: A NVP-based perinatal HIV prevention program initiated in Lusaka, Zambia in November 2001.

Results: The first 12 months cost US$221 000 and enabled 178 district health employees to be trained in voluntary counseling and testing: 17 263 pregnant women were counseled for HIV, 12 438 (72%) were tested, and 2924 (24%) were found to be infected with HIV. NVP has been taken by 1654 (57%) mothers and 1157 (40%) babies. It is estimated that at least 190 infants have been spared HIV infection (11 per 1000 counseled women or 65 per 1000 identified HIV-infected women).

Conclusions: Prevention of mother-to-child HIV transmission is feasible and cost effective in resource-limited settings. In Lusaka, thousands of women have received voluntary counseling and testing and NVP therapy under the present scheme. Patient attrition and non-adherence represented a major source of program inefficiency, which requires to be systematically addressed.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Antiviral Agents / economics
  • Antiviral Agents / therapeutic use*
  • Cost-Benefit Analysis
  • Counseling
  • Developing Countries*
  • Drug Costs
  • Female
  • HIV Infections / prevention & control*
  • HIV Infections / transmission*
  • Humans
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical / prevention & control*
  • Male
  • Nevirapine / economics
  • Nevirapine / therapeutic use*
  • Patient Compliance
  • Pregnancy
  • Pregnancy Complications, Infectious / prevention & control*
  • Urban Health
  • Zambia


  • Antiviral Agents
  • Nevirapine