The global community has committed to elimination of mother-to-child transmission, or vertical transmission, of HIV, syphilis and hepatitis B virus (HBV) as a public health priority and reducing global disease burden, quality reproductive, maternal and child health services to a level no longer a public health concern. Achieving and maintaining elimination requires strong political and public health commitment. Strengthened, resilient health systems improve a broad range of services and outcomes while similarities in prevention interventions add to the benefit of an integrated approach. Validation is an attestation that a country has successfully met standard criteria for elimination, or for being at one of the 3 levels of achievement on the ‘Path to Elimination’ while delivering quality services for women, girls and their children, through the life-course, respecting human rights and ensuring gender equality and community engagement. It requires systems that comprehensively identify and monitor new infections and infant outcomes. Establishment of criteria for validation began in 2007 with global consultations while lessons learnt advised publication of 2 editions of global guidance on criteria and processes for validation: elimination of mother-to-child transmission of HIV and syphilis (the ‘Orange Book’). This document, the third version, adds on EMTCT of HBV, bringing together a package of interventions and metrics to support integrated management and monitoring of vertical transmission across a wide range of epidemiological and programmatic contexts.

Achieving validation of elimination of mother-to-child transmission (EMTCT) of HIV, syphilis and hepatitis B virus (HBV) is a tremendous accomplishment, requiring health ministry-led accountability, rigorous data analysis, intensive programme assessment and multi-level collaboration. This governance guidance outlines the standardized structures and processes used to validate EMTCT of HIV, syphilis and HBV at the national, regional and global levels. Replacing an earlier version published in June 2020 addressing EMTCT of HIV and syphilis, this revised governance document aligns with new information in the Global guidance on criteria and processes for validation: elimination of mother-to-child transmission of HIV, syphilis, and hepatitis B virus, in which WHO sets criteria for validation of triple elimination.

To ensure that countries can effectively benefit from digital health investments, “digital adaptation kits” (DAKs) are designed to facilitate the accurate reflection of WHO’s clinical, public health and data use guidelines in the digital systems that countries are adopting. DAKs are operational, software-neutral, standardized documentations that distil clinical, public health and data use guidance into a format that can be transparently incorporated into digital systems. For this particular DAK, the operational requirements are based on systems that provide the functionalities of digital tracking and decision support (DTDS) and include components such as personas, workflows, core data elements, decision-support algorithms, scheduling logic and reporting indicators. Web annexes provide certain components in additional detail including: data dictionary (Web Annex A), decision-support logic (Web Annex B), indicator definitions (Web Annex C), and functional and non-functional requirements (Web Annex D). Data elements within the DAK (Web Annex A) are mapped to standards-based terminology, such as the International Classification of Diseases (ICD), to facilitate interoperability. This DAK focuses on providing the content requirements for a DTDS system for HIV care used by health workers in primary health care settings. It also includes cross- cutting elements focused on the client, such as self-care interventions.