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.

Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.

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.

he starting point for this guideline is the point at which a woman has learnt that she is living with HIV and it therefore covers key issues for providing comprehensive sexual and reproductive health and rights-related services and support for women living with HIV. As women living with HIV face unique challenges and human rights violations related to their sexuality and reproduction within their families and communities as well as from the health-care institutions where they seek care particular emphasis is placed on the creation of an enabling environment to support more effective health interventions and better health outcomes. This guideline is meant to help countries to more effectively and efficiently plan develop and monitor programmes and services that promote gender equality and human rights and hence are more acceptable and appropriate for women living with HIV taking into account the national and local epidemiological context. It discusses implementation issues that health interventions and service delivery must address to achieve gender equality and support human rights.

Hepatitis B and C cause most cases of hepatitis in the United States and the world. The two diseases account for about a million deaths a year and 78 percent of world's hepatocellular carcinoma and more than half of all fatal cirrhosis. In 2013 viral hepatitis, of which hepatitis B virus (HBV) and hepatitis C virus (HCV) are the most common types, surpassed HIV and AIDS to become the seventh leading cause of death worldwide. The world now has the tools to prevent hepatitis B and cure hepatitis C. Perfect vaccination could eradicate HBV, but it would take two generations at least. In the meantime, there is no cure for the millions of people already infected. Conversely, there is no vaccine for HCV, but new direct-acting antivirals can cure 95 percent of chronic infections, though these drugs are unlikely to reach all chronically-infected people anytime soon. This report, the first of two, examines the feasibility of hepatitis B and C elimination in the United States and identifies critical success factors. The phase two report will outline a strategy for meeting the elimination goals discussed in this report.