Q: CONTACTS

• Prof. Julio Rakotonirina Director of Health and Humanitarian Affairs E-mail: JulioR@africa-union.org • Dr. Sheila Shawa Senior Technical and Partnerships Specialist E-mail: ShawaS@africa-union.org • Mr. Kenneth Kabagambe Head of Organizing Secretariat Executive Director - The National Organisation for People Living with Hepatitis B E-mail: kkabagambe@noplhb.org • Eric Junior Wagobera Program Officer E-mail: WagoberaE@africa-union.org

Question 1

BACKGROUND

Accepted Answer

The triple infections of HIV, Hepatitis B virus (HBV), and Syphilis represent a significant and interconnected public health challenge across the African continent, particularly concerning mother-to-child transmission (MTCT). These infections are known to share common routes of transmission, including vertical transmission during pregnancy, labour, delivery, or breastfeeding, placing infants at high risk even before birth. High prevalence rates of these infections among women of reproductive age in many African countries pose a direct substantial risk of transmission to their newborns.

Without effective prevention, screening, and treatment being integrated into maternal and child health services, MTCT perpetuates the cycle of these diseases, leading to considerable morbidity, mortality, and long-term health complications in children, thereby straining the already burdened healthcare systems and thus hindering socioeconomic development. The combined impact of these preventable infections significantly contributes to adverse pregnancy outcomes and undermines efforts to improve maternal and child health survival rates, highlighting the critical need for integrated strategies, such as the Triple Elimination initiative.

The Triple Elimination initiative is an overarching strategy that supports the elimination of mother-to-child transmission of the three diseases – human immunodeficiency virus (HIV) infection, syphilis, and hepatitis B. Significant progress towards triple elimination has been made in some regions, but progress has been slow in Africa which bears the highest burden of these diseases. HIV, hepatitis B, and syphilis are among the leading public health challenges in Africa, contributing to significant morbidity and mortality across the continent. Although Africa accounts for a substantial proportion of these diseases, achieving the goal of eliminating all three by 2030 remains a critical but daunting challenge, and progress in the African region remains slow.

Efforts to combat the triple infections of HIV, hepatitis B, and syphilis have made significant strides, but gaps in prevention, diagnosis, treatment, and awareness continue to hinder progress. These gaps are particularly pronounced in under-resourced health systems. However, opportunities exist to align strategies for addressing these diseases simultaneously through leveraging existing health programs, such as HIV care systems, and expanding their scope to include hepatitis B and syphilis. The African Region has committed to the dual elimination of HIV and syphilis, and committing to the triple elimination of mother-to-child transmissions by including hepatitis B would tackle three important causes of maternal and pediatric morbidity and mortality.

The Triple Elimination initiative aims to eradicate mother-to-child transmission of HIV, Hepatitis B, and Syphilis in Africa, where these infections have become a public health burden. Despite significant progress, challenges remain, for example, for HIV, MTCT rates have dropped significantly in many countries due to the widespread use of antiretroviral therapy among pregnant women. However, some countries still report MTCT rates above 5%1, particularly in areas with limited healthcare access. Hepatitis B still poses a unique challenge, as up to 90% of infants born to mothers with high viral loads risk chronic infection if not vaccinated at birth2. Syphilis, though preventable and treatable, continues to cause adverse outcomes like stillbirth and neonatal death, with prevalence among pregnant women exceeding 1% in some regions.

Integrated healthcare services are seen as being critical for achieving the desired triple elimination, such as testing for all three infections during antenatal care, coupled with timely interventions. For instance, some countries implementing comprehensive programs have seen over 80% reductions in new pediatric HIV cases. However, progress on HBV and syphilis elimination has been slower, with limited access to vaccines and treatment being among the key barriers. The World Health Organization's framework emphasizes scaling up these services while protecting human rights and ensuring gender equality. The path to elimination is challenging but achievable with sustained efforts and international collaboration.

Question 2

INTRODUCTION

Accepted Answer

The African Union Commission in collaboration with the Ministry of Health of the Republic of Uganda, the World Health Organization, Africa CDC, AUDA-NEPAD, the National Organization for People Living with Hepatitis B, and other partners will host the High-Level Conference on the Triple Elimination of HIV, Hepatitis B, and Syphilis in Africa from 21 to 23 July 2025, at the Speke Resort Convention Center, in Kampala, Uganda. The conference themed: “Unifying Actions, Transforming Futures: Achieving Triple Elimination in Africa by 2030”, seeks to galvanize urgent actions for securing high-level political commitment to address systemic gaps in the prevention, diagnosis, treatment, and awareness of HIV, Hepatitis B, and Syphilis.

The conference is organized in alignment with the Africa Elimination of Vertical Transmission of HIV, Syphilis, and HBV Plan by 2030 and Keeping their Mothers Alive (AEVT) Plan that was recently endorsed during the Fifth Ordinary Session of the African Union’s Specialized Technical Committee on Health, Nutrition, Population, and Drug Control (STC-HNPDC-5) held in August 2024 in Addis Ababa, Ethiopia. The plan, which will be launched during this conference, is an accountability framework developed by the African Union Commission and its partners to guide Member States in eliminating the mother-to-child transmission of HIV, Syphilis, and Hepatitis B Virus, while building on previous efforts and aligning with both continental and global initiatives, such as the Africa Health Strategy (2016-2030), and the World Health Organization's Triple Elimination Initiative.

In this regard, the conference will foster and strengthen collaboration among AU Member
States, international health organizations, donors as well as the private sector to promote synergies for increased resource allocation, including funding, towards national triple elimination programs. This includes emphasizing an integrated approach through maternal and child health platforms, addressing the shared transmission routes and management of these infections, with a focus on the four strategic pillars: early and expanded testing, closing treatment gaps for pregnant/breastfeeding women and children, preventing new infections, and removing barriers to accessing integrated care.

The conference will seek to secure and leverage high-level political commitment from the policy/decisionmakers to advance the achievement of triple elimination goals by 2030, mobilize resources through discussions on innovative financing mechanisms, public-private partnerships, and global funding commitments, as well as explore opportunities for improving access to essential treatments to accelerate triple elimination efforts across the continent.

This conference will bring together key policy and decision-makers from African Union
Member States such as Ministries of Health, Health Institutions/Organizations, Donors, Private Entities, and other stakeholders to discuss strategies, innovations, and funding pathways to achieve the triple elimination of HIV, Hepatitis B, and syphilis across the continent by 2030.

Question 3

MAIN OBJECTIVE

Accepted Answer

To advocate for increased political commitment, funding, and strategic collaborations to achieve the triple elimination of HIV, Hepatitis B, and syphilis in Africa.

SPECIFIC OBJECTIVES
1. Raise Awareness and Political Commitment: Mobilize high-level political and global health leaders to prioritize the triple elimination of HIV, Hepatitis B, and syphilis in national and regional health agendas. Advocate for robust national and international
funding commitments for comprehensive elimination programs.

2. Strengthen Partnerships and Collaboration: Facilitate collaboration among governments, international health organizations, donors, the private sector, and civil society to implement integrated health interventions. Enhance synergies between HIV, hepatitis B, and syphilis control programs to utilize existing health infrastructure effectively.

3. Advocate for Funding Towards Elimination Efforts: Engage donors, private sector, and philanthropic organizations to increase financial support for triple elimination efforts in Africa. Identification of funding gaps and the development of strategies for sustainable financing, including domestic resource mobilization for sustained investment in diagnostics, treatment, public health campaigns, and system strengthening to meet 2030 elimination targets.

4. Share Best Practices and Innovations: Highlight successful case studies and innovative approaches in disease control, showcasing progress in eliminating HIV, Hepatitis B, and syphilis. Promote knowledge-sharing among governments, researchers, and practitioners to replicate successful interventions across the continent.

Question 4

EXPECTED OUTCOMES

Accepted Answer

1. Strengthened Commitment Toward Triple Elimination Goals: Renewed political and financial commitment toward the elimination of mother-to-child transmission of HIV, Hepatitis B, and Syphilis in Africa by 2030.

2. Launch of the African Triple Elimination Action Framework: Presentation and endorsement of a continental strategy and action plan to guide countries in scaling up integrated interventions and tracking progress.

3. Policy Dialogue and Consensus Building: High-level engagement among policymakers, health ministries, donors, CSOs, and implementing partners to align national policies with global and regional elimination targets.

4. Best Practices and Innovations Shared: Documentation and dissemination of best practices, lessons learned, and innovative models from country-level programs that have made progress in integrated service delivery.

5. Strengthened Multi-sectoral Collaboration: Increased collaboration between health sectors (maternal and child health, HIV, STI, hepatitis programs), civil society, academic institutions, and the private sector to drive integrated service delivery.

6. Call to Action and Joint Communiqué: Issuance of a Joint Communiqué or Call to Action signed by participating countries and partners, reaffirming their commitment to triple elimination and outlining next steps.

7. Monitoring and Accountability Roadmap: Agreement on key indicators and a framework for monitoring progress, accountability, and periodic review at regional and national levels.

Question 5

EXPECTED PARTICIPANTS

Accepted Answer

Representatives from AU Ministries of Health and Ministries of Finance, Regional Economic Communities, Legislators from AU Parliamentary Health Committees, Donors, international health partners, non-governmental organizations, Patient representatives across the HIV and hepatitis communities and civil society organizations, Representatives from the private sector and philanthropic organizations, Researchers, academics and public health experts, Pharmaceutical and Healthcare Companies, i.e. Biotech firms, vaccine producers, and diagnostics manufacturers, and media representatives.

Question 6

WORKING LANGUAGES

Accepted Answer

English, French, Arabic, and Portuguese.

Question 7

ORGANIZERS

Accepted Answer

African Union Commission, Ministry of Health of the Republic of Uganda, Africa CDC, AUDANEPAD, World Health Organization, UNICEF, UNAIDS, The National Organisation for People Living with Hepatitis B, Organisation of African First Ladies Development, Hepatitis B Foundation of USA, PATH, Clinton Health Access Initiative.

Question 8

EVENT FORMAT

Accepted Answer

Panel discussions, brainstorming sessions, group work, presentations, question and answer sessions, and professional networking.

Question 9

CONTACTS

Accepted Answer

• Prof. Julio RakotonirinaDirector of Health and Humanitarian Affairs E-mail: JulioR@africa-union.org• Dr. Sheila ShawaSenior Technical and Partnerships Specialist E-mail: ShawaS@africa-union.org• Mr. Kenneth KabagambeHead of Organizing Secretariat Executive Director - The National Organisation for People Living with Hepatitis B E-mail: kkabagambe@noplhb.org• Eric Junior WagoberaProgram Officer E-mail: WagoberaE@africa-union.org