Dr. Rosenfield was approached by the foundations involved in the effort to lead a broad partnership coalition that will include technical and service delivery organizations in developing countries and international institutions and non-governmental organizations.

MTCT-Plus will initially be focused in sub-Saharan Africa and will work through partners already engaged in efforts to decrease maternal-to-child transmission (MTCT) of HIV. The project builds on the rapidly expanding efforts in Africa to prevent MTCT using a single dose of an anti-retroviral drug for the mother and one for the infant after birth.

Although groundbreaking progress is being made in preventing infection of children, the absence of care for mothers has been identified both as a moral dilemma and as a disincentive to participation. MTCT-Plus seeks to extend HIV treatment to women and their children; infected mothers will be provided an essential care package with appropriate therapies initiated where indicated. In addition, MTCT-Plus will offer basic care for the prevention and treatment of related opportunistic infections.

In the interest of getting the project operational as soon as possible, MTCT-Plus will be piloted as an extension of programs that are currently providing MTCT prevention services, including those administered by UNICEF, the Elizabeth Glaser Pediatric AIDS Foundation, Médecins Sans Frontières, and other organizations.

Many U.S. and international foundations are contemplating funding. Commitments have been received from the Bill and Melinda Gates, William and Flora Hewlett, Robert Wood Johnson, Henry J. Kaiser Family, John D. and Catherine T. MacArthur, David and Lucile Packard, Rockefeller, Starr, and UN foundations.