In a significant step towards combating the HIV epidemic, the World Health Organization (WHO) responded to a call to support the National Department of Health (NDoH) in South Africa, to embark on the path to elimination of triple elimination of HIV, syphilis and Hepatitis B.  A training workshop was held from 6-8 February 2024, in Johannesburg to orient key stakeholders on Triple Elimination and the process of validation, the global tools, necessary skills and knowledge to assess and validate the progress made by South Africa towards triple elimination, in a high burden country.

The workshop, supported by WHO in collaboration with NDoH, UNICEF, UNAIDS, and UNFPA, aimed to identify the strengths and gains, as well as the gaps and challenges that have to be addressed in order to be certified as being on the Path to Elimination (PTE) of Mother to Child Transmission (EMTCT) of HIV, syphilis, and hepatitis B virus (HBV). The training brought together multisectoral stakeholders, both online and in person, including SANAC, civil society organizations (CSO’s) such as Side by Side, human rights organizations, National Institute for Communicable Diseases (NICD), Centre for Disease Control (CDC), and United States Agency for International Development(USAID). The ministries of health (MoH) from Botswana and Eswatini also joined to share their experiences for ‘South-South’ learning. In 2021, Botswana was certified by WHO, for silver tier on the Path to Elimination of mother-to-child transmission of HIV after successfully meeting the criteria and achieving all process and impact indicators. Notably, this initiative aligns with WHO AFRO's broader regional commitment and effort to encourage and support countries in the African region to achieve Triple Elimination of mother-to-child transmission (EMTCT) or vertical transmission of HIV, syphilis and hepatitis B virus (HBV) and elimination of Viral Hepatitis as a public health priority.

The training agenda covered various crucial aspects such as validation structures, global criteria, and assessment processes. Participants were briefed on the current progress of EMTCT in South Africa, highlighting achievements and areas needing improvement based on a self-assessment which had been undertaken by the NDOH in collaboration with partners. Furthermore, the workshop provided insights into governance structures, assessment tools, and thematic areas of evaluation such as triple EMTCT or prevention of vertical transmission programs (VTP), laboratory systems and services, surveillance and data evaluation, and Human rights, gender equity and community engagement.

Through interactive discussions and practical exercises, participants collaborated on crafting a comprehensive national validation roadmap tailored to South Africa's context. Dr. Sithembile Dlamini-Nqeketo, the WHO South Africa National Professional Officer (NPO) for Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCAH) emphasized the importance of WHO supporting the process and training in guiding the country's efforts towards HIV elimination. She advocated and highlighted the importance of the workshop and stated that the need for integration and coordination of all the sectors involved in the response and the process.

The training concluded with the presentation and adoption of the proposed PTE roadmap, marking a significant milestone in South Africa's commitment to ending the HIV epidemic. Representatives from WHO, UNICEF, and UNAIDS commended the collaborative efforts and reiterated their support for the country's endeavors in achieving HIV elimination goals and the early and involvement of Women living with HIV (WLHIV) or with HBV and recognizing the underserved areas and hard to reach areas and populations.

As South Africa continues its journey towards ending vertical transmission of HIV, Syphilis and Viral Hepatitis B in children, the newly equipped team from the National department of health and all stakeholders form a working Committee that stands ready to lead the validation process, ensuring accountability and driving progress towards a future free from the triple burden of diseases.