Triple Elimination Toolkit for Pacific island countries

Many Pacific island countries have high rates of HIV, syphilis and hepatitis B (HBV). Mother-to-child transmission is a major cause of this issue.  

Our research has shown that Pacific island countries are not on track to meet the World Health Organization target of eliminating mother-to-child transmission of these viruses by 2030.  

The Triple Elimination Toolkit project supports integrated delivery of essential services that could help Pacific island countries to get back on track to meet elimination targets and protect thousands of infants from lifelong infection.  

The problem

Mother-to-child transmission is a major driver of HIV, syphilis and hepatitis B. These 3 infections can be effectively prevented and eliminated by interventions, including:  

• antenatal testing 
• treatment 
• counselling 
• safe delivery at childbirth
• hepatitis B vaccination 
• infant follow-up 
• optimal infant feeding  
• lifelong treatment and care.  

Integration of these interventions to prevent HIV, syphilis and hepatitis B into routine services, such as antenatal care services, is referred to as ‘Triple Elimination’. 

Midwives and nurses are critical to achieving Triple Elimination.  

A major barrier to the implementation of Triple Elimination services across Pacific island countries is limited knowledge, confidence and resources to support midwives and nurses to integrate Triple Elimination services into routine antenatal and postnatal care. 

Testing a solution 

To address these issues, Burnet has worked with partners in Solomon Islands and Vanuatu to co-design a Triple Elimination Toolkit in 2025.  

Our partners are:

• Solomon Islands Ministry of Health and Medical Services
• Vanuatu Ministry of Health
• Vanuatu Family Health Association.  

The aim of the Triple Elimination Toolkit is to support nurses and midwives in Pacific Island Countries to deliver essential interventions to prevent mother-to-child transmission of HIV, syphilis and hepatitis B.  

The toolkit is like a briefcase that midwives and nurses can use in antenatal and other health clinics to support pregnant women to be tested, receive treatment and make sure their infants are vaccinated against hepatitis B.  

The toolkits are customised to the context and services available in Solomon Islands and Vanuatu. They can also be customised to other countries.  

With funding from the Canada Fund for Local Interventions, we are producing several Triple Elimination Toolkits to be used in antenatal clinics across Solomon Islands and Vanuatu and will deliver 'training-of-trainers' to support rollout to midwives and nurses.