Cuba is the first country in the world to receive validation from the World
Health Organization for wiping out mother-to-child transmission of HIV and
syphilis.
Cuba’s achievement represents an important step toward an AIDS-free generation say the WHO.
In the announcement on Tuesday, Dr. Margaret Chan, Director-General of the World
Health Organization (WHO), describes the achievement as a “major victory” and an
“important step” toward an AIDS-free generation.
“Eliminating transmission of a virus is one of the greatest public
health achievements possible,” says Dr. Chan.
Michel Sidibé, Executive Director of UNAIDS says the achievements shows it is
possible to end the AIDS epidemic and they now “expect Cuba to be the first of many
countries coming forward to seek validation that they have ended their epidemics
among children.”
Since 2010, WHO, the Pan American Health Organization (PAHO) and other partners
have been working in Cuba and other countries in the Americas to put in place
regional initiatives to eliminate mother-to-child transmission of HIV and
syphilis.
The initiatives ensure early access to prenatal care, and to HIV and syphilis
testing for pregnant women and their partners. Where pregnant women test positive,
they and their babies receive prompt treatment, plus the babies are delivered by
cesarean section and are not breastfed.
Another feature of the initiative is that programs for HIV and sexually
transmitted infections are offered as an integral part of mother and child health
programs in equitable, accessible and universal health systems.
For a country to be recognized as having eliminated mother-to-child transmission
of HIV and syphilis, it must pass the validation process and criteria that WHO and
their key partners issued in 2014.
Validation by panel of international experts
The validation process recognizes that no treatment is 100% effective in
preventing mother-to-child-transmission, so it defines elimination as a “reduction
of transmission to such a low level that it no longer constitutes a public health
problem.”
In 2013, only two babies were born with HIV in Cuba, and only 5 babies were born
with syphilis inherited from their mothers.
To carry out the validation, a PAHO and WHO mission spent 5 days in Cuba in
March 2015. The mission included experts from several countries in the Americas,
plus the Bahamas, Italy, Japan, the US and Zambia. They visited health centers,
laboratories, and government offices across the island, interviewing health and
other officials.
The validation process places great emphasis on services being offered free of
coercion and in line with human rights.
PAHO Director, Dr. Carissa F. Etienne, says:
“Cuba’s achievement today provides inspiration for other countries to advance
towards elimination of mother-to-child transmission of HIV and syphilis.”
Every year around the world around 1.4 million HIV-infected women get pregnant.
Without treatment, there is a 15-45% chance they will pass the virus to the baby in
the womb, or during birth or breastfeeding.
But that risk falls to just over 1% if mothers and their babies receive
antiretrovirals during all the stages where infection can occur.
Number of children born with HIV has halved
According to WHO, the number of children globally born every year with HIV is
now nearly half what it was in 2009, when it was around 400,000.
Also, since 2009, the proportion of HIV-infected pregnant women in low- and
middle-income countries who receive effective anti-HIV drugs to prevent passing it
to their child has doubled.
A WHO statement says:
“Among the 22 countries which account for 90% of new HIV infections,
8 have already reduced new HIV infections among children by over 50% since 2009,
based on 2013 data, and another four are close to this mark.”
Syphilis, which infects nearly 1 million pregnant women around the world every
year, is cost-effective and easy to screen and treat during pregnancy. Doing so
eliminates most of the complications of infection, which include miscarriage and
stillbirth, plus death, low birthweight and serious infections of newborns.
In 2012, syphilis affected 360,000 pregnancies through stillbirths, death of
newborns, premature births and infected babies.
Following a global campaign to eliminate mother-to-child syphilis in 2007, WHO
estimate that by 2014, more than 40 countries were testing 95% or more of pregnant
women in prenatal care for syphilis.
Meanwhile, Medical News Today recently reported a study that suggests
risk of HIV reduces with longer secondary
education. For the study, the researchers focused on Botswana, the most HIV-affected country in the world, and where recent reforms have increased time spent
in secondary education.
Written by Catharine Paddock PhD