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Cuba first country to eliminate vertical transmission of HIV, syphilis
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WHO has recognized Cuba as the first country to officially meet all requirements for elimination of mother-to-child transmission of HIV and syphilis.
To receive validation, countries must have a congenital HIV rate of less than 2% and a congenital syphilis rate of less than 0.5 per 1,000 live births, Adèle S. Benzaken, DrPH, co-president of the regional validation committee and deputy director, STD/AIDS department, Brazilian Ministry of Health, said at a press conference. Countries also must provide widespread ART for pregnant women who are HIV positive and adequate health care services for mothers with syphilis.
Roberto Morales Ojeda , MD, MPH, minister of public health in Cuba, said that earning this recognition stems from a commitment Cuba and other Pan-American countries made at the 2010 WHO meeting to eliminate mother-to-child transmission of HIV and syphilis. He said that Cuba has been under the 2% threshold for HIV mother-to-child transmission for each of the last 3 years, and that 0.25% of Cubans aged 15 to 49 years are HIV positive.
Benzaken said 86% of pregnant women infected by HIV in Cuba have been treated with antivirals over the last 3 years, and the vast majority of women with syphilis have received treatment.
Programs to combat syphilis have been in place in Cuba since the 1970s, according to Ojeda. He credited Cuba’s universal health coverage, despite the country’s “scant financial resources,” with helping the country achieve this recognition. Other Pan-American countries are following Cuba’s lead.
“We have shown that we are turning the corner, and we have done that because of the commitment of many governments,” Carissa F. Etienne, MBBS, MSc, director of the Pan American Health Organization (PAHO), said. “We are hopeful that [the rest of] this region can move to the position that Cuba is in very shortly.”
According to a press release issued by PAHO, WHO and UNAIDS, Anguilla, Barbados, Canada, Montserrat, Puerto Rico and the United States are among the Pan-American countries and territories that have reached the requirements but not yet requested validation. Etienne said Belarus, Bulgaria, Cambodia, Malaysia, Thailand and Oman are among the countries that have already applied for validation.
Every year, an estimated 1.4 million women with HIV become pregnant globally, according to PAHO. The chance of a mother transmitting the virus to her child before and after birth, which ranges from 15% to 45%, drops to about 1% if they both receive ART. – by David Jwanier