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WHO validates Cuba as first nation to eliminate maternal-fetal HIV transmission

WHO validates elimination of mother-to-child transmission of HIV and syphilis in Cuba

World Health Organization, June 30, 2015

Cuba today became the first country in the world to receive validation from WHO that it has eliminated mother-to-child transmission of HIV and syphilis.

“Eliminating transmission of a virus is one of the greatest public health achievements possible,” said Dr Margaret Chan, WHO Director-General. “This is a major victory in our long fight against HIV and sexually transmitted infections, and an important step towards having an AIDS-free generation” she added.

Cuba’s achievement

WHO/PAHO (World Health Organization/Pan American Health Organization) has been working with partners in Cuba and other countries in the Americas since 2010 to implement a regional initiative to eliminate mother-to-child transmission of HIV and syphilis.

As part of the initiative, the country has worked to ensure early access to prenatal care, HIV and syphilis testing for both pregnant women and their partners, treatment for women who test positive and their babies, caesarean deliveries and substitution of breastfeeding. These services are provided as part of an equitable, accessible and universal health system in which maternal and child health programs are integrated with programs for HIV and sexually transmitted infections.

“Cuba’s success demonstrates that universal access and universal health coverage are feasible and indeed are the key to success, even against challenges as daunting as HIV,” said PAHO Director, Dr Carissa F. Etienne.

(As treatment for prevention of mother-to-child-transmission is not 100% effective, elimination of transmission is defined 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 3 babies were born with congenital syphilis.)

http://www.who.int/mediacentre/news/releases/2015/mtct-hiv-cuba/en/

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HIV Among Pregnant Women, Infants, and Children

Centers for Disease Control and Prevention, June 23, 2015

At the end of 2009, an estimated 10,834 persons who were diagnosed with HIV when they were younger than 13 years were living in the 46 states with long-term, confidential name-based HIV reporting. Of the total, 9,522 (88%) of these persons acquired HIV perinatally.

In 2010, an estimated 217 children younger than the age of 13 years were diagnosed with HIV in the 46 states with long-term, confidential name-based HIV infection reporting since at least 2007; 162 (75%) of those children were perinatally infected.

http://www.cdc.gov/hiv/group/gender/pregnantwomen/index.html

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Comment:

By Don McCanne, MD

Cuba is the first nation to be validated by the World Health Organization as having reduced maternal-fetal transmission of HIV to such a low level that it no longer constitutes a public health problem. Their success is attributed in part to “an equitable, accessible and universal health system in which maternal and child health programs are integrated with programs for HIV and sexually transmitted infections.”

Do you suppose that if the United States adopted an equitable, accessible and universal health system that it would help further reduce our rate of maternal-fetal HIV transmission? Can we try?