Cuba Becomes First Nation to Eliminate Mother-to-Child Transmission of HIV and Syphilis
Cuba is being celebrated for their latest groundbreaking advancement in health and science. According to the World Health Organization, Cuba is the first nation in the world to eliminate mother-to-child transmission of HIV and syphilis.
Approximately 14,100 individuals (0.2 percent of the population) in Cuba are living with HIV/AIDS. Often, though not exclusively, the virus is transmitted via commercial sex work, and it's linked to cultural and behavioral patterns (early initiation of sexual activities, gender inequalities) and a lack of access to protective measures. The act of eliminating mother-to-child transmissions of HIV and syphilis means more than improved outcomes for the children of infected parties, but it means hope for a cure.
"Eliminating transmission of a virus is one of the greatest public health achievements possible," said Dr Margaret Chan, WHO Director-General, in a statement. "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."
Many are calling for a celebration of Cuba and children and families everywhere. Michel Sidibé, Executive Director of UNAIDS, has said that the advancements in Cuba prove that it's possible to end the AIDS epidemic. Also, he expects that Cuba will be the first of many nations to "seek validation that they have ended their epidemics among children." In 2013, just two children were born with HIV in Cuba, and only five born with congenital syphilis. This meets the official WHO criteria for elimination, which is less than 50 cases per 100,000 live births for at least 1 year.
Globally, an estimated 1.4 million women living with HIV become pregnant each year. If untreated, there's a 15-45 percent chance that they'll transmit the virus to their child during their pregnancy, labor, delivery or breastfeeding. However, the risk of transmission plummets to just a little over 1 percent if mothers take antiretroviral medicines throughout various stages of a woman's pregnancy.
Since 2009, the number of children born with HIV infection has been cut in half (400,000 in 2009 to 240,000 in 2013), but global goals have pushed for a global target of less than 40,000 new child infections per year by 2015. In addition to children born with HIV, nearly 1 million pregnant women globally are infected with syphilis, resulting in neonatal death, low-birth-weight infants, early fetal loss, stillbirth and serious neonatal infections. That said, these complications can be eliminated with penicillin and cost-effective screening.
Since 2010, WHO/PAHO partnered with Cuba and other American nations to apply to a regional initiative to put an end to mother-to-child transmission of HIV and syphilis. Part of the initiative involves conducting syphilis testing on pregnant women and their partners, treating women who test positive and their babies. Efforts are made to make sure that women receive treatment, and their children live free of HIV and syphilis. By 2014, more than 40 countries tested 95 percent or more of pregnant women in prenatal care for syphilis thanks to efforts to prioritize the prevention and treatment of mother-to-child transmission of syphilis.
"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. "Cuba's achievement today provides inspiration for other countries to advance towards elimination of mother-to-child transmission of HIV and syphilis".
During a five-day visit to Cuba in March 2015, an international expert mission, comprising experts from Argentina, the Bahamas, Brazil, Colombia, Italy, Japan, Nicaragua, Suriname, the United States of America and Zambia, visited Cuba to validate the nation's progress toward the elimination of mother-to-child transmission of HIV and syphilis. Through visits to health centers, government offices and laboratories, mission experts attested that Cuba successfully met criteria for the elimination of mother-to-child transmission of HIV and syphilis.
At least two large countries, the U.S. and Canada, likely have reached the elimination goal but aren't presently seeking WHO validation, which is required for validation of elimination. The validation process involves documentation and site visits, and approximately 30 other nations are presently requesting that status.
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