The World Health Organization (WHO) declared Cuba to be the first country to ever receive a validation that the mother-to-child transmission of HIV and syphilis has been eradicated. Since 2010, WHO and its Western counterpart, Pan American Health Organization (PAHO), have been in collaboration with officials in Cuba and other countries in the Americas to carry out actions that can help phase out HIV and syphilis due to mother-to-child transmissions.
The country achieved this feat through the implementation of numerous maternal and child health programs that are performed in collaboration with the country's HIV and sexually transmitted diseases program. The specific interventions under this initiative include prompt availability of prenatal care, diagnostic evaluations of pregnant women and their partners for HIV and syphilis and provision of treatment to HIV-positive women and their newborns.
A team of experts from Brazil, Colombia, Argentina, Suriname, Italy, Nicaragua, Japan, Zambia, the Bahamas and the United States of America went to Cuba in March 2015 and conducted an investigation to validate the status of the country's mother-to-child transmission of HIV and syphilis. For five days, the experts visited laboratories, health facilities and government departments to interview some of the health officials and key persons in this endeavor.
"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," says Dr Carissa F. Etienne, director of PAHO. "Cuba's achievement today provides inspiration for other countries to advance towards elimination of mother-to-child transmission of HIV and syphilis."
The validation process of WHO is outlined in the 2014 publication, Guidance on global processes and criteria for validation of elimination of mother-to-child transmission of HIV and syphilis, which was created by the organization and its partners. In this guide, the various criteria that countries need to meet in order for them to be validated are indicated.
The validation that pertains to the elimination of HIV and syphilis spread may be achieved through a set standard reduction rate of transmission that does not aggregate a public health dilemma. This is the primary standard set by WHO as treatment is not expected to yield a 100 percent disease elimination rate. The panel of experts also looked into how human rights are being advocated to guarantee that the health services were provided in accordance to the principles of human rights and that it was rendered without intimidation. Part of being 'validated' is the ongoing responsibility of the country to continue with their current programs.
The estimated annual incidence of women with HIV getting pregnant is 1.4 million. If these women remain untreated, their babies have a 15-45 percent chance of acquiring the virus during the pregnancy stage, delivery process or during breastfeeding. According to WHO, this risk may decline to one percent if mothers and their babies are administered with antiretroviral drugs during the period at which the infection may develop.
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