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

World Health Organization
June 30, 2015
WHO validates elimination of mother-to-child transmission of HIV and
syphilis in Cuba

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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Centers for Disease Control and Prevention
June 23, 2015
HIV Among Pregnant Women, Infants, and Children

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

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?