Cuba is the first country to end mother-to-child HIV transmission


The World Health Organization (WHO) on Tuesday 30 June 2015 declared Cuba the first country in the world to eliminate the transmission of HIV and syphilis from mother to child.

The WHO said in a statement that an international delegation that it and the Pan American Health Organization sent to Cuba in March determined the country met the criteria for the designation.

In 2013, only two children in Cuba were born with HIV and five with syphilis, the statement said.

ScienceDirect reports that it was brought about by relatively simple strategies: better testing and treatment of expectant parents, and providing HIV- and syphilis-positive mothers with options to protect their babies, such as bottle-feeding and C-sections.

WHO director general, Margaret Chan, told the press that what Cuba has done differently is integrate these treatments into accessible and affordable universal healthcare, so that they've become a normal part of treatment for all pregnant women.

"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," PAHO Director Carissa Etienne said in the statement.

Cuba's Communist government considers its free healthcare a major achievement of the 1959 revolution, although ordinary Cubans complain of a decline in standards since the fall of the Soviet Union, the country's former benefactor, in 1991.

The PAHO and WHO credited Cuba with offering women early access to prenatal care, HIV and syphilis testing, and treatment for mothers who test positive.

The two organisations began an effort to end congenital transmission of HIV and syphilis in Cuba and other countries in the Americas in 2010.

About mother-to-child HIV transmission

Every year, globally, an estimated 1.4 million women living with HIV become pregnant. Untreated, they have a 15-45% chance of transmitting the virus to their children during pregnancy, labour, delivery or breastfeeding. H

However, that risk drops to just over 1% if antiretroviral medicines are given to both mothers and children throughout the stages when infection can occur. 

With treatment that percentage can be reduced to less than 1 per cent.

Research particularly from South Africa has shown that a combination of exclusive breastfeeding and the use of antiretroviral treatment can significantly reduce the risk of transmitting HIV to babies through breastfeeding.

One of the barriers South Africa faces is that pregnant women may not seek PMTCT (prevention of mother-to-child transmission) services because they fear stigma if they are found to be HIV-positive following an HIV test. 

The WHO reports that although the burden of HIV infection in South Africa had been large for many years, the country did not implement a PMTCT programme  until 2002. South Africa is currently implementing a national action framework for PMTCT that covers the 5 years from 2012 to 2016.

If no preventative steps are taken, the risk of HIV transmission during childbirth is estimated to be 10-20%. The chance of transmission is even greater if the baby is exposed to HIV-infected blood or fluids. 

Read more:

Preventing mother-to-baby transmission of HIV

An aggressive form of HIV uncovered in Cuba

How an HIV+ baby was cured

National Department of Health PMTCT Guidelines (PDF)

Image: doctor in front of Cuban flag, Shutterstock

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