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Six Caribbean countries eliminate motherto- child transmission of HIV and syphilis

Sunday, December 03, 2017



ANGUILLA, Antigua and Barbuda, Bermuda, the Cayman Islands, Montserrat, and Saint Kitts and Nevis were on Friday certified by the World Health Organization (WHO) as having eliminated mother-to-child transmission of HIV and syphilis.

“This elimination is the result of our strong political commitment to public health and of making the health of mothers, children and families a regional priority,” Timothy Harris, prime Minister of St Kitts and Nevis, is quoted as saying in a release from the Pan Caribbean Partnership against HIV/AIDS (PANCAP).

Over the last six years, the Caribbean has succeeded in reducing new HIV infections in children by more than half.

“This is an amazing achievement given the high rates of HIV in the past, and we intend to improve on this success story even more in the future.”

Carissa F Etienne, director of the Pan American Health Organization (PAHO) and regional director for the Americas of WHO, said: “This elimination is a remarkable achievement that puts the Americas at the forefront of the global effort to ensure that no child is born with HIV or congenital syphilis.

“With political commitment, stronger health systems, and timely prevention, diagnosis and treatment, we can achieve great changes,” she added.

“UNAIDS congratulates the six states and territories on this important achievement,” said Michel Sidibé, executive director of UNAIDS. “All countries should follow their example and ensure that every child has an HIV-free start to his or her life.”

In 2015, Cuba, another Caribbean island, became the first country in the world to receive validation from WHO for having achieved elimination of mother-to-child transmission of HIV and syphilis. Subsequently, Thailand and Belarus were also validated as having achieved dual elimination, while Armenia received validation of its elimination of mother-to-child transmission of HIV and the Republic of Moldova was validated for the elimination of congenital syphilis, the release said.

Since the launch in 2010 of the Regional Initiative for the Elimination of Mother-to-Child Transmission of HIV and Congenital Syphilis in Latin America and the Caribbean — coordinated by PAHO and the United Nations Children's Fund (UNICEF), with support from other regional partners — new HIV infections have been reduced in the Caribbean by more than 52 per cent among children, from 1800 in 2010 to fewer than a thousand in 2016. Reported cases of congenital syphilis, meanwhile, remain below the goal of having no more than 50 cases per 100,000 live births, although they have not declined since 2010, and it is likely there is underreporting of cases.

“The elimination of mother-to-child transmission of HIV and syphilis is not just a dream; it's an achievable goal,” Maria Cristina Perceval, UNICEF regional director for Latin America and the Caribbean, is quoted as saying in the release. “Today (Friday) we can say we are closer to ensuring an AIDS-free generation.”

In the Caribbean, as of 2016, 74 per cent of pregnant women living with HIV, 64 per cent more than in 2010, had access to antiretroviral therapy to protect their health and significantly reduce the possibility of transmitting the virus to their children during pregnancy, delivery or breastfeeding, the release said. The increased access to treatment contributed to a 52 per cent reduction in the rate of mother-to-child transmission of HIV between 2010 and 2016, which is now at nine per cent, still higher than the target of two per cent.

Other changes in the health sector that have contributed to this progress, according to the release, include intensive participation by both the public and private health sectors, led by the ministries of health, in the implementation of comprehensive maternal and child health services, with an emphasis on universal coverage and quality antenatal and prenatal care. They also include expanded testing to ensure early detection and immediate treatment for both HIV and syphilis, laboratory networks of guaranteed quality in accordance with international standards, and the implementation of essential measures to guarantee the human rights of women living with HIV.

“The validation for the elimination of mother-to-child transmission of HIV and syphilis sends a strong message that the Caribbean is making remarkable inroads to achieving the goal of an AIDS-free generation, and the achievement directly aligns with achieving our vision and objectives,” said Dereck Springer, director of the Pan Caribbean Partnership against HIV and AIDS. “The spread of the disease from mothers to children is being halted, but elimination status must be maintained and other Caribbean countries must strengthen their services with the goal of receiving validation from WHO.”

The elimination of mother-to-child transmission of HIV and syphilis is an important milestone for ending AIDS and sexually transmitted infections as public health threats by 2030, commitments endorsed by the United Nations General Assembly and by the World Health Assembly. Other PAHO member states in the Caribbean are participating in the formal validation process, and it is expected that more will be recognised for their achievements in 2018, the release said.

The release said the validation process begins with a request from a country to PAHO for the validation of the elimination of mother-to-child transmission of HIV and syphilis. Then, an independent Regional Validation Committee is formed to carry forward the process, using the global validation standards recommended by WHO.

In the case of these Caribbean states and territories, the members of the regional committee were experts from 10 countries of the Americas who reviewed the reports of each state and carried out virtual and in situ evaluations in four key areas: Health programmes and services, data and information systems, laboratory quality and human rights, gender equality and community participation.

On the recommendation of the regional committee, the Global Validation Advisory Committee conducted a second review and recommended to the director-general of WHO the validation of Anguilla, Antigua and Barbuda, Bermuda, the Cayman Islands, Montserrat, and Saint Kitts and Nevis for the achievement of the elimination of mother-to-child transmission of HIV and syphilis as a public health threat, the release said.

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