Cuba eliminates mother to child transmission of HIV

The World Health Organisation (WHO) has confirmed that Cuba is officially the first country to eliminate mother to child transmission of HIV (MTCT). Cuba has been working with WHO and the Pan American Health Organisation (PAHO) since 2010 as part of a regional programme to eliminate both MTCT and syphilis. Elimination in this sense means ‘a reduction of transmission to such a low level that it no longer constitutes a public health problem.’

Around the world, an estimated 1.4 million women living with HIV fall pregnant each year. For women who do not take treatment, the likelihood of transmitting the virus to their baby during pregnancy, labour, delivery or breastfeeding is 15-45%. This risk is reduced to around 1% if both mother and child are given antiretrovirals throughout. Huge strides have been made globally – since 2009 the number of children born with HIV each year has decreased by nearly 50%. However, coverage of programmes addressing MTCT is not universal.

Cuba’s success is attributed to women having early access to antenatal services, both women and their partners testing for HIV, woman and their babies accessing treatment, births by caesarean-section and substituting breast-milk with replacement milk.The emphasis on involving partners is an important element that has been missed out in many contexts. Prevention of MTCT services in Cuba have been delivered as part of a universal health system that integrates maternal and child health with HIV and STI programmes.

This significant achievement demonstrates what can be achieved when universal access and universal health coverage are prioritised. We hope that Cuba will be the first of many countries to bring an end to vertical transmission of HIV to ensure that no child is born with HIV.