Cuba Eliminates Mother-to-Child Transmission of HIV and Syphilis

Over the next two weeks Impact will post the top 12 global health moments of 2015 with commentary from experts. We want to hear your thoughts, too. So login and comment, share on social media and reflect on what has been a pretty interesting year for global health.


This year marked a momentous accomplishment by Cuba: it became the first country in the world to eliminate mother-to-child transmission of HIV and syphilis. Formal validation of elimination was received from the Pan American Health Organization (PAHO) / World Health Organization (WHO) in June 2015 upon confirmation that less than 2% of children whose mothers have HIV were born with the virus.

“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.”

Cuba’s victory was attributed to the focus on early access to prenatal care, HIV and syphilis testing for pregnant women and their partners, treatment for women who test positive and their babies, caesarean deliveries, and substitution for breastfeeding. WHO reports that 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. “Cuba’s achievement today provides inspiration for other countries to advance towards elimination of mother-to-child transmission of HIV and syphilis.”

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Globally, efforts to reduce mother-to-child transmission of HIV (MTCT) have seen enormous success. The number of children born annually with HIV has almost halved since 2009 — down from 400,000 in 2009 to 240,000 in 2013 – any many countries are poised to achieve full elimination.

Providing women living with HIV safe and effective means to prevent unintended pregnancy, and to safely conceive wanted children is essential to achieving this goal globally. 36% of women and 28% of men in a study of serodiscordant couples expressed a desire to have a child. 55% of couples did not want a child.[1] 44% of women living with HIV reported planning to get pregnant,[2] while 31% of women on ART and 29% of women positive but not on ART expressed desires to have children.[3]

As a result, each year, 1.4 million women living with HIV become pregnant. According to WHO, untreated, they have a 15-45% chance of transmitting the virus to their children during pregnancy, labor, delivery, or breastfeeding. Cuba’s monumental achievement brings the world one step closer in reaching the global community’s commitment to ending the AIDS epidemic by 2030.

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Photo Credit (banner): Sven Creutzmann/Mambo Photo / Contributor
Caption: HAVANA – OCTOBER 21: A pregnant Cuban woman leaves the polling station after casting her vote October 21, 2007 in Havana, Cuba. Cubans are electing more than 15,000 municipal delegates in a voting process that will culminate in a new National Assembly in March 2008.

[1] Mujugira, A, et al. Delay of Antiretroviral Therapy Initiation Is Common in East African HIV-Infected Individuals in Serodiscordant Partnerships. JAIDS, August 2014, Vol. 66.

[2] Asfaw, Hussen and Gashe, Fikre. Fertility intentions among HIV positive women aged 18–49 years in Addis Ababa Ethiopia: a cross sectional study. Reproductive Health Journal, 2014, 11:36.

[3] Kaida, A et al. Childbearing Intentions of HIV-Positive Women of Reproductive Age in Soweto, South Africa: The Influence of Expanding Access to HAART in an HIV Hyperendemic Setting. American Journal of Public Health, February 2011, Vol. 101.