Towards an HIV-Free Generation in Cuba

Last year Cuba became the first country in the world to eliminate mother-to-child transmission of HIV and syphilis as public health problems. Other countries are following suit. Andreia Azevedo Soares reports. Five years ago, Yusleidys Fernandez looked in the mirror and saw rashes on her face. She went to a community-based polyclinic in the Cuban capital, Flavana, for a check-up. A physician looked at her skin lesions and offered her an HIV test. The initial result was positive. Follow-up testing confirmed the distressing news. was so scared. I couldnu0027t believe it was happening to me. I felt devastated. I was so young and had not even had children, says Fernandez. Now at 29 years, Fernandez is the proud mother of a healthy three-year-old girl called Lola. Lola is one of 112 healthy babies born to mothers with HIV in Cuba in 2013. That year, only two babies were born with HIV in the Caribbean country and only three babies were born with congenital syphilis. More than a million pregnant women are infected with syphilis worldwide, a debilitating chronic bacterial disease that can be fatal for their babies but that is treatable with penicillin. The World Health Organization (WHO) and its partners are working with countries to prevent the transmission of both HIV and syphilis from mother to child. On 30 June 2015, Cuba became the first country in the world to receive official recognition from WHO for having eliminated mother-to-child transmission of HIV and syphilis as public health problems. Cubau0027s success was followed by similar news from Belarus and Thailand. Armenia has since received WHO recognition for having eliminated mother-to-child transmission of HIV and Moldova for having eliminated congenital syphilis. [ILLUSTRATION OMITTED] Elimination is defined as fewer than 50 babies born with HIV infection per 100 000 live births. addition, mother-to-child transmission rates of HIV should be less than 2% a year. The HIV epidemic in Latin America and the Caribbean countries began in the 1980s. Cuba was one of the first countries in the region to rollout an HIV prevention and treatment programme, which now provides antiretroviral therapy to all people with HIV. As a result of programmes like this in the region, the prevalence of HIV infection among pregnant women in these countries is about 0.5% or less. Since 2010, experts from WHO headquarters and the Pan American Health Organization (PAHO), WHOu0027s Regional Office for the Americas, have been working with Cuba and other Latin American and Caribbean countries to implement a regional initiative; the goal is to reduce mother-to-child transmission of HIV to a very low level that it is no longer a public health according to WHOu0027s Global guidance on criteria and processes for validation: elimination of mother-to-child transmission of HIV and syphilis published in 2014. 2013, nine countries and territories in the Americas reported data suggesting that they had achieved or were close to these elimination goals. Cuba was one of them. (The others were Anguila, Barbados, Canada, Jamaica, Montserrat, Puerto Rico, Saint Kitts and Nevis, and the United States of America.) fact, Cuba had been reporting such data three years earlier according to Dr Maria Isela Lantero, head of Cubau0027s national HIV/AIDS programme. In the case of congenital syphilis, we already had indicators showing that we had eliminated the problem since the 1980s, says Lantero. With HIV it took longer. the beginning of the epidemic in our country few women got pregnant. It was normal: there was a lot of fear. We didnu0027t know much about the disease and we didnu0027t have the disease control methods we have today, Lantero says. Pregnant women with HIV who are not receiving antiretroviral therapy have a 15-45% chance of transmitting the infection to their babies during pregnancy, labour, delivery or breastfeeding. …