Annals of Tropical Medicine and Public Health

EDITORIAL COMMENTARY
Year
: 2017  |  Volume : 10  |  Issue : 3  |  Page : 531--532

Accomplishing mother-to-child elimination of human immunodeficiency and syphilis: A remarkable achievement and a ray of hope for other nations


Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy 
 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Chennai, Tamil Nadu, India

Correspondence Address:
Saurabh R Shrivastava
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, 3rd Floor, Ammapettai Village, Thiruporur, Guduvancherry Main Road, Sembakkam Post, Kancheepuram, Tamil Nadu
India




How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Accomplishing mother-to-child elimination of human immunodeficiency and syphilis: A remarkable achievement and a ray of hope for other nations.Ann Trop Med Public Health 2017;10:531-532


How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Accomplishing mother-to-child elimination of human immunodeficiency and syphilis: A remarkable achievement and a ray of hope for other nations. Ann Trop Med Public Health [serial online] 2017 [cited 2019 Aug 21 ];10:531-532
Available from: http://www.atmph.org/text.asp?2017/10/3/531/196490


Full Text

In order to respond to the rising incidence of sexually transmitted infections and to end the acquired immune deficiency syndrome (AIDS) epidemic globally, achieving elimination of the mother-to-child transmission of human immunodeficiency (HIV) and syphilis by 2030 has been acknowledged as a crucial milestone.[1]

Furthermore, despite these concerns, being the front-runner in most of the nations' maternal and child health action plan, barring a few nations, many nations are struggling to move at the desired pace.[1],[2] In fact, it is very important to understand that by eliminating these perinatal infections successfully, the best opportunities can be provided to the children to have an ideal beginning to their lives.[3]

It is very important to understand that the risk of transmission of HIV from an untreated mother to her child is around 15% to 45%, and the risk remarkably reduces to almost 1% on administration of appropriate drugs to both the mother and the child.[1] Owing to the fact that the treatment option available to prevent mother-to-child-transmission is not full proof, elimination of transmission has been operationally defined as minimizing the transmission to such a low level that it ceases to be a public health concern.[4]

Cuba became the first nation to accomplish the feat in 2015, and now the World Health Organization has validated the elimination of mother-to-child transmission of both HIV and syphilis in Thailand ( first nation to achieve the target in Asia-Pacific region), Armenia, Belarus, and the Republic of Moldova.[1],[4] This validation has been done by experts from different nations and international welfare agencies on the basis of rigorous assessment of varied indicators that a nation should meet.[4]

This elimination is a mark of reversal of the epidemic and transformation in the lives of thousands of women and children affected by the diseases.[1] These nations have been able to achieve the elimination due to their sustained commitment, integration of maternal, and child welfare with other reproductive health and HIV services such as early access to antenatal care, extending laboratory testing for the diseases among pregnant women and their sexual partners, providing appropriate treatment to women who test positive, their partners as well as their children.[2],[4] In addition, efforts have been made to improve the knowledge about the diseases among the general population and high-risk group of people, ensure that all people have equitable access to both diagnostic and therapeutic services, early diagnosis in infants, community engagement, and outreach campaigns have been organized to reach to vulnerable populations.[1],[4]

For Thailand, to meet the elimination target is a remarkable development, as the nation had a significantly high number of people infected with HIV, and now due to the consistent efforts, the nation has ensured an AIDS-free generation.[1] In fact, close to 98% and 95% of the pregnant women in Thailand and Europe have access to antiretroviral therapy, respectively, and even an 87% reduction has been observed in the annual incidence of HIV among women since the estimates obtained in 2000.[1] On the similar note, three of the European nations have also been successfully ensuring universal access to disease-related prevention, treatment, and care services, through the support of different international welfare agencies.[4]

It is crucial to realize that this is not the end, and persistent efforts are required to maintain the status.[1],[4] Furthermore, in the global mission to eliminate both the diseases from the world by 2030 and to replicate the results in other nations, the need of the hour is to focus on ensuring advocacy and sustained political commitment; improving the access to and the quality of maternal and child health services; organizing screening of all pregnant women and offering treatment to all positive cases and their partners; and strengthening surveillance, monitoring, and evaluation aspects to achieve elimination of congenital syphilis.[2],[5] However, it is quite essential to respond to the challenges existing in the field of advocacy, shortage of proportionate rise in funding, and deficits in training of the health care workers.[2],[4]

To conclude, achieving mother-to-child elimination of HIV and syphilis in four nations is a tremendous achievement, and it is a direct indication of the movement of the world toward an AIDS-free generation. Furthermore, this should serve as a boost for the neighboring nations to strengthen the response and ensure that every child is allowed to grow in an HIV-free environment.

Financial support and sponsorship

Nil

Conflicts of interest

None

References

1World Health Organization, WHO validates countries' elimination of mother-to-child transmission of HIV and syphilis; 2016. Available from: http://who.int/mediacentre/news/statements/2016/mother-child-hiv-syphilis/en/. [Last accessed on 2016 Jun 8].
2Cerda R, Perez F, Domingues RM, Luz PM, Grinsztejn B, Veloso VG, et al. Prenatal transmission of syphilis and human immunodeficiency virus in Brazil: Achieving regional targets for elimination. Open Forum Infect Dis 2015;2:ofv073.
3Kiarie J, Mishra CK, Temmerman M, Newman L. Accelerating the dual elimination of mother-to-child transmission of syphilis and HIV: Why now? Int J Gynaecol Obstet 2015;130:S1-3.
4World Health Organization. Thailand is first country in Asia to eliminate mother-to-child transmission of HIV and syphilis; 2016. Available from: http://www.searo.who.int/mediacentre/releases/2016/1627/en/. [Last accessed on 2016 Jun 8].
5Wedderburn CJ, Murtagh M, Toskin I, Peeling RW. Using electronic readers to monitor progress toward elimination of mother-to-child transmission of HIV and syphilis: An opinion piece. Int J Gynaecol Obstet 2015;130:S81-3.