Cuba ends mother-to-child HIV transmissions

Cuba is the first country to eliminate the transmission of the AIDS virus from mothers to children, according to a statement released Tuesday by the World Health Organization.

"We expect Cuba to be the first of many countries coming forward to seek validation that they have ended their epidemics among children," Michel Sidibé, the executive director of UNAIDS, the United Nations program on HIV/AIDS, said in a statement.

"It shows that ending the AIDS epidemic is possible," he said.

Cuba had to meet a number of requirements in order to receive the WHO validation, including having fewer than 50 children born with HIV infections out of every 100,000 live births for one year. WHO also recognized Cuba for eliminating the transmission of syphilis to children after the country met a similar standard.

WHO and the Pan American Health Organization (PAHO) had been working with Cuba to achieve this goal since 2010.

Each year, an estimated 1.4 million women with HIV in the world become pregnant. If they do not receive treatment, the chances of passing the AIDS virus on to their children ranges from 15% to 45%. However, if both mother and child receive antiretroviral medicines, which keep HIV from growing and multiplying, the chance of transmission drops to just over 1%.

The benefit of treatment is similarly strong for women with syphilis. One million women with syphilis get pregnant every year, but screening and medicine can almost eliminate the risks to children, which include stillbirth, low birth weight and neonatal infections, according to WHO.

The news out of Cuba is noteworthy, Chris Beyrer, an HIV epidemiologist at the Johns Hopkins Bloomberg School and president of the International AIDS Society, told USA TODAY Network.

"(The WHO validation) is indeed a remarkable achievement and it's something to celebrate, but it's not the complete elimination," Beyrer said. Completely ending all cases of HIV and syphilis transmission is nearly impossible, but the validation by WHO means that there is a complete program in place to address these problems, he said.

Some credit the results in Cuba to the country's health care system.

"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," PAHO director Carissa Etienne said in a statement.

Cuba's publicly funded health care system is part of the reason the approach in Cuba has worked, according to Beyrer.

"That is the right platform and the right basis for which to do universal screening for all women," Beyrer said, saying it ensures that more women are screened regularly and have access to the necessary treatment. Cuba also had the benefit of starting with a relatively low prevalence of the AIDS virus, he said.

HIV transmission from mother to child during pregnancy, birth and breastfeeding has also been significantly reduced in the USA through treatment and early screening. The USA does not usually seek approval from organizations like WHO, according to Beyrer. But the CDC reported in 2010 that only 162 children living with HIV under the age of 13 were confirmed as having been perinatally infected in 46 states combined.

"We have done a remarkable job across states and at a national level addressing HIV transmission from mother to child," Beyrer said.

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