Elimination of HIV and syphilis in Cuba

Cuba became the first country in the world to receive validation from the World Health Organisation (WHO) that it has eliminated mother-to-child transmission of HIV and syphilis.

Every year, globally, an estimated 1.4 million women living with HIV become pregnant. Untreated, they have a 15-45% chance of transmitting the virus to their children during pregnancy, labour, delivery or breastfeeding. However, that risk drops to just over 1% if antiretroviral medicines are given to both mothers and children throughout the stages when infection can occur.

Nearly 1 million pregnant women worldwide are infected with syphilis annually. However, simple, cost-effective screening and treatment options during pregnancy, such as penicillin, can eliminate most of these complications.

Mother-to-child transmission of these diseases is considered eliminated when the rates of infection are brought to levels so low as to be considered no longer a public health problem. In the case of HIV, this is defined as fewer than 2 in every 100 babies born to women with HIV, which is the lowest rate considered possible with the prevention methods currently available. In the case of syphilis, elimination is defined as less than 1 case for every 2,000 live births.

As part of the regional initiative, Cuba has worked to ensure early access to prenatal care, HIV and syphilis testing for both pregnant women and their partners, treatment for women who test positive and their babies, substitution of breastfeeding, and prevention of HIV and syphilis before and during pregnancy through condom use and other prevention measures. As a result of these efforts, in 2013, only two babies were born with HIV in Cuba, and only three were born with congenital syphilis — reflecting transmission rates below the elimination thresholds.