Sexual and reproductive health

WHO validates elimination of mother-to-child transmission of HIV and syphilis in Thailand, Armenia, Belarus and the Republic of Moldova

“A clear signal to other countries that elimination is possible”

7 June 2016: WHO congratulates Thailand and Belarus for their achievement of eliminating of mother-to-child transmission of both HIV and syphilis, and Armenia and the Republic of Moldova for eliminating mother-to-child transmission of HIV and syphilis, respectively.

Photo of the country representatives at special side-event

“To ensure children are born healthy is to give them the best possible start in life. It is immensely encouraging to see these countries succeed in eliminating mother-to-child transmission of these two infections”

Dr Margaret Chan, WHO Director-General

Eliminating maternal-to-child transmission of HIV and syphilis is key to the global effort to combat sexually transmitted infections and to end AIDS by 2030.

Mother-to-child transmission of syphilis and HIV

Nearly 1 million pregnant women worldwide are infected with syphilis annually. This can result in early fetal loss and stillbirth, neonatal death, low-birth-weight infants and serious neonatal infections, often referred to as congenital syphilis. However, simple, cost-effective screening and treatment options during pregnancy, such as penicillin, can eliminate most of these complications.

The number of infants affected by congenital syphilis annually is estimated at 350,000 with over half of these occurring as stillbirths or neonatal deaths. Efforts to improve antenatal syphilis screening and treatment of syphilis-infected pregnant women with benzathine penicillin can prevent these fatal outcomes.

Photo of a pregnant woman.

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.

The number of children born annually with HIV has almost halved since 2009 – down from 400,000 in 2009 to 240,000 in 2013. Intensified efforts are needed however to ensure these numbers continue to fall.

How countries are validated

In 2014, WHO and key partners published the Guidance on global processes and criteria for validation of elimination of mother-to-child transmission of HIV and syphilis, which outlines the validation process and the different indicators countries need to meet.

As treatment for prevention of mother-to-child-transmission is not 100% effective, elimination of transmission is defined as a reduction of transmission to such a low level that it no longer constitutes a public health problem.

Thailand, Belarus, Armenia and the Republic of Moldova follow Cuba, which in June of 2015, became the first country in the world to receive WHO validation for the elimination of mother-to-child transmission of HIV and syphilis.

The validation process pays particular attention to the upholding of human rights, in order to ensure that services were provided free of coercion and in accordance with human rights principles.

Recipe for success

At the 69th World Health Assembly in May 2016, WHO Member States endorsed the intersecting Global health sector strategies for sexually transmitted infections, HIV, and viral hepatitis 2016-2021. The news of successful elimination of mother-to-child transmission of HIV and syphilis achieved by Thailand, Belarus, Armenia and the Republic of Moldova, in addition to Cuba, illustrates how such integrated approaches, implemented with the support of governments, health systems, civil society organizations and communities, can achieve significant change.

Dr Zsuzsanna Jakab, WHO Regional Director for Europe commented, “It is only by ensuring truly universal access to HIV and syphilis prevention, treatment and care for all, while respecting individual rights, that the HIV and syphilis epidemics in children will be eliminated”.

The Minister of the Republic of Moldova receives a certificate.

A shared celebration

The successes of Thailand, Belarus, Armenia and the Republic of Moldova were marked today by a special side-event, which took place during the UN high-level meeting on ending AIDS, at the UN Headquarters in New York. WHO presented certificates to Ministers of Health from the newly-validated countries, and remarks were made by Poonam Khetrapal Singh, WHO Regional Director for South East Asia; Ren Minghui, WHO Assistant Director-General; Dr Ian Askew, Director of WHO Department of Reproductive Health and Research, who represented the WHO Family, Women’s and Children’s cluster at the event; Michel Sidibé, UNAIDS Executive Director; senior representatives from UNICEF and UNFPA; as well as the Ministers of Health from the successful countries.

"In his closing remarks, the WHO Assistant Director General Ren Minghui said: “Congratulations to Thailand, Armenia, Belarus, and Moldova - your success is testament to the importance of integration of maternal and child health programs with sexual and reproductive health and HIV services.”