COPENHAGEN/GENEVA/ISTANBUL, 7 June 2016—United Nations agencies congratulate Belarus for eliminating 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. During a ceremony in New York City, elimination validation certificates were presented to the ministers of health of the three European countries, who were attending the United Nations General Assembly High-level Meeting on Ending AIDS.

“To ensure children are born healthy is to give them the best possible start in life. It is immensely encouraging to see countries succeed in eliminating mother-to-child transmission of these two diseases,” said WHO Director-General Dr Margaret Chan. “This is a tremendous achievement – a clear signal to other countries that elimination is possible and that the world is on the way to an AIDS-free generation.” Ending the epidemics of AIDS by 2030 is a key target of the Sustainable Development Goal on health and well-being.

“Every child growing up free from HIV thanks to antiretroviral medicines is a testimony to the progress the world is making in eliminating mother-to-child transmission of HIV," said UNAIDS Executive Director Michel Sidibé. “As we meet in New York at the High-level Meeting on Ending AIDS to plan the next, crucial phase of the response to HIV, we will draw upon the successes of these countries to highlight the extraordinary achievements that can be made through the rapid expansion of access to life-saving treatment.”

Achievements in Armenia, Belarus and the Republic of Moldova

The World Health Organization (WHO) has been working in Armenia, Belarus and the Republic of Moldova since 2010 with the Joint United Nations Programme on HIV/AIDS (UNAIDS), the United Nations Children's Fund (UNICEF) and the United Nations Population Fund (UNFPA) to eliminate mother-to-child transmission of HIV and syphilis.

“This is a success for these countries and a celebration for children and families. We expect that these achievements will inspire many other European countries to seek validation that they have ended mother-to-child transmission of HIV and syphilis,” added Dr Zsuzsanna Jakab, WHO Regional Director for Europe. “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.”

“After two decades of intensive efforts in the Region, we now have validated proof that it is possible to realize the right of all children to be born HIV-free. As we move forward, it is important that children have equitable access to services that can help them thrive and develop in a supportive family environment, with their mothers alive and nurturing their well-being,” said Marie-Pierre Poirier, UNICEF Regional Director for Europe and Central Asia.

Depending on the progress of national efforts, countries may choose validation of the elimination of mother-to-child transmission of HIV, syphilis or both. Armenia, Belarus and the Republic of Moldova have worked to ensure early universal access to free services for antenatal care, HIV and syphilis testing for pregnant women and their partners, treatment for women who test positive, early diagnosis in infants, free infant formula and community engagement. These services are provided as part of an equitable, accessible, universal health system in which maternal and child health programmes are integrated with programmes for HIV and sexually transmitted infections.

“The remarkable achievements of these countries in eliminating HIV and syphilis transmission to infants underscore the importance of robust maternal health services,” according to Dr Babatunde Osotimehin, Executive Director, UNFPA. “Only by offering pregnant women integrated HIV and syphilis care as part of a rights-based, comprehensive package of sexual and reproductive health services, including family planning, can we truly keep the mother–baby pair alive and thriving.” The validation process for the three countries was conducted by WHO in collaboration with UNAIDS, UNICEF and UNFPA.

Europe’s progress in reducing mother-to-child transmission of HIV and syphilis

The reduction in the number of new cases of HIV and congenital syphilis infections among children is one of Europe’s successes in its response to HIV and sexually transmitted infections in the past few years. Mother-to-child transmission accounted for just 1% of new cases of HIV infection reported in 2014 in the WHO European Region.

Ensuring that pregnant women living with HIV and their children have access to antiretroviral therapy lowers the risk of mother-to-child transmission of HIV from up to 45% to 1%. Up to 95% of HIV-infected pregnant women receive antiretroviral therapy in Europe – the highest percentage globally, and more than 70% of infants of HIV-positive women were tested within two months of birth.

Screening and treatment during pregnancy are essential to prevent mother-to-child transmission of syphilis, which can cause miscarriage, stillbirth or neonatal death in up to 80% of cases. Over 60% of European countries offer syphilis testing to pregnant women, and all countries in the Region offer free treatment to syphilis-infected pregnant women.

WHO support to European countries

WHO has been supporting European countries in eliminating mother-to-child transmission by providing guidance on the use of antiretroviral drugs and on validation criteria and processes of elimination of mother-to-child transmission of HIV and syphilis.

Two regional consultations in 2015 reviewed progress, addressed the remaining challenges and recommended actions to accelerate efforts towards elimination of mother-to-child transmission of HIV and syphilis as well as validation of their elimination.

Through a new action plan on HIV response, WHO will continue to support countries in the WHO European Region in their efforts to eliminate mother-to-child transmission of HIV and syphilis by 2030.

Notes to editors

• As treatment for prevention of mother-to-child-transmission is not 100% effective, elimination of transmission is defined as a reduction in transmission to such a low level that it no longer constitutes a public health problem.
• The term “validation” is used to attest that a country has successfully met the criteria for eliminating mother-to-child transmission of HIV and/or syphilis at a specific time; countries are required to maintain ongoing programmes.

Links

• Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection http://www.who.int/hiv/pub/guidelines/arv2013/en/
• Guidance on global processes and criteria for validation of elimination of mother-to-child transmission of HIV and syphilis http://www.who.int/reproductivehealth/publications/rtis/9789241505888/en/
• Methods for surveillance and monitoring of congenital syphilis elimination within existing systems http://www.who.int/reproductivehealth/publications/rtis/9789241503020/en/
• The global elimination of congenital syphilis: rationale and strategy for action http://www.who.int/reproductivehealth/publications/rtis/9789241595858/en/
• WHO/Europe HIV http://www.euro.who.int/en/health-topics/communicable-diseases/hivaids
• WHO/Headquarters HIV http://www.who.int/hiv/en
• UNAIDS http://www.unaids.org/en/
• UNICEF HIV http://www.unicef.org/aids/
• UNFPA http://eeca.unfpa.org

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

NEW DELHI/BANGKOK, 7 June 2016— Thailand today received validation from WHO for having eliminated mother-to-child transmission of HIV and syphilis, becoming the first country in Asia and the Pacific region and also the first with a large HIV epidemic to ensure an AIDS-free generation.  The Minister of Health of Thailand was presented with the certificate of validation during a ceremony which took place in New York on the eve of the United Nations General-Assembly High-Level Meeting on Ending AIDS.

 “This is a remarkable achievement for a country where thousands of people live with HIV. Thailand’s unwavering commitment to core public health principles has made elimination of mother-to-child transmission of HIV and syphilis a reality, a critical step for rolling back the HIV epidemic. Thailand has demonstrated to the world that HIV can be defeated,” Dr Poonam Khetrapal Singh, Regional Director, WHO South-East Asia Region, said presenting the certificate of validation to Thailand in New York.

"Thailand has turned around its epidemic and transformed the lives of thousands of women and children affected by HIV," said UNAIDS Executive Director, Michel Sidibé. "Thailand's progress shows how much can be achieved when science and medicine are underpinned by sustained political commitment."

"By investing in strong maternal and child health care and national AIDS prevention measures, Thailand has demonstrated there are ways to protect children from the global AIDS pandemic response,” said Karin Hulshof, Regional Director, UNICEF East Asia-Pacific Region. “Thailand’s achievement inspires its neighbours to greater action. There are still 21,000 infants who are born with HIV each year in the Asia-Pacific region, and more than 200,000 children who are growing up with HIV.”

Untreated, women living with HIV 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.

According to Thailand’s Ministry of Public Health 98% of all pregnant women living with HIV have access to antiretroviral therapy and the rate of mother-to-child transmission of HIV has been reduced to less than 2%. In 2000, an estimated 1000 children became infected with HIV. In 2015, the number of children who became infected with HIV through mother to child transmission was reduced to 85, a decline of more than 90%, a significant achievement in a country where an estimated 450 000 people were living with HIV in 2014.

At the same time, sustained efforts and success in preventing new HIV infections have helped reduce HIV among women of childbearing age. According to Thailand’s health authorities, between 2000 and 2014, the annual number of women newly infected with HIV fell from 15 000 to 1 900 – a 87% reduction. Thailand’s Universal Health Coverage framework ensured essential health services were available to both rich and poor. The country’s commitment to equitable access has ensured that both Thai citizens and migrants are covered for HIV treatment.

Thailand’s commitment to the UNAIDS-led ‘Global Plan towards the elimination of new HIV Infections among children by 2015 and keeping their mothers alive’, combined with the Government’s decision to provide all pregnant women – including documented and undocumented migrant workers – free antenatal care, delivery and services for HIV and syphilis pushed treatment coverage rates up, culminating in validation of elimination of mother-to-child transmission.

Thailand’s pioneering success and leadership demonstrates how countries can make real change when good policy is followed up with high-level commitment. WHO, UNAIDS and UNICEF will continue to work with other countries in the region, along with partners to replicate Thailand’s success.

WHO validation process

In 2014, WHO and key partners published the guidance on global processes and criteria for the validation of the 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.

An international expert mission convened by WHO visited Thailand in April 2016 to validate the progress toward the elimination of mother-to-child transmission of HIV and syphilis. The members visited health centres, laboratories, and government offices, and interviewed health officials and other key actors. The mission included experts from Australia, Cambodia, China, Philippines, India, Indonesia, Nepal, Thailand, United States and representatives from WHO, UNICEF and UNAIDS.

Video on Thailand's success:  https://www.youtube.com/watch?v=eVIh3pnnOh4&feature=youtu.be

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

Representatives of ministries of health, national AIDS committees and civil society organizations from 19 countries in western and central Africa gathered in Dakar, Senegal, from 16 to 18 November to take stock of progress, challenges and opportunities for the prevention of mother-to-child transmission and paediatric care of HIV.

Together with experts from international organizations, they called for action to Fast-Track the AIDS response and achieve the 90–90–90 treatment target by 2020. To reach the target in the context of mother-to-child transmission of HIV and paediatric care of HIV, it is critical to scale up HIV testing and antiretroviral therapy for pregnant women and children living with HIV.

The participants agreed on key elements of a regional strategy to accelerate the identification and effective management of pregnant women and children living with HIV. They also called on national and international actors to mobilize and cooperate so that children are no longer born with HIV or die of AIDS-related causes in western and central Africa.

Quotes

The First Lady of Djibouti, Kadra Mahamoud Haid, and the Executive Director of UNAIDS, Michel Sidibé, have taken part in an event to announce a further acceleration of the country’s campaign to eliminate mother-to-child transmission of HIV.

At the event, the Djibouti Minister of Health, Kassim Issak Osman, said that projects to prevent mother-to child-transmission of HIV had shown clear benefits and would be expanded to allow more pregnant women and new mothers to access them.           

At the end of 2014, about one in five pregnant women living with HIV in Djibouti were accessing antiretroviral medicines to keep them healthy and prevent them from transmitting the virus to their children.

Quotes

During a visit to South Africa, UNAIDS Executive Director Michel Sidibé met with President Jacob Zuma and First Lady Tobeka Zuma to discuss the country’s response to HIV.

During their meeting, President Zuma and Mr Sidibé applauded the contribution made by community health workers in reducing mother-to-child transmission of HIV. They discussed a successful service delivery model in KwaZulu-Natal that puts community health workers at the centre. This model has helped to drive down the number of new HIV infections among children in the province. If replicated across the country, the model could put South Africa firmly on track to eliminate new HIV infections among children.

In his meeting with Ms Zuma, discussions focused on the health of young women and adolescent girls, who are at particular risk of HIV infection.

Quotes

At a high-level event in New York on 28 September, the Organization of African First Ladies Against HIV/AIDS (OAFLA) endorsed the newly adopted Sustainable Development Goals (SDGs) and pledged to redouble their efforts to help ensure a safe and healthy future for women, children and young people. 

The event, Building on MDGs to invest in the Post-2015 Development Agenda, took place during the 70th session of the UN General Assembly and was led by Gertrude Mutharika, the First Lady of Malawi and Vice-Chair of OAFLA. The meeting brought together First Ladies from across the continent, as well as heads of UN agencies and major international donors, to explore how the SDGs will tackle the ‘unfinished business’ of the Millennium Development Goals. In addition, Lorena Castillo de Varela, First Lady of Panama, and UNAIDS Goodwill Ambassador Victoria Beckham attended the meeting as special guests.

They were joined by representatives of the Fashion 4 Development (F4D) initiative which aims to harness the influence of the fashion world to create positive social change. F4D co-hosted the meeting with OAFLA, with support from UNAIDS, the UN Population Fund (UNFPA), the International Planned Parenthood Federation (IPPF) and the Global Fund.

OAFLA reviewed its own role in helping attain the SDGs, linking its Strategic Plan 2014-2018 with global efforts to reach the new goals. It also took the opportunity to increase its profile at the global gathering with the aim of developing new partnerships and platforms through which to share its messages, programmes and activities.  

After introductory presentations, including one given by UNAIDS Executive Director Michel Sidibé, the meeting broke up into two roundtable discussion groups to examine HIV treatment and prevention for young people; and investing in women’s and adolescents’ health in the post-2015 development framework.

The First Ladies reaffirmed their commitment to eliminate mother-to-child transmission of HIV and keeping mothers alive by championing the end of early marriage and adolescent pregnancy, improving access to HIV services and ensuring that all children diagnosed with HIV receive treatment.

OAFLA members also committed to end new HIV infections among young women and adolescent girls and ensure AIDS is no longer the leading cause of death among adolescents. These commitments are expected to be key priority areas of implementation for 2015 and 2016 by OAFLA member states and their partners.

Quotes

If the newly adopted Sustainable Development Goals (SDGs) are to be achieved the needs of women, children and adolescents must be at the heart of the development agenda, said United Nations Secretary-General Ban Ki-moon as he launched a bold initiative at the 70th session of the UN General Assembly.

The updated Global Strategy for Women’s, Children’s and Adolescents’ Health is intended to ensure that the SDG commitment to accelerate progress in reducing newborn, child and maternal mortality becomes a reality for women, children and young people around the globe.

Launched on 26 September during the UN Sustainable Development Summit, the initiative builds on the Global Strategy for Women’s and Children’s Health, spearheaded by the Secretary-General in 2010, that blossomed into the Every Woman Every Child global movement. This movement has seen the galvanizing of political commitment, multi-stakeholder partnerships and action that has led to significant progress in reducing maternal and infant mortality. However, Ban Ki-moon told the gathering that efforts now need to step up a gear.

To ensure that the necessary resources are available, a major section of the high-level two-hour event involved the announcement of key strategic commitments from world leaders, multilateral organizations, CEOs from the private sector and other partners.

Young people also played a vital role, taking the floor to tell the gathering what they want and need over the next 15 years and what they commit to do to improve the health of their generation. Young people representing The PACT, a coalition of youth organisations supported by UNAIDS, as well as Restless Development and Y-PEER shared commitments to the updated Global Strategy to end all preventable maternal, child and adolescent deaths by 2030 and the end of the AIDS epidemic by 2030.

Introduced by UNAIDS Executive Director Michel Sidibé, Ishita Chaudhry spoke about the importance of governments committing to adolescents and to support young people to be agents of change to help ensure that mothers, children and adolescents everywhere survive and lead healthy lives.

Quotes

UNAIDS has been awarded first prize in the Popular Medicine category of the British Medical Association (BMA) Book Awards for its book The Bravest Boy I Know.

The prestigious awards were announced at a ceremony on 3 September at BMA House in London. An annual event, the awards aim to encourage and reward excellence in medical publishing, with prizes given out in categories and an overall BMA Medical Book of the Year award made from the category winners.

The Bravest Boy I Know is about two friends, Kendi and Kayla. Kendi is living with HIV. The story is set in Africa and is a heart-warming tale of how the two friends deal with HIV in a positive way. The book conveys the important message that by taking medicine, children living with HIV can live active and healthy lives, while also explaining that the medicines can make children feel unwell and tired.

The judges noted that the book, “Is a unique offering … and is well-presented and engaging. If used appropriately it could be an important public health tool.”

UNAIDS Director of Communications and Global Advocacy Annemarie Hou, accepting the award on behalf of UNAIDS, said, “This is a tremendous honour and recognition that children everywhere need access to high-quality health information.”

The book, which is beautifully illustrated by celebrated artist Sujean Rim, was launched in May 2014 by UNAIDS and the United Nations World Tourism Organization’s Sustainable Tourism for Eliminating Poverty (ST-EP) Foundation at an event attended by the United Nations Secretary-General Ban Ki-moon and Ambassador Dho Young-shim, Chairperson of the ST-EP Foundation. The book is dedicated to Mr Ban for his work in prioritizing education through the Global Education First Initiative, which aims to put every child in school, improve the quality of learning and foster global citizenship.

Speaking at the launch in 2014, Mr Ban said that, “This book, which will be delivered to schools across Africa through ST-EP’s Small Libraries project, will help everyone understand that young people can live normal and fulfilling lives with HIV.”

Ambassador Dho said at the launch in 2014, “As the UN MDGs Advocate for Education, I firmly believe in the power of education to accelerate the achievement of all UN MDGs by 2015, and particularly Goal 6—aimed at HIV. This meaningful collaboration with UNAIDS is creating synergies that will have a powerful impact on the education and the health of children.”

In addition to winning first prize in the Popular Medicine category, UNAIDS was also Highly Commended for The Gap Report in the Public Health category and for The Cities Report in the Health and Social Care category.