Cuba First Country to Eliminate Mother to Child HIV Transmission

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June 30, 2015 – The Caribbean region has the second highest incidence of HIV after sub-Saharan African but has made steady progress over the past decade in reducing new infections and on Tuesday Cuba achieved a feat that has so far evaded the rest of the world.

The World Health Organization announced that the island nation has become the first country to eliminate mother-to-child transmission of HIV. The most recent figures from WHO show that 240,000 children globally were born with HIV in 2013, down from 400,000 in 2009.

“Eliminating transmission of the virus is one of the greatest public health achievements possible,” WHO Executive-Director Margaret Chan said in a statement. “This is a celebration for Cuba and a celebration for children and families everywhere.”

An estimated 1.4 million women living with HIV become pregnant annually and, unless treated with anti-retrovirals, have a 15-45 percent chance of transmitting the virus during pregnancy, labor or through breastfeeding. If both mother and child receive antiretroviral treatment during these crucial stages then the risk of transmission is lowered to about 1 percent, according to WHO.

The Caribbean nation has also eliminated mother-to-child transmission of syphilis. Some 1 million pregnant women are infected with the disease annually and it results in early miscarriage and stillbirth, newborn death, low-birth-weight and other serious infection in newborns.

The WHO guidelines for validating elimination of mother-to-child transmission of HIV and syphilis notes that as treatment is not 100 percent effective, elimination is defined as a reduction to such a low-level that it no longer constitutes a public health concern. Among the indicators are new HIV infections among infants are less than 50 cases per 100,000 live births or less than 5 percent for women living with HIV who are breastfeeding. These targets must be met for two consecutive years.

In 2013, only two babies in Cuba were born with HIV and only five with syphilis.

– Denis Fitzgerald 
On Twitter @denisfitz

Jump in New HIV Cases in Eastern Europe

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Nov. 27, 2013 – New diagnoses of the HIV virus are up nine percent in Eastern Europe, according to figures released by the World Health Organization on Thursday.

Of the 131,000 new cases of HIV reported in the European region in 2012, 102,000 occurred in Eastern Europe, with 76,000 of those cases reported in Russia, accounting for almost 60 percent of new infections, according to the data which was released ahead of World Aids Day on Dec. 1.

About 35 percent of HIV cases in Russia occur among injecting drug users while heterosexual transmission accounts for about 30 percent of cases. The exposure route of the remaining 35 percent is unknown but it is thought that most occur among men who have sex with men.

It was reported last month that a new virulent strain of HIV in Russia was spreading at a rapid rate and accounts for more than 50 percent of new infections.

The Moscow Times reported that Russian schools generally offer little or no sex education, which contributes to the high rate of infection. The paper added that Pavel Astakhov, Russia’s children’s rights advocate, said in September that he opposed teaching teenagers about sexual health in school, saying that Russian literature is “the best sex education there is.”

– Denis Fitzgerald
On Twitter @denisfitz

Annual World Health Assembly Highlights Global Health Burden

May 20, 2013 – The annual meeting of the World Health Assembly, the governing body of the World Health Organization, which opened in Geneva on Monday provides an interesting overview of the current global health situation and priorities for the years ahead.

The proposed $3.9 billion budget for the 2014-15 biennium includes an eight percent reduction in the budget for communicable diseases, with cuts in the HIV/Aids and Tuberculosis budgets, and a 20 percent increase in the budget to tackle non-communicable diseases (NCDs), aimed reducing the prevalence of cancer, cardio-vascular diseases and substance abuse.

The reduction in the HIV/Aids budget reflects the significant progress made in reducing new infections – a 20 percent overall decrease since 2003, including a 40 percent decrease in new infections among children over that period. Anti-retroviral drugs now reach eight million people living with HIV, up from two million in 2006.

The increase in the NCDs budget is indicative of the growing burden on health systems and the related increase in mortality: some two-thirds of the estimated 60 million deaths annually are a result of non-communicable diseases.

Among the primary aims of the increased NCDs budget is reducing harmful alcohol use, reducing tobacco use, and increasing mental health awareness and treatment – particularly in low-income countries. WHO’s mental health action plan notes that almost half the world’s population lives in countries where there is just one psychiatrist for 200,000 or more people.

Some facts and figures from documents and resolutions that will be discussed and voted on at the WHA over the next week:

– Close to 900,000 people commit suicide each year

– Between 76 precent and 85 percent of people with severe mental disorders receive no treatment for their in low-income and middle-income countries

– Between 2000 and 2011 the reported incidence of measles decreased globally by 65 percent, in tandem with more vaccinations

30 percent of married women in the West Bank and 51 percent of married women in the Gaza Strip had experienced violence from their husbands in the preceding 12 months

– As of Feb. 14 2013 the numbers of both cases of polio and countries experiencing cases were at their lowest-ever recorded levels: Globally, 222 cases had been reported in 2012, a 66% decline compared with 2011. Five countries reported cases in 2012 compared with 16 in 2011

– About 16 million adolescent girls between 15 years and 19 years give birth each year. Babies born to adolescent mothers account for roughly 11% of all births worldwide

– Denis Fitzgerald

UN Warns of HIV Epidemic in Arab World

Nov. 27, 2012 – The U.N. Aids agency is warning of an HIV epidemic in the Arab World, one of only two regions globally where there’s an increase in the number of new infections.

The latest report from UNAIDS shows a 35 percent increase in new infections from 2001 to 2011 in the Middle East and North Africa compared with a 20 percent decline globally over the same period.

The number of people living with HIV in the Arab World is estimated at about 500,000, with an increasing number of children newly infected, again bucking the global trend.

The situation in Arab countries is compounded by social stigma, discriminatory laws, and a lack of funding for HIV treatment and prevention.

Some 56 percent of pregnant women living with HIV globally received antiretroviral treatment in 2011 to prevent mother-to-child transmission but that figure is less than 10 percent for the Middle East and North Africa region.

Similarly, 54 percent of all people living with HIV and eligible for antiretroviral therapy globally received treatment but that figure drops to 15 percent in Arab countries.

The consequences are borne out in the mortality rates for the Arab world – a 17 percent increase in the number of people dying from Aids-related illnesses from 2005 to 2011. The only other region to witness an increase in mortality in the same period is Eastern Europe and Central Asia, which is also the only other region to experience an increase in new infections from 2001-2011.

Among the groups most heavily affected are men who have sex with men and their situation is made worse by laws criminalizing same-sex sexual activity imposed by states in the region – in some instances punishable by death. (Jordan and Iraq are the only countries, and the West Bank is the only territory, where same-sex sexual activity is legal.)

“The persistence of stigma, discrimination and punitive laws underscores the need for greatly expanded action to ground AIDS responses in human rights,” the UNAIDS report states. “Countries should take steps to better understand and address the factors that contribute to vulnerability to HIV and impede service access; take steps to measure and reduce stigma and discrimination; initiate legal reform as well as pragmatic steps to enforce protective laws.”

– Denis Fitzgerald