Abstract
Every year, an estimated 180 000 babies in the Western Pacific Region are infected by hepatitis B, 13 000 by syphilis and 1400 by HIV through mother-to-child transmission. (1) These infections can be largely prevented by antenatal screening, treatment and timely vaccination for newborns. Despite challenges in controlling each disease, major achievements have been made. National immunization programmes have reduced the regional hepatitis B prevalence from over 8% in 1990 to 0.93% among children born in 2012. In addition, HIV testing and treatment have helped keep the regional prevalence of HIV infections at 0.1%. In contrast, the number of maternal syphilis cases is still high in the Western Pacific Region, with an estimated 45 million cases in 2012. Elimination of mother-to-child transmission of these infections cannot be achieved through vertically applied programming and require using and augmenting to the shared Maternal, Newborn and Child Health platform to coordinate, integrate and enable cost efficiencies for these elimination efforts. The Regional Framework for Triple Elimination of Mother-to-Child Transmission of HIV, Hepatitis B and Syphilis in Asia and the Pacific 2018–2030 offers such a coordinated approach towards achieving the triple elimination of mother-to-child transmission of HIV, hepatitis B and syphilis and provides guidance for decision-makers, managers and health professionals working in programmes addressing maternal, newborn and child health, HIV, hepatitis, sexually transmitted infections and immunization.
Highlights
The Regional Framework for Triple Elimination of Mother-to-Child Transmission of HIV, Hepatitis B and Syphilis in Asia and the Pacific 2018– 20302 (Triple Elimination Framework) was endorsed by all Member States at the sixty-eighth session of the Regional Committee for the Western Pacific
Endorsed by the World Health Assembly in 2016, the 2030 elimination targets for the Global Health Sector Strategy on HIV 2016–2021, the Global Health Sector Strategy on Viral Hepatitis 2016–2021 and the Global Health Sector Strategy on Sexually Transmitted Infections 2016–2021 include: 0.1% or lower hepatitis B surface antigen (HBsAg) prevalence among children and 50 or fewer cases per 100 000 live births for paediatric HIV infections and congenital syphilis.[3,4,5]. These three diseases have a significant burden in the Western Pacific Region: the Region alone accounts for 45% of all global hepatitis B infections;[2] an increasing trend of syphilis infections is observed among key populations including women of reproductive age;[6] and while HIV prevalence is low throughout the Region at 0.1%, the HIV mother-to-child transmission (MTCT) rate is high at 12%.7 a Division of Communicable Disease, World Health Organization Regional Office for the Western Pacific, Manila, Philippines. b Division of Building Healthy Communities and Populations, World Health Organization Regional Office for the Western Pacific, Manila, Philippines. c Imperial College London, London, England
DTP3 vaccine coverage for children has remained over 95% since 2009 with 97.3% coverage in 2016.10 These multiple entry points in receiving peripartum services provide a unique opportunity for coordination and integration of HIV, hepatitis B and syphilis interventions to move towards elimination of mother-to-child transmission (EMTCT) of these infections
Summary
The Regional Framework for Triple Elimination of Mother-to-Child Transmission of HIV, Hepatitis B and Syphilis in Asia and the Pacific 2018– 20302 (Triple Elimination Framework) was endorsed by all Member States at the sixty-eighth session of the Regional Committee for the Western Pacific.
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