Leveraging Health System Gains Towards Eliminating Mother-to-Child Transmission (EMTCT) of HIV and Syphilis: How Maldives Became the Second Country in WHO South-East Asia Region to Achieve This Feat

Abstract

AbstractMaldives eliminated mother-to-child transmission of HIV and syphilis in 2019, joining the first few countries in the world to ensure a generation free of these deadly diseases. Maldives was the second country in the WHO South-East Asia Region to achieve this feat, after Thailand. Maldives has a low-level HIV epidemic with very few known cases of HIV infection among Maldivian citizens living in the country. The elimination of mother-to-child transmission (EMTCT) programme exceeded the 95% targets set for process indicators, in particular, ANC coverage, testing for HIV and testing for syphilis. Maldives’ success is attributed to its proactive, persistent and long-term public health measures, initiated even before the first case of HIV infection was detected in the country in 1991. The country’s AIDS Control Programme, launched in 1987, prioritized creating awareness, preventing HIV transmission with a focus on the at-risk population, while also providing quality care, support and treatment to people living with HIV/AIDS and syphilis. A unique feature of the country’s AIDS control programme has been the total integration of all health services, including preventive services, into the general health system. Prevention of mother-to-child transmission has been a major component of the National Strategic Plan for Prevention and Control of HIV/AIDS 2014-18. All public and private hospitals and health centres in the country offer a range of health services, such as universal access to antenatal care and screening for HIV and syphilis. These concerted and consistent efforts had ensured low transmission of HIV and syphilis for several years.