The following is a message from Director of PANCAP, Mr Dereck Springer on the EMTCT – Plus initiative:

The Pan American Health Organisation (PAHO) recently launched the EMTCT – Plus: Framework for Elimination of Mother-to-Child Transmission of HIV, Syphilis, Hepatitis B and Chagas. The objective of the EMTCT-Plus initiative is to achieve and sustain the elimination of mother-to-child transmission of HIV, Syphilis, Chagas, and perinatal Hepatitis B (HBV) as a public health threat. It embraces the principles and lines of action of the Strategy for Universal Access to Health and Universal Health Coverage, building upon the lessons learned from the PAHO 2010 Strategy and Plan of Action for the EMTCT of HIV and Congenital Syphilis.

In 2016, 18,000 new infections occurred in the Caribbean. The region continues to be heavily impacted by the HIV epidemic with an estimated prevalence of 1.3% and 310,000 persons living with the disease at the end of 2016.

The investments made in HIV Prevention of Mother-to-Child Transmission (PMTCT) in the region is significant. The progress is evident.
In June 2015, Cuba became the first country in the world to achieve elimination of mother to child transmission (EMTCT) of HIV and Syphilis. This achievement was lauded by the World Health Organisation (WHO) as a major victory in the fight against HIV and an important step in achieving an AIDS free generation. Since then, the region has accelerated efforts to achieve elimination status. Option B Plus is the defined standard of care and fully implemented. There have been significant investments in capacity building for health care workers across the region in delivering the highest quality of care that is based on scientific evidence. All pregnant HIV infected women are initiated on antiretroviral therapy as early as possible and maintained for life. Laboratory systems have been strengthened to provide quality assured early infant diagnosis to all exposed infants.

Across the region, our programmes are striving to ensure viral suppression throughout pregnancy and delivery, so that no baby is born HIV positive. At the end of 2016, ART coverage among HIV pregnant mothers is 74% and 1700 new infections were averted as a result of Prevention of Mother-to-Child Transmission (PMTCT) programmes. Currently, several countries in the region are undergoing the WHO validation process for HIV and Syphilis. Many more are in the final stages of preparing and submitting their documentation.

The EMTCT Plus initiative launched by WHO and aimed at the elimination of four (4) diseases, namely HIV, Syphilis, Hepatitis B and Chagas disease, is strategic in leveraging the momentum of HIV PMTCT initiatives. The Partnership envisages the EMTCT Plus initiative as a coordinated approach, building on well-established and successful platforms and systems of Maternal and Child Health (MCH) programmes. The successes and lessons learned around sustainability and integrating HIV PMTCT responses within MCH programmes will serve as key tools in guiding EMTCT of Syphilis, Hepatitis B and Chagas disease.

The Partnership welcomes the EMTCT Plus Initiative and commits to working with PAHO and all stakeholders in the achievement of this significant regional public health good.