The World Health Organization (WHO) has validated Brazil for the elimination of mother-to-child transmission (EMTCT) of HIV, marking a significant public health achievement. As the most populous nation in the Americas to reach this milestone, Brazil demonstrates its enduring commitment to universal and free healthcare through its Unified Health System (SUS), which is rooted in a robust primary healthcare framework and a dedication to human rights.
“Eliminating mother-to-child transmission of HIV is a major public health achievement for any country, especially for a country as large and complex as Brazil,” stated Dr. Tedros Adhanom Ghebreyesus, WHO Director-General. “Brazil has shown that with sustained political commitment and equitable access to quality health services, every country can ensure that every child is born free of HIV and every mother receives the care she deserves.”
Meeting Validation Criteria
The validation ceremony, held in Brasília, was attended by President Luiz Inácio Lula da Silva, Brazil’s Minister of Health Alexandre Padilha, and the Director of the Pan American Health Organization (PAHO) Dr. Jarbas Barbosa, alongside representatives from UNAIDS. Brazil met all the criteria for EMTCT validation, including reducing vertical transmission of HIV to below 2% and achieving over 95% coverage for prenatal care, routine HIV testing, and timely treatment for pregnant women living with HIV.
In addition to meeting these targets, Brazil showcased its capability in providing quality services for mothers and infants, maintaining robust data and laboratory systems, and upholding human rights, gender equality, and community engagement. The country adopted a progressive, subnational approach by initially certifying states and municipalities with over 100,000 inhabitants, adapting the PAHO/WHO validation methodology to its national context while ensuring coherence nationwide.
“This achievement shows that eliminating vertical transmission of HIV is possible when pregnant women know their HIV status, receive timely treatment, and have access to maternal health services and safe delivery,” said Dr. Jarbas Barbosa, Director of PAHO.
Broader Initiative and Global Context
Brazil’s success is part of the broader EMTCT Plus Initiative, which aims to eradicate mother-to-child transmission of HIV, syphilis, hepatitis B, and congenital Chagas, in collaboration with UNICEF and UNAIDS. This initiative is embedded within PAHO’s Elimination Initiative, a regional effort to eliminate more than 30 communicable diseases and related conditions in the Americas by 2030.
Over the past decade, more than 50,000 pediatric HIV infections have been prevented in the Region of the Americas due to the implementation of this initiative. “I am delighted that Brazil has just been certified by WHO/PAHO for eliminating vertical transmission – the first country of more than 100 million people to do so,” stated Winnie Byanyima, UNAIDS Executive Director. “And they did it by doing what we know works – prioritizing universal health care, tackling the social determinants that drive the epidemic, protecting human rights, and even – when necessary – breaking monopolies to secure access to medicines.”
Globally, Brazil joins a group of 19 countries and territories validated by WHO for EMTCT. Twelve of these are in the Region of the Americas, with Cuba being the first country worldwide to be validated for EMTCT of HIV and the elimination of congenital syphilis in 2015. Other countries in the region include Anguilla, Antigua and Barbuda, Bermuda, Cayman Islands, Montserrat, and Saint Kitts and Nevis, among others.
Implications and Future Prospects
This achievement not only highlights Brazil’s healthcare capabilities but also sets a precedent for other nations with similar healthcare challenges. The success underscores the importance of political will, comprehensive healthcare policies, and community involvement in tackling public health issues. As Brazil continues to lead by example, it paves the way for other countries to follow suit, potentially transforming the landscape of global health.
Looking ahead, Brazil’s model could serve as a blueprint for other populous nations striving to eliminate mother-to-child transmission of HIV. The continued focus on equitable healthcare access and addressing social determinants of health will be crucial in sustaining this success and expanding it to other areas of public health.
The validation of Brazil’s efforts by WHO is not just a recognition of past achievements but a call to action for continued vigilance and innovation in public health strategies. As the world moves closer to the 2030 targets set by PAHO’s Elimination Initiative, Brazil’s accomplishment offers hope and a roadmap for other countries aiming to achieve similar milestones.
