The World Health Organization (WHO) has officially validated Brazil for the elimination of mother-to-child transmission (EMTCT) of HIV, marking a historic achievement as the most populous nation in the Americas to reach this milestone. This accomplishment underscores Brazil’s enduring dedication to universal and free healthcare access through its Unified Health System (SUS), supported by a robust primary healthcare framework and a commitment 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.”
The milestone was celebrated in Brasília during a ceremony 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.
Meeting Validation Criteria
Brazil successfully met all 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. Beyond meeting these targets, Brazil demonstrated the delivery of quality services for mothers and infants, robust data and laboratory systems, and a steadfast commitment to human rights, gender equality, and community engagement.
The country employed a progressive, subnational approach by initially certifying states and municipalities with populations over 100,000, adapting the PAHO/WHO validation methodology to its national context while ensuring consistency across the country. This evaluation, supported by PAHO, was conducted by independent experts who reviewed data, documentation, and health facility operations. Their findings were then assessed by WHO’s Global Validation Advisory Committee, which formally recommended Brazil’s validation for elimination.
“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. “It is also the result of the tireless dedication of thousands of health professionals, community health workers, and civil society organizations.”
Part of a Broader Initiative
Over the past decade (2015-2024), more than 50,000 pediatric HIV infections have been averted in the Americas due to the initiative to eliminate mother-to-child transmission of HIV. Brazil’s success is part of the broader EMTCT Plus Initiative, which also aims to eliminate mother-to-child transmission of 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 eradicate over 30 communicable diseases and related conditions in the Americas by 2030.
“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,” remarked 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.”
Global Context and Future Implications
Globally, Brazil joins 19 countries and territories validated by WHO for EMTCT, with twelve of these in the Americas. In 2015, Cuba became the first country worldwide to be validated for EMTCT of HIV and the elimination of congenital syphilis. Other countries in the region include Anguilla, Antigua and Barbuda, Bermuda, Cayman Islands, Montserrat, and Saint Kitts and Nevis in 2017; Dominica in 2020; Belize in 2023; and Jamaica and Saint Vincent and the Grenadines in 2024. Outside the Americas, countries validated for EMTCT of HIV include Armenia, Belarus, Malaysia, Maldives, Oman, Sri Lanka, and Thailand.
The success in Brazil not only highlights the effectiveness of its healthcare policies but also serves as an inspiring model for other nations striving to eliminate mother-to-child transmission of HIV. The achievement reinforces the importance of political will, comprehensive healthcare access, and the integration of human rights into public health strategies.
Looking forward, Brazil’s accomplishment may encourage further advancements in public health initiatives across the globe, emphasizing the potential for widespread impact when countries commit to equitable healthcare access and innovative solutions to complex health challenges.
