Without attracting the attention it deserves, a silent revolution has happened in Cuba: it has become the first country to eliminate mother-to-child transmission (MTCT) of HIV and AIDS. Canada is on the verge of achieving the same breakthrough. In 2013, Cuba reported only two children born with HIV, while Canada recorded only one transmission in the whole of 2014. WHO has marked these successes as a huge step towards having an AIDS-free generation. To appreciate its importance, we only have to note that, worldwide, around 1.4 million women living with HIV become pregnant every year and are left untreated; about 15 to 45 per cent of them would transmit the virus to their babies. If treated with anti-retroviral medicines, the risk of transmission falls to as low as one per cent.
Eradication of vertical transmission of HIV signifies a high point in the long-drawn battle to develop a frontline weapon to end AIDS epidemic. WHO is upbeat about the prospects of total elimination of MTCT as many nations are close to meeting the goal while many others are making appreciable progress towards minimising transmission. Sadly, India is not in this list. WHO’s Global Plan for elimination of new HIV infections among children has 2015 as its deadline. An intensive National AIDS Control Programme has been running in India for decades. Yet India shoulders the third highest HIV-AIDS load in the world. More than 25 per cent of pregnant women in the country are still not tested for HIV either during pregnancy or childbirth.
The Prevention of Parent to Child Transmission of HIV/AIDS programme has managed to cover only about 37 per cent of pregnancies in 13 years. As with all government programmes in India, AIDS control has reflected the malaise of administrative apathy and insincere implementation. Elimination of MTCT in India can only be achieved through universal access to PPTCT services for preventing pre-natal transmission. But plans to take the services to the doorsteps of people living with HIV by providing them services at primary health centres and community health centres are yet to take off. In a country where HIV and AIDS continue to carry social stigma, it is essential to reach out to the patients rather than waiting for them to avail the services.