On October 13, 2025, the World Well being Group announced that the Republic of Maldives had grow to be the primary nation on the planet to get rid of mother-to-child transmission (EMTCT) of HIV, syphilis, and Hepatitis B virus (HBV). This validation, endorsed by the WHO Director-Common after rigorous assessment, implies that the Maldives has lowered the transmission of all three infections from moms to newborns to ranges not thought of a public well being drawback. Earlier than this milestone, 19 international locations (Cuba, Malaysia, Belarus, Sri Lanka, Armenia, Moldova, Namibia, Belize, Jamaica, Saint Vincent and the Grenadines, Dominica, Thailand, Anguilla, Antigua and Barbuda, Bermuda, Cayman Islands, Montserrat, St. Kitts and Nevis and Oman) had achieved single or twin elimination of HIV and/or syphilis. But, none had reached the mixed benchmark of eliminating all three infections.
Vertical transmission
Vertical transmission refers back to the switch of an infection from a dad or mum to a baby throughout being pregnant, childbirth, or breastfeeding. From a medical standpoint, it’s a organic occasion; from an moral perspective, it’s a profound social failure. A baby who acquires an an infection at delivery carries a burden it didn’t select, usually formed by gaps in consciousness, entry, or social safety. Stopping vertical transmission isn’t merely a medical obligation however an moral one. Permitting a new child to inherit a preventable an infection is a collective injustice that societies should try to finish. Vertical transmission has lengthy been an indicator of fairness and social justice inside well being methods. Its elimination represents equity throughout gender, geography, and sophistication.
Three ailments, one purpose
The three infections (HIV, syphilis, and HBV) share a standard transmission pathway however have distinct organic penalties. HIV (Human Immunodeficiency Virus) can cross the placenta or unfold throughout supply and breastfeeding. With out remedy, as much as 30% of infants of HIV-positive moms grow to be contaminated, however well timed antiretroviral remedy can cut back this threat to beneath 2%. Syphilis, attributable to Treponema pallidum, is transmitted when the bacterium crosses the placenta. Untreated maternal syphilis can lead to miscarriage, stillbirth, or congenital infection, outcomes which might be fully preventable by way of early screening and penicillin remedy. HBV is transmitted primarily at delivery. An toddler uncovered to HBV faces a 90% probability of creating persistent an infection, which later predisposes the kid to cirrhosis and liver most cancers. When the HBV Immunoglobulin and HBV vaccine is run inside 12 and 24 hours, it may well forestall nearly all such transmissions. Collectively, these infections not solely threaten bodily well being but additionally carrysignificant social stigma, usually discouraging ladies (and later their contaminated newborns) from in search of well timed testing or care.
How validation works
The WHO validation course of is a structured, multi-level assessment designed to make sure accuracy and sustainability. Each nation begins with a proposal despatched by the Well being Ministry to the WHO by way of a Nationwide Validation Committee (NVC), which compiles knowledge, verifies data, and assesses testing, remedy, and vaccination protection. The nationwide report is then reviewed by a WHO Regional Validation Committee (RVC) that performs website assessments and audits laboratory high quality. Lastly, the International Validation Advisory Committee (GVAC) critiques the regional findings and recommends certification to the WHO Director-Common, who points an official validation certificates. Even after recognition, international locations should periodically show that they proceed to take care of elimination each three years for HIV and syphilis and each 5 years for Hepatitis B. This cyclical reassessment ensures that elimination stays a residing public well being normal somewhat than a one-time milestone.
Elimination targets
A rustic should meet strict 25 specific targets for epidemiological affect and well being system efficiency to qualify for validation based mostly on affect, course of, and viral load amongst moms and infants.
Classes for India
Based on provisional 2024 estimates from the WHO South-East Asia Area, over 23,000 pregnant ladies had been affected by syphilis, resulting in the delivery of greater than 8,000 infants with congenital syphilis. Round 25,000 HIV-positive pregnant ladies required remedy to stop transmission to their infants. In the meantime, Hepatitis B remains a major concern, affecting over 42 million folks throughout the area. T
The Maldives’ success presents hope that India and different international locations can adapt to their scale. Replicating its strategy throughout a nation of 1.45 billion folks will not be pragmatic, however its ideas are relevant. India can start by focusing on island areas similar to Lakshadweep and the Andaman and Nicobar Islands, adopted by different Union Territories and smaller states. Reaching elimination on the sub-district and district ranges would enable India to develop in the direction of a nationwide milestone progressively. Whereas the Maldives demonstrates feasibility, its inhabitants dimension and centralised system are distinctive. The lesson is to not imitate its construction however to emulate its self-discipline.
Language and sensitivity
India additionally presents an necessary conceptual contribution to international well being communication. The WHO framework refers to vertical transmission as “mother-to-child transmission,” however India mandates, by way of each conference and authorities order, the usage of “parent-to-child transmission.” This terminology recognises that accountability for an infection doesn’t relaxation solely with moms. In lots of instances, ladies might themselves be victims of sexual violence or an infection acquired from a partner/offender. The inclusive time period displays gender sensitivity and acknowledges that males, too, share accountability for transmission prevention. This linguistic shift isn’t semantic; it symbolises empathy. It ensures that public-health communication doesn’t stigmatise moms, who’re already marginalised.
International and ethical crucial
The elimination of parent-to-child transmission is each a medical and moral necessity. The message for India and the remainder of the world is that triple elimination is technically possible when well being programmes are built-in, verified, and prioritised based mostly on knowledge. For the WHO, the Indian expertise with inclusive terminology and multi-programme integration presents classes in cultural adaptation and moral framing. Stopping vertical transmission protects infants and the dignity of moms and households. Every an infection prevented is a life course altered, proving that prevention stays essentially the most humane type of care.
(Dr. C. Aravinda is an educational and public well being doctor. The views expressed are private. aravindaaiimsjr10@hotmail.com)
Printed – October 15, 2025 02:42 pm IST
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