Maldives Becomes First to Eliminate Mother-to-Child Transmission of HIV, Hep B & Syphilis

Maldives Achieves Historic Triple Elimination of Mother-to-Child Transmission of HIV, Hepatitis B, and Syphilis

Introduction

In a landmark global public health achievement, the Maldives has become the first country in the world to achieve the triple elimination of mother-to-child transmission (MTCT) of HIV, hepatitis B, and syphilis, as validated by the World Health Organization (WHO). This milestone signifies not only the country’s strong healthcare system but also its effective maternal and child health interventions rooted in universal coverage, preventive medicine, and community participation.

I. Background and Context

Mother-to-child transmission (MTCT) remains one of the major global challenges in achieving universal health coverage and eliminating infectious diseases. HIV, hepatitis B, and syphilis can all be transmitted from an infected mother to her child during pregnancy, childbirth, or breastfeeding, leading to lifelong health complications or infant mortality.The WHO’s Triple Elimination Initiative, launched in 2014, encourages countries to integrate services for the prevention and treatment of HIV, syphilis, and hepatitis B within maternal, newborn, and child health programmes. Maldives’ achievement is therefore not only national in scope but a global precedent for comprehensive, integrated disease control.

II. Key Achievements and Validation Criteria

1. Validation by WHO:
   • The Maldives was officially validated by the WHO in 2025 for having eliminated MTCT of all three infections — a global first.
   • WHO Director-General Dr. Tedros Adhanom Ghebreyesus commended the Maldives for its sustained public health investments and equity-driven policies.
2. Public Health Indicators:
   • Over 95% of pregnant women in the Maldives receive comprehensive antenatal care, including screening for HIV, syphilis, and hepatitis B.
   • The country achieved universal immunization coverage, with nearly all newborns receiving hepatitis B birth-dose vaccination.
   • Integrated healthcare systems ensure early diagnosis, treatment, and follow-up care, preventing vertical transmission.
3. Triple Elimination Parameters:
   • HIV: Transmission rate below 2%.
   • Syphilis: Fewer than 50 cases per 100,000 live births.
   • Hepatitis B: HBsAg prevalence below 0.1% among children aged five years.

III. Governance, Policy, and Implementation

The Maldives’ success can be attributed to:

1. Integrated Health Systems Approach:
   • Strong coordination between maternal health, immunization, and infectious disease control programmes.
   • Robust health information systems for real-time monitoring of infection rates and maternal health indicators.
2. Universal Health Coverage:
   • The Maldives provides free, equitable access to antenatal, delivery, and postnatal care across all islands, ensuring no woman or child is left behind.
3. Community Engagement:
   • Widespread awareness campaigns have reduced stigma around HIV and promoted voluntary testing and treatment adherence.
4. Government Commitment:
   • Maldives’ Ministry of Health, under Minister Abdulla Nazim Ibrahim, reaffirmed the government’s pledge to sustain elimination and prevent resurgence through continued investment and surveillance.

IV. Global and Regional Significance

1. WHO South-East Asia Context:
   • The WHO South-East Asia Region accounts for more than 42 million hepatitis B infections and around 25,000 HIV-positive pregnant women annually.
   • Maldives’ achievement sets a benchmark for regional counterparts like Sri Lanka, Thailand, and Bhutan, which have also made significant progress in MTCT prevention.
2. Model for Integrated Elimination:
   • This milestone demonstrates how small island developing states (SIDS) can achieve global health goals through strategic partnerships, decentralised healthcare delivery, and evidence-based policymaking.
3. Alignment with SDGs:
   • The triple elimination directly supports UN Sustainable Development Goal 3 (Good Health and Well-being) — particularly the targets to end epidemics of AIDS and hepatitis by 2030.

V. Challenges and Sustainability

1. Maintaining Surveillance:
   • Post-validation, maintaining elimination requires rigorous surveillance and continued investment in laboratory capacity to prevent resurgence.
2. Vaccine and Drug Supply Chains:
   • Ensuring uninterrupted access to hepatitis B vaccines and antiretroviral therapy remains vital, particularly amid global supply constraints.
3. Replication Across Regions:
   • Translating the Maldivian model to larger, more complex countries poses governance and financing challenges, requiring adaptive frameworks.

VI. Analytical Significance for India and Global Health Policy

For India, which continues to battle vertical transmission of HIV and hepatitis B, the Maldives’ model highlights the importance of:

• Integrated maternal and child health programs combining immunization, diagnostics, and treatment.
• Community-based awareness and decentralised primary care delivery.
• Strengthening surveillance systems under initiatives like the National Viral Hepatitis Control Programme and National AIDS Control Programme.

At the global level, Maldives’ achievement signals the viability of elimination targets under the WHO’s 2030 agenda, emphasizing inter-sectoral coordination, universal screening, and equity-based health access.

Conclusion

The Maldives’ triple elimination of MTCT of HIV, Hepatitis B, and Syphilis is a historic milestone in global health governance. It stands as a testament to how a small island nation, through political will, integrated service delivery, and equitable healthcare, can lead the world in achieving WHO’s elimination goals.The achievement not only reinforces the Maldives’ health sovereignty but also serves as a model of inspiration for other developing nations, illustrating that comprehensive maternal and child health interventions can yield transformative results when rooted in access, awareness, and accountability.

Updated - October 13, 2025 9:37 PM | News On Air