Communism, cigars and vintage cars aren’t the only things Cuba is well known for. Despite its poverty, the country has long boasted a public healthcare system that assures quality medical services to all its citizens, irrespective of their economic status. Now, the WHO has certified Cuba as the first country in the world to effectively eliminate mother-to-baby transmission of HIV, which causes AIDS, and syphilis. The WHO hailed this as “one of the greatest public health achievements possible”, in no small part because it was achieved by pursuing relatively straightforward strategies: high rates of HIV testing, better screening and treatment of expectant parents, concentrating on high-risk groups, and giving HIV- and syphilis-positive mothers options to protect their babies, like bottle-feeding and Caesarean deliveries.
These measures have become enmeshed with the normal treatment for all pregnant women because they form part of a universal healthcare system that is both affordable and accessible. In contrast, in India, with its generally poor (though improving) record on maternal health, less than 30 per cent of HIV-positive pregnant women have access to prevention of mother-to-child transmission of HIV services, such as medication that can prevent the passing of the virus to the foetus and support the mother’s health. Almost 1.5 lakh children in India live with HIV, most of who contracted the virus from their mothers during pregnancy, at birth or through breastfeeding.
As Cuba’s example shows, eliminating the spread of HIV from mother to child requires a sustained public health strategy that integrates HIV-testing, counselling and treatment into current maternal and child health programmes, especially by bringing on board private health service providers, which handle 44 per cent of all institutional deliveries. India successfully pursued such a strategy to eradicate polio. It can draw from its own experience, and from Cuba’s, for another big win for its healthcare system.