In a historic public health achievement, the Maldives has become the world’s first nation to eliminate mother-to-child transmission (MTCT) of HIV, syphilis, and hepatitis B. The World Health Organization (WHO) has officially validated this milestone, marking a significant victory for maternal and child health.
On 13 October 2025, WHO recognized the Maldives for achieving triple elimination of MTCT. The country had previously eliminated HIV and syphilis transmission from mother to child in 2019, and with the inclusion of hepatitis B, it now sets a global standard. The validation highlights the effectiveness of sustained healthcare policies, universal care, and integrated health systems in preventing vertical transmission of infectious diseases.
Mother-to-child transmission continues to impact millions globally. In the WHO South-East Asia Region, provisional 2024 estimates show that over 23,000 pregnant women had syphilis, resulting in more than 8,000 infants born with congenital syphilis. Around 25,000 HIV-positive pregnant women required treatment to prevent transmission to their babies, while hepatitis B still affects over 42 million people in the region.
HIV (Human Immunodeficiency Virus) is a virus that attacks the body’s immune system, specifically the CD4 cells (T cells), which help fight infections. If untreated, HIV can weaken the immune system over time, making the body more vulnerable to infections and certain cancers.
As of 2024, approximately 40.8 million people worldwide were living with HIV, with 1.3 million new infections reported that year. 2
Syphilis is a preventable and curable bacterial sexually transmitted infection (STI) that can cause serious health complications if left untreated. It is primarily transmitted through oral, vaginal, and anal sex, as well as from mother to child during pregnancy and through blood transfusions. Many infections remain asymptomatic or unrecognized. In pregnant women, untreated syphilis can result in stillbirth, newborn death, or congenital syphilis.
Hepatitis B is a viral infection that attacks the liver, potentially leading to chronic disease, cirrhosis, or liver cancer. It is primarily transmitted through contact with infected blood and body fluids, including during childbirth, unprotected sex, and unsafe medical practices.
In 2022, approximately 254 million people globally were living with chronic hepatitis B, with 1.2 million new infections reported that year. The infection can be prevented with a safe and effective vaccine, which is typically administered shortly after birth.
The Maldives’ success rests on several key strategies:
Universal Antenatal Screening: Over 95% of pregnant women receive early testing for HIV, syphilis, and hepatitis B during antenatal care.
High Vaccine Coverage: Newborns receive timely doses of the hepatitis B vaccine, followed by a complete immunization schedule.
Inclusive Healthcare Access: All residents, including migrants, have free access to diagnostics, treatment, and maternal care under universal health coverage.
Integrated Health Services: Prevention efforts for HIV, syphilis, and hepatitis B are embedded into routine maternal and child health programs, ensuring coordinated delivery.
Robust Monitoring: Nationwide serosurveys confirmed zero hepatitis B cases among school-entry children, meeting WHO criteria for elimination validation.
The Maldives’ achievement demonstrates that even countries with geographical and logistical challenges can eliminate vertical transmission of major infections with political commitment and effective health strategies.
This milestone serves as a model for other nations striving to end mother-to-child transmission of HIV, syphilis, and hepatitis B by 2030. It proves that integrating preventive screening, vaccination, and maternal care into routine health services can produce remarkable outcomes.
References:
1. World Health Organization. “Maldives Becomes the First Country to Achieve ‘Triple Elimination’ of Mother-to-Child Transmission of HIV, Syphilis and Hepatitis B.” News release, October 13, 2025. https://www.who.int/news/item/13-10-2025-maldives-becomes-the-first-country-to-achieve-triple-elimination-of-mother-to-child-transmission-of-hiv-syphilis-and-hepatitis-b
2. World Health Organization. "HIV and AIDS." Fact sheet, July 15, 2025. Accessed October 14, 2025. https://www.who.int/news-room/fact-sheets/detail/hiv-aids.
3. World Health Organization. “Syphilis.” Fact sheet, May 29, 2025. Accessed October 14, 2025. https://www.who.int/news-room/fact-sheets/detail/syphilis.
4. World Health Organization. "Hepatitis B." Last modified July 23, 2025. https://www.who.int/news-room/fact-sheets/detail/hepatitis-b.
(Rh/Eth/ARC)
