Maldives Validated by WHO as First Country to Achieve Triple EMTCT of HIV, Syphilis, and Hepatitis B

The World Health Organization (WHO) has validated the Maldives as the first country to achieve “triple elimination” of mother-to-child transmission (EMTCT) of HIV, syphilis, and hepatitis B, confirming sustained EMTCT of HIV and syphilis since 2019 and new validation for hepatitis B.¹

WHO’s South-East Asia update attributes the milestone to long-running systems investments that maintained high antenatal-care coverage and integrated first-trimester screening for all three infections across dispersed island communities. National data cited by WHO include hepatitis B birth-dose coverage above 95 percent and a school-based serosurvey showing zero hepatitis B infections among young children, alongside zero pediatric HIV and no congenital syphilis cases reported from 2019 to 2023.¹

WHO situates the validation against the region’s ongoing burden, noting continued needs for antiretroviral prophylaxis in pregnancies affected by HIV and persistent risks of congenital syphilis and chronic hepatitis B, underscoring the importance of integrated EMTCT services at scale.¹ For countries planning similar efforts, WHO and UNICEF have issued programmatic guidance that translates the Triple Elimination Framework into country roadmaps.²

What the WHO–UNICEF Triple Elimination Framework Emphasizes

Four Core Pillars:

1.Primary prevention of infection and vertical transmission: routine hepatitis B birth dose within 24 hours, completion of the infant immunization schedule, STI and HIV prevention, and safer-sex counseling.²

2.Linkages with sexual and reproductive health: integrate HIV, syphilis, and hepatitis B services into antenatal, family planning, and postpartum care, with partner testing where appropriate.²

3.Essential maternal EMTCT services: early first-trimester screening for HIV, syphilis, and HBsAg; timely prophylaxis or treatment such as antiretroviral therapy for HIV, penicillin for syphilis, and antivirals in high-risk hepatitis B; safe delivery practices; and clear referral pathways.²

4.Infant, child, and partner services: hepatitis B birth dose and vaccine series; infant testing and prophylaxis as indicated for HIV and syphilis; early infant diagnosis and follow-up; partner notification and linkage to care.²

Cross-cutting Enablers

1.Health-system strengthening: trained workforce, reliable supplies of tests, vaccines, and medicines, quality assurance, and sustainable financing.²

2.Strategic information: standardized indicators, electronic registries, real-time monitoring, and data use for course correction.²

3.Leadership and partnerships: national coordination across programs and levels of care with clear governance and accountability.²

4. Community engagement and equity: address barriers such as cost, geography, and stigma; include migrants and hard-to-reach groups; and build trust through outreach and education.²

Sharing WHO’s announcement on his official X account, President Dr Mohamed Muizzu “expressed his appreciation to all health professionals, communities, and partners whose unwavering dedication enabled the Maldives to achieve the historic milestone,” and underscored that the recognition reflects the government’s continued commitment to preventive health.³

For frontline clinicians, triple EMTCT validation signals reliable case finding, prophylaxis, and vaccination pathways at the population level. The Maldives example highlights same-visit screening during pregnancy and timely hepatitis B birth-dose administration that reduce perinatal transmission risk and downstream complications of chronic hepatitis B. The implementation model offers a practical template for integrated antenatal screening, prophylaxis, and immunization that other health systems can adapt as they pursue EMTCT targets. ^1-2

References

1.WHO. Maldives becomes first country in the world to achieve triple elimination of mother-to-child transmission of HIV, syphilis and hepatitis B. October 13, 2025. Accessed October 21, 2025. https://www.who.int/maldives/news/detail/13-10-2025-maldives-becomes-first-country-in-the-world-to-achieve-triple-elimination-of-mother-to-child-transmission-of-hiv--syphilis-and-hepatitis-b#:~:text=Mal%C3%A9%2C%20October%202025%3A%20The%20Republic,World%20Health%20Organization%20(WHO)

2.WHO. Country guidance for planning triple elimination of mother-to-child transmission of HIV, syphilis and hepatitis B virus programmes. July 14, 2025. Accessed October 21, 2025. https://www.who.int/publications/i/item/9789240112490

3.President hails milestone as Maldives becomes first country to achieve triple elimination of mother-to-child transmission of HIV, syphilis, and hepatitis B. October 13, 2025. Accessed OCtober 21, 2025. https://presidency.gov.mv/Press/Article/35302?utm_source=chatgpt.com