A Landmark Public Health Achievement
The World Health Organization (WHO) officially validated Brazil on December 18, 2025, for eliminating mother-to-child transmission (EMTCT) of HIV. This significant recognition positions Brazil as the most populous country in the Americas and the first nation with a population exceeding 100 million to achieve this historic public health milestone.
Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, emphasized the achievement's importance, stating, 'Brazil has shown that with sustained political commitment and equitable access to quality health services, every country can ensure that every child is born free of HIV and every mother receives the care she deserves.' Winnie Byanyima, UNAIDS Executive Director, also lauded Brazil, noting that they 'did it by doing what we know works: prioritising universal healthcare, tackling the social determinants that drive the epidemic, protecting human rights, and even when necessary breaking monopolies to secure access to medicines.'
Brazil's Comprehensive Strategy and Success
Brazil's success is the culmination of decades of sustained investment and a comprehensive public health strategy. The country met all the stringent criteria for EMTCT validation, including:
- Reducing the vertical transmission of HIV to below 2%.
- Achieving over 95% coverage for prenatal care.
- Ensuring over 95% coverage for routine HIV testing for pregnant women.
- Providing timely treatment for pregnant women living with HIV.
These achievements were largely driven by Brazil's Unified Health System (SUS), which provides universal and free access to health services, anchored in a strong primary health-care system. Key elements of Brazil's approach included:
- Expanding routine HIV testing during prenatal care.
- Ensuring timely access to antiretroviral therapy for pregnant women.
- Implementing a progressive, subnational certification strategy, recognizing states and municipalities that met elimination targets.
- Demonstrating robust data and laboratory systems.
- A strong commitment to human rights, gender equality, and community engagement.
- The Bolsa Família cash transfer program, which was linked to significant reductions in AIDS cases and deaths among vulnerable women and children.
In 2023, Brazil recorded an HIV mother-to-child transmission rate below 2% and an incidence of HIV in children under 0.5 per 1,000 live births. The country's AIDS mortality rate in 2023 was 3.9 deaths per 100,000 people, the lowest since 2013.
Global Context and Future Implications
Brazil now joins a growing number of countries and territories worldwide validated by WHO for eliminating mother-to-child transmission of HIV. In the Americas, Cuba was the first country to achieve this dual validation for HIV and syphilis in 2015. Other nations in the region, including Anguilla, Antigua and Barbuda, Bermuda, Cayman Islands, Montserrat, St. Kitts and Nevis, Belize, Jamaica, and Saint Vincent and the Grenadines, have also been recognized.
Brazil's success is part of the broader EMTCT Plus Initiative, which aims to eliminate mother-to-child transmission of HIV, syphilis, hepatitis B, and congenital Chagas disease, in collaboration with UNICEF and UNAIDS. This initiative is embedded within the Pan American Health Organization's (PAHO) wider Elimination Initiative, which targets the elimination of more than 30 communicable diseases and related conditions in the Americas by 2030.
Dr. Jarbas Barbosa, Director of PAHO, highlighted that this achievement 'shows that eliminating vertical transmission of HIV is possible when pregnant women know their HIV status, receive timely treatment, and have access to maternal health services and safe delivery.' Brazil's accomplishment serves as a powerful model for other nations striving to end pediatric HIV and ensure healthier outcomes for mothers and children globally.
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