Havana, December 1, 2018—Cuba’s public health system has adopted a “90-90-90” strategy to end the AIDS epidemic, in keeping with the global aims of the UNAIDS Program. There is one difference: UNAIDS proposes to reach that goal by 2030, but Cuba is pushing up the goalpost to 2020.
The strategy means working to ensure that 90% of people with HIV know that they are living with the virus, 90% receive medical care to minimize partner infections and progression to full-blown AIDS, and 90% reach suppression of viral load (the virus detectable in less than 20 copies per milliliter of blood).
Public education key to reaching 2020 goals in Cuba.
HIV diagnosis in Cuba has plateaued at some 2000 new cases annually, in a country where health care is universal and antiretrovirals free of charge to those needing them, since various “cocktails” are produced domestically. Cuba is also weaning itself from financing by the Global Fund to fight AIDS, TB and Malaria (Global Fund), aiming to rely entirely on its own funding by 2020. If this is accomplished, amid major challenges (including the US embargo), it would be a first for Latin America (From 2003 to 2017, the Global Fund provided US$110 million to Cuba’s HIV/AIDS program.)
Cuba already chalked up another first, certified by WHO in 2015 as the world’s first country to eliminate mother-to-child HIV transmission.
In 2017, 23,500 people were living with HIV in Cuba (81% men, 19% women), predominantly (70%) men who have sex with men, according to national data. Transmission is 99% via sexual contact, and there is also some concern for rising incidence among seniors and persons over 50 years old.
In order to reach the 90-90-90 goals, work needs to be stepped up in several areas, according to Dr. María Isela Lantero, who heads the Ministry of Public Health’s Sexually Transmitted Infections and HIV/AIDS Department. She told IPS earlier this year that while over 80% of those living with the virus know their status and receive decentralized care from family physicians and specialists, j just 65% have undetectable viral load. Paradoxically, because transmission rates are relatively low and antiretrovirals available, another issue is low risk perception, meaning more public education is a must.
For more, see:
- Origin and Evolutionary History of HIV-1 Subtype B in Cuba April–July 2017, Vol 19, No 2–3
- HIV-1 Genetic Variability in Cuba and Implications for Transmission and Clinical Progression October 2015, Vol 17, No 4
- Factors Related to Antiretroviral Therapy Adherence in Children and Adolescents with HIV/AIDS in Cuba January 2015, Vol 17, No 1
- Mental Health of Primary Caregivers for Children and Adolescents with HIV/AIDS in Cuba April 2012, Vol 14, No 2
