The Republic of Maldives has become the first ever country to achieve the end of mother-to-child transmission of Hepatitis B, HIV, and Syphilis, according to a press release issued by the World Health Organization on 13 October 2025. Mother-to-child transmission of HIV and Syphilis in the country was achieved in 2019, with the conformation this month that mother-to-child transmission of Hepatitis B has been eliminated making the Maldives the world's first county to achieve 'triple-elimination' of these diseases.
Maldives forms part of the WHO Southeast Asia Region, which (confusingly) also includes most South Asian countries, and is based in New Delhi. It is estimated that across this region, more than 24 000 pregnant women were infected with Syphilis, an and over 8000 babies were born with the congenital form of the disease. In the same year, more than 25 000 pregnant women received treatment to prevent them passing on HIV to their babies. Figures relating to mother-to-child transmission of Hepatitis B are not available, but more than 24 million people across the region are living with the disease.
Syphilis is a sexually transmitted disease caused by the Spirochaete Bacterium Treponema pallidum. The symptoms of Syphilis can be variable, and it can go through long periods of dormancy, making the disease difficult to diagnose without modern testing methods. Syphilis infection in pregnant women leads to a raised risk of miscarriage, and infants born with the disease are prone to physical deformities, damage to the liver and spleen, and neurological problems. Syphilis can be treated with a range of antibiotics, including penicillin, although the development of a vaccine has proved difficult.
Human Immunodeficiency Virus, or HIV, is a form of Lentivirus which causes infections in Humans, spread through sexual intercourse or exchange of blood. Notably, the Virus infects the cells of the Human immune system, where it is hard for that immune system to attack, and eventually leads to a breakdown of the immune system known as AIDS (Acquired Immune Deficiency Syndrome), during which the body becomes vulnerable to a wide range of infections, including many by micro-organisms which are not usually pathogenic. Untreated, HIV invariably leads to AIDS, and AIDS is invariably fatal, but, as with Syphilis, HIV infections can go through long phases of dormancy, leaving infected people unaware that they have the disease. Neither an effective vaccine nor a cure for HIV has yet been developed, however, it is possible to suppress the infection with a combination of anti-viral drugs, allowing patients to lead relatively normal lives, as long as their supply of antivirals is not interrupted. Children born to mothers with HIV are not automatically infected, as the Virus is usually unable to cross the placenta, but there is a high chance of infection during birth if the mother is not receiving treatment.
Hepatitis B is Viral infection of Humans, primarily targeting the cells of the liver. It can be transmitted through sexual intercourse, blood-to-blood infections, or from mother-to-child during pregnancy. Hepatitis B is seldom fatal, but untreated it can cause recurring bouts of debilitating nausea, accompanied by jaundice, vomiting, stomach cramps, and exhaustion. Untreated Hepatitis B can leave patients vulnerable to cirrhosis and liver cancer, which can prove fatal. Not all people infected with Hepatitis B ever develop symptoms, though children born with the infection are both more prone to symptoms and more prone to severe symptoms. An effective vaccine has been available for Hepatitis B since 1991. Most adults infected with Hepatitis B fight of the infection on their own, although it can be treated with a range of anti-viral drugs.
Maldives has achieved its 'triple elimination' through a combination of extensive free anti-natal care, testing for all three diseases, and vaccinations against Hepatitis B, with around 95% of pregnant women in the country thought to have been reached. These policies form part of a system of free universal healthcare for all residents of the islands, including migrants, with over 10% of the country's GDP being invested in healthcare.
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